Kids and Kidneys

Question 1

potential causes of malignant HT in paeds and management?

Answer 1

encephalopathy, CCF.

Admit to ED and initiate slow reduction of BP with close monitoring.

Question 2

most common cause of paed haematuria? (non-transient and non-artefactual)

Answer 2

UTI

Question 3

renal causes of haematuria (5)?

Answer 3

1. hypercalciuria
2. thin basement membrane disease
   less common:
3. alport syndrome
4. GN - IgA, Henoch-Schonlein Purpura
5. coagulopathy

Question 4

urological causes of haematuria (4)?

Answer 4

1. Calculi
2. Tumour
3. Stricture
4. Trauma

Question 5

lab findings of micro vs macroscopic haematuria?

Answer 5

micro: >10 RBC/microlitre;
macro: visible to > 1 million RBC/microlitre

Question 6

clinical signs and causes of nephrotic syndrome?

Answer 6

oedema, hypoalbuminaemia (<25 g/L), proteinuria (24hr), hypercholesterolaemia.

Cx: infection, thrombosis, dehydration, effusions; MCD (minimal change disease)

Question 7

Who gets minimal change disease, what causes it and how managed? Outcomes?

Answer 7

Typically aged 2-8yrs old. Triggered by infection. Managed with steroids. 90% respond. Some relapse.

Question 8

what is nephritic syndrome? what are the clinical signs

Answer 8

acute inflammation of glomerulus causing impaired filtration. signs are hypertension, haamaturia (gross, micro), proteinuria, raised creatinine, oliguria

Question 9

how would you investigate the common causes of nephritic syndrome?

Answer 9

Ix:
MSU-MCS, 
Pr:Cr, 
phase contrast micro, 
ANA, dsDNA, 
C3, C4, 
ASOT (anti-streptolysin O titre), 
anti-DNA'se B, 
ANCA, 
HBV, HCV

Question 10

Describe the hx, workup, complications, and tx of a typical post-strep GN case?

Answer 10

2-4 weeks after a strep skin/throat infection.
Positive strep serology
Low C3, C4
Complications: Hypertension and hyperkalaemia
Tx: Frusemide

Question 11

3 main complications of renal failure for a child?

Answer 11

poor growth
anaemia
bone disease