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Pediatric Board Prep > Nephro > Flashcards

Nephro Flashcards

0
Q

Anion gap calculation:

A

Na - (Cl + HCO3)

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1
Q

How do you calculate a FENa? What does a FENa of > 1 indicate?

A

=[(uNa x PCr)/(pNa x uCr)] x 100

>intrinsic causes of renal failure

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2
Q

Osmolality calculation:

A

=2(Na) + (BUN/2.8) + (glucose/18)

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3
Q

How do you calculate a urine anion gap?

A

=Na + K - Cl

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4
Q

What is nephrotic range proteinuria?

A

3.5g/day

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5
Q

What are the causes of normal AG metabolic acidosis?

A 
Rta
Diarrhea 
Adrenal insufficiency
Meds (acetazolamide)
Normal saline, TPN
GI- fistulas, ileostomy
  • UAG > 0 indicates RTA
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6
Q

AG metabolic acidosis causes:

A 
Methanol
Uremia
DKA
Paraldehyde, formaldehyde 
Iron, ischemia, infection
Lactic acidosis
Ethylene glycol
Salicylates, starvation
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7
Q

What metabolic changes occur with ethylene glycol ingestion?

A

High gap acidosis. Calcium oxalate crystals in urine.

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8
Q

Causes of metabolic alkalosis:

A 
GI losses: NG, vomiting, antacids
Renal losses: loop/HCTZ, 1 mineralcorticoid (cushings, hyperaldosteronism)
Alkali administration: citrate, acetate
Volume contraction: diuresis, laxative
Intra cellular H+ shift 2/2 hypokalemia
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9
Q

4 causes of persistent asymptomatic hematuria:

A

Idiopathic hypercalciuria
IgA nephropathy
Thin basement membrane disease
Alport syndrome

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10
Q

How are complement levels affected in APSGN?

A

C3 low, C4 normal. C3 normalizes in 6-8 weeks

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11
Q

For MPGN what will happen to C3?

A

It will be persistently decreased. This, presence of nephrotic syndrome, and lack of strep findings will distinguish it from PSGN.

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12
Q

What is the main treatment for MPGN?

A

Prolonged course of steroids

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13
Q

What lab test is positive is wegners granulomatosis?

A

C-ANCA

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14
Q

What lab test is positive in microscopic polyarteritis?

A

P-ANCA

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15
Q

What is churg Strauss syndrome?

A

Autoimmune vascular is characterized by allergic asthma, eosinophilia with GN and st other organ damage

16
Q

What vaccine is recommended for children with nephrotic syndrome?

A

Strep pneumococcus vaccine

17
Q

Where are the most common sites for thrombotic event in a child with nephrotic syndrome?

A

Renal vein and Sagittal sinus

18
Q

What are the findings of Alport syndrome?

A

Hematuria -> proteinuria, HTN, renal failure. Sensorineural deafness, lenticonus, perimacular pigment

19
Q

How is benign familial hematuria transmitted?

A

AD

20
Q

What classic findings are associated with ARPKD and ADPKD?

A

ARPKD- hepatic fibrosis

ADPKD- berry aneurysm of circle of Willis

21
Q

What is Laurence-moon-bardet-biedl syndrome?

A

Obesity, retinitis pigmentosa, hypogenitalism, polydactyly, MR, cystic dysphasia of kidneys

22
Q

Xray findings in medullary sponge kidney? Pyelo gram?

A

Xray- calcifications

Pyelo gram- linear striations

23
Q

Lab findings and causes of type 1 RTA:

A

Hypokalemic, non acidic urine > 6, hypercalciuria-> renal stones. Amphotericin B, SLE, lithium, glue sniffing, chronic hepatitis

24
Q

Lab findings and causes of type 2 RTA:

A

Normokalemic, acidic urine<6, aminoaciduria. Fanconi syndrome, acetazolamide and 6-mp, heavy metal poisoning.

25
Q

Lab findings and causes of RTA 4:

A

Hyperkalemic, hyperchloremic, acidosis. Obstructive uropathy, interstitial renal dz, multicystic dysplastic kidneys

26
Q

What electrolyte abnormality occurs with cisplatin use?

A

Hypomagnesemia

27
Q

Hallmark urine sediment finding in ATN?

A

Muddy brown granular casts

28
Q

Lab findings in rhabdomyolysis:

A

High CPK, high K, high Phos, high uric acid, low calcium

29
Q

Which abx are commonly associated with AIN?

A

Beta lactams
Bactrim
Rifampin
Fluoroquinolones

30
Q

How does NSAID induced AIN differ clinically from other causes of AIN?

A

Often nephrotic range proteinuria with minimal glomerular changes

31
Q

Differentiate between key findings on UA of AIN v acute GN:

A

GN- heavy albuminuria, RBC casts, fat bodies

AIN- eos, RBCs, WBCs, WBC casts, beta 2 microalbuminuria

32
Q

What age group and race most commonly present with urethral prolapse?

A

Black girls, age 4-10

33
Q

Central causes of microphallus:

A

Kallman syndrome
PWS
Panhypopituitarism

34
Q

dietary changes during acute renal failure

A

infant - low Phos formula

children: 70% calories from carbs, <20% lipids

Pediatric Board Prep (11 decks)

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