Nephro Flashcards
Describe the presentation of a young patient with hypertension, tea-colored urine, massive proteinuria, and edema, who had a history of upper respiratory tract infection 1-2 weeks ago. Diagnosis:
Poststreptococcal glomerulonephritis (PSGN).
What is the most important step in the treatment of PSGN?
Initiating anti-hypertensive drugs and fluid restriction.
How should the diet be modified in a patient with PSGN?
Increase carbohydrates and decrease protein intake.
Define the fate of patients with PSGN.
Complete recovery in over 95% of patients.
Describe the diagnosis of a young patient presenting with hypertension, tea-colored urine, massive proteinuria, and edema, with a history of upper respiratory tract infection 1-2 days ago. Diagnosis:
IgA nephropathy.
What is the most common cause of renal failure in pediatric patients?
IgA nephropathy.
What is the most common type of glomerulonephritis?
IgA nephropathy.
Explain the association between upper respiratory tract infection and glomerulonephritis in IgA nephropathy.
Both conditions can occur simultaneously.
Explain the association between upper respiratory tract infection and glomerulonephritis in PSGN.
URTI preceding GN by 1-2 weeks is characteristic of PSGN.
Describe the presentation of a child with blood in urine, normal blood pressure, normal renal function tests, and no proteinuria. Diagnosis:
Basement membrane nephropathy (benign hematuria).
What is the treatment approach for basement membrane nephropathy?
Reassurance.
Describe the diagnosis of a patient presenting with recurrent painless hematuria and deafness. Diagnosis:
Alport syndrome.
In a child who develops renal failure a few weeks after an attack of bloody diarrhea, what is the likely diagnosis?
Hemolytic uremic syndrome (HUS).
Explain the features of HUS.
Renal failure, anemia, thrombocytopenia, and schistocytes following an E. coli O157:H7 infection.
What is the treatment for HUS?
Plasmapheresis.
Describe the scenario in an adult with renal failure, fever, neurological manifestations, and the likely diagnosis.
Thrombotic thrombocytopenic purpura (TTP).
What is the treatment for TTP?
Plasmapheresis.
Describe the diagnosis of a child with a history of recent viral upper respiratory tract infection who develops hematuria, rash in buttocks, abdominal pain, and joint pain. Diagnosis:
Henoch-Schönlein purpura (HSP).
What is the most important complication of HSP?
Intussusception.
Explain the diagnosis of a child who presents with proteinuria after a fall, with a normal physical exam and normal lab results. Diagnosis:
Orthostatic proteinuria.
What is the management approach for a child with orthostatic proteinuria?
Repeat the test; if still positive, perform a 24-hour urine collection.
Describe the presentation of a child with marked proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema.
The child likely has nephrotic syndrome.
What is the treatment for nephrotic syndrome in children?
Treatment includes cortisone( prednisone) and dietary adjustments such as increasing protein intake.
What is the investigation of choice for vesico-ureteric reflux (VUR) in children?
Voiding cystourethrogram (VCUG) is the preferred investigation.
How can renal scarring from recurrent UTIs be assessed?
Renal scarring can be evaluated using a DMSA scan.
Define the treatment of choice for renal scarring due to recurrent UTIs.
Continuous prophylactic antibiotics like TMP-SMX are the preferred treatment.
Do children with the first attack of UTI require a specific investigation?
Yes, children with the first UTI should undergo an ultrasound (US).
Describe the diagnosis and investigation for a child with recurrent attacks of abdominal pain, fever, and a renal mass on examination.
The child likely has uretero-pelvic junction obstruction, and the investigation of choice is VCUG.
