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Paediatrics > Lecture 14 Paediatric Nephrology > Flashcards

Lecture 14 Paediatric Nephrology Flashcards

1
Q

Proteinuria is a sign of what syndrome

A

Nephrotic Syndrome

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2
Q

Haematuria is a sign of what syndrome

A

Nephritic Syndrome

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3
Q

Haemolytic Uraemic Syndrome causes what type of kidney injury

A

Acute Kidney Injury

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4
Q

What percentage of the cardiac output do the nephrons receive

A

25%

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5
Q

Name 5 functions of the kidney

A 
Waste
Water
Salt
Acid base
Endocrine
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6
Q

What are the 2 types of proteins that make up the Glomerular Filtration Barrier

A

Type Iv collagen

Laminin

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7
Q

Where are Type IV collagen and Laminin synthesised from

A

Podocytes

Endothelial cells

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8
Q

Where are Mesangial cells found

A

Embedded in GBM

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9
Q

What is the function of Mesangial cells

A

Structural support

Regulates blood flow of the glomerular capillaries

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10
Q

Which component of the nephron is affected in minimal change disease

A

Epithelial (podocyte)

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11
Q

Which component of the nephron is affected in Post Infectious Glomerulonephritis

A

Basement Membrane

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12
Q

Which component of the nephron is affected in PIGN and Haemolytic Uraemic Syndrome

A

Endothelial cell

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13
Q

Which component of the nephron is affected in IgA Nephropathy

A

Mesangial cells

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14
Q

Which component of the nephron is affected in congenital nephrotic syndrome

A

Podocyte cytoskeletal integrity

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15
Q

Which component of the nephron is affected in Alport Syndrome

A

Basement membrane proteins

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16
Q

How is Proteinuria diagnosed

A

Dipstix
Protein Creatinine Raio >250mg
24 hour urine collection

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17
Q

What are the typical features of Nephrotic Syndrome

A

Age 1-10
Normal blood pressure
No frank haematuria
Normal renal function

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18
Q

What are the atypical features of Nephrotic syndrome

A

Suggestions of autommune disease
Abnormal renal function
Steroid resistance

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19
Q

What is the treatment for Nephrotic Syndrome

A

Predinsolone

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20
Q

Give an example of acquired steroid resistant nephrotic syndrome

A

Focal Segmental Glomerulosclerosis

21
Q

How is Haematuria diagnosied

A

Macroscopic- colour change

Microscopic- Dipstix

22
Q

Name causes of Haemturia

A 
Clotting disorders
Glomerulonephritis
Wolm's 
Cysts
Sarcomas
Stone
UTI
Trauma
Urethritis
23
Q

What organism commonly causes Acute post-infectious Glomerulonephritis

A

Group A strep Haemolytic

24
Q

What are the site of infections for PIGN

A

Throat

Skin

25
How is PIGN diagnosed
Bacterial culture Positive ASOT Low C3 normalises
26
How is PIGN treated
Antibiotics Support renal functions Diuretics
27
What is the cause of IgA Nephropathy
1-2 days after URTI
28
How is IgA nephropathy diagnosed
Clinical picture | Biopsy- IgA deposits
29
What is the treatment of IgA Nephropathy
ACEI | Immunosuppression
30
What are the symptoms of Henoch Schonlein Purpura IgA related Vasculitis
Abdominal pain Renal involvement Arthritis or arthralgia Purpuric rash (thigh and buttock)
31
Name 3 causes of IgA vasculitis
Viral URTI Streptococcus Drugs
32
How is IgA vasculitis treated
Glucocorticoid therapy | Immunosuppression
33
What Acute Kidney Injury 1
Measured creatinine >1.5-2x reference
34
What Acute Kidney Injury 2
Measured creatinine 2-3x reference
35
What is Acute Kidney Injury 3
Serum creatinine >3x reference
36
Name pre-renal causes of AKI (4)
Glomerular disease Tubular injury NSAID Autoimmune
37
Name post renal causes of AKI
Obstructive Uropathies
38
What are the clinical features Haemolytic Uraemic Syndrome
Haemolysis Thrombocytopenia AKI
39
Name the causes of typical HUS
E.coli- Entero-haemorrhagic E.coli- Verotoxic producing Pneumococcal infections Drugs
40
Name a common feature of atypical HUS
Blood diarrhoea
41
What is the management of Haemolytic Uraemic Syndrome
Monitor: fluid, waste, electrolytes, acid base, hormones Maintain: IV normal saline and fluid Minimise: NSAIDs, antibiotics
42
What are the congenital factors linked to CKI
Turner, Trisomy 21
43
What is the presentation of CKD
``` Fever Vomiting Loin tenderness Loss of appetite Weight loss Itch Polyuria Lethargy UTIs ```
44
How is CKD diagnosed
Dipstix- leucocyte esterase activity, nitrites Microscopy: Pyuria and bacturia Culture >10^5
45
What are the further investigations used to confirm CKD
US DMSA MAG3 scan
46
What is a DMSA isotope scan used to assess
Scarring and function
47
How is CKD managed
Oral antibiotics Fluids Hygiene Manage voiding dysfunction
48
How does CKD cause metabolic bone disease
Causes phosphate retention Increased PTH Leads to Hypocalcaemia
49
What are the treatment principles for Metabolic Bone Disease
Low phosphate diet Phosphate binders Active Vitamin D

Paediatrics (30 decks)

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