Nephro Flashcards by Gielene Bayoneto

Persistent presence of more than 5 RBCs/HPF in uncentrifuged urine, occurs in 4-6% of urine samples from school-age children

Hematuria

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MC cause of gross hematuria

Bacterial and Viral UTI

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Indicated if with persistent microscopic hematuria and recurrent gross hematuria assoc with dec renal function, proteinuria or hypertension

Renal Biopsy

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Gross hematuria 1-2 days after onset of viral URTI resolves within 5 days

IgA Nephropathy

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Primary treatment of IgA nephropathy

BP control and Mgt of significant proteinuria

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Pattern of lumpy-bumpy deposits of immunoglobulin and complement on the glomerular BM and in the mesangium

PSGN

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Microscopic hematuria and/or proteinuria without gross hematuria

Thin Basement Membrane Disease

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Acute nephritic syndrome after antecedent streptococcal pharyngitis

1-2 weeks

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Acute nephritic syndrome after antecedent streptococcal skin infection

3-6 weeks

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In Acute nephritic syndrome, microscopic hematuria persists until

1-2 years

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In Acute nephritic syndrome, urinary protein usually normalizes by

4-6 weeks

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In Acute nephritic syndrome, acute phase resolves within

6-8 weeks

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Remains the gold standard for establishing the diagnosis of SLE nephritis

Kidney biopsy and evaluation of renal histopathology

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Prescribed for most patients with SLE for extrarenal manifestations

Hydroxychloroquine

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Classic tetrad of HSP nephritis

palpable purpura, arthritis or arthralgia, abdominal pain and evidence for renal disease

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MC small-vessel vasculitis in children

HSP

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An autoimmune disease characterized by pulmonary hemorrhage, rapidly progressive GN and elevated anti-glomerular basement membrane antibody titers

Goodpasture disease

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In Good pasture, antibodies is against

type IV collagen

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Common cause of community acquired AKI in young children

HUS

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It is the MC form of thrombotic microangiopathy in children

HUS

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MC form of HUS is caused by

STEC

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Traid of HUS

microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency

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MC cause of acute TIN in children

Drugs

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Hallmarks of TIN

extensive lymphocytic infiltration of the tubulointerstitium, interstitial edema and varying degrees of tubular necrosis and regeneration

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Classically heralded by the sudden onset of gross hematuria and unilateral or bilateral flank masses

Renal vein thrombosis

Often made antenatally by the demonstration of oligohydramnios and bilateral enlarged kidneys on prenatal ultrasound. Infant presents with bilateral flank masses during the neonatal period or in early infancy

AR polycystic kidney disease

Adult onset, systemic disorder with possible cyst formation in multiple organs

AD polycystic kidney disease

MC cause of persistent proteinuria in school age children and adolescents, occurring in up to 60% of children with persistent proteinuria

Orthostatic proteinuria

Triad of Nephrotic syndrome

hypoalbuminemia (<2.5g/dL), edema and hyperlipidemia (cholesterol >200mg/dL)

MC glomerular lesions assoc with idiopathic nephrotic syndrome

Minimal Change Disease

Infectious agent that may cause nephrotic syndrome

Malaria, schistosomiasis, filarial

MC presenting symptom of children with nephrotic syndrome

Edema

Nephrotic syndrome where UPCR>2 or >3+ protein on urine dipstick for 3 consecutive days

Relapse

Mainstay therapy of Nephrotic syndrome

Corticosteroids

Most frequent etiologic agent of px with nephrotic syndrome with peritonitis

Pneumococcus

Steroid resistance is defined as the failure to achieve remission after

8 weeks of steroid therapy

MC cause of end-stage renal disease in adolescent

FSGS

Vaccine given to px with Nephrotic syndrome

PPV, PCV, Flu

Dose of prednisone where live vaccines vaccination is allowed

1mg/kg OD or 2mg/kg alternate days

Occurs as the result of impaired aldosterone production (hypoaldosteronism) or impaired renal responsiveness to aldosterone (pseudohypoaldosteronism); hyperkalmic

Type 4 RTA

Defect in reabsorption of HCO3 with acidic urine (pH <5.5) with Low molecular weight, glycosuria, phosphaturia, aminoaciduria

Type 2 RTA / proximal tubular acidosis

Impaired H excretion, alkaline urine with hypokalemia, hypercalciuria and hypocitraturia

Type 1 RTA / Distal RTA

Mainstay therapy of all forms of RTA

Bicarbonate replacement

Rare AR cause of hypokalemic hypochloremic metabolic alkalosis, with distinct features of hypocalciuria and hypomagnesemia

Gitelman syndrome

Onset: antenatal, hypokalemic, metabolic alkalosis, hypercalciuria, High serum Mg, High serum renin, aldosterone, needed LOOP diuretics

Bartter Syndrome

Onset: Childhood/adulthood, hypokalemic, metabolic alkalosis, hypocalciuria, Low serum Mg, High serum renin, aldosterone, needed THIAZIDE diuretics

Gitelman syndrome

Defined as inc in serum Crea by =/> 0.3mg/dL from baseline, Inc in serum crea by =/> 1.5x from baseline and urine vol =/< 0.5ml/kg/hr x 6 hrs

AKI

Prerenal cause of AKI

Sepsis

Intrinsic cause of AKI

HUS

Post renal cause of AKI

Neurogenic Bladder

MC cause of intrinsic renal AKI

ATN

MC employed in neonates and infants with AKI, although this modality may be used in children and adolescent of all ages

Peritoneal dialysis

Criteria of CKD is GFR of ___ for =/> 3 mos with or without the other signs of kidney damage

<60ml/min/BSA for =/> 3 mos

Cause of anemia in CKD patients

inadequate erythropoietin production

Optimal therapy for children with ESRD

Kidney transplant

MC cause of UTI

E. coli

Symptoms include dysuria, urgency, frequency, suprapubic pain, incontinence and possible malodorous urine

cystitis

Characterized by any or all of the ff; abdominal, back, flank pain, fever, malaise, NV and occ diarrhea

Pyelonephritis

Causes of renal and perinephric abscess

S. aureus and E. coli

90-100% specific component of urinalysis

Nitrite test

Suggest infection if WBC >3-6/hpf

Pyuria

First line type of imaging for screening and will likely demonstrate an enlarged kidney with a possible mass

KUB UTZ

Undescended testis must be treated surgically at

9-15 months

MC disorder of sexual differentiation in males

Cryptorchidism

MC cause of severe testicular pain in males age 12 yrs old and older and is uncommon before age of 10 yr

Testicular torsion

Golden hour for testicular torsion

6 hours

MC cause of testicular pain in males 4-10 yr old

Torsion of the appendix testis/ epididymis

Treatment of Torsion of the appendix testis/ epididymis

bed rest for 24 hrs and analgesia

MC surgically correctible cause of infertility in males

Varicocele

Congenital hydrocele usually resolves at what age

9 months

MC gynecologic-based problem for prepubertal children with a reported incidence of 17-50%

Vulvovaginitis