Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pedia > Nephrology > Flashcards

Nephrology Flashcards

1
Q

Nephritic

A

OHH

Oliguria
Hypertension
Hematuria
Azotemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Nephrotic

A

PALE (EPHAL)

Proteinuria (nephrotic range)
Albumin low
Lipid high
Edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Grossly red urine

A

LOWER URINARY TRACT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

brown, cola, tea, burgundy colored urine

proteinuria >100 mg/dL

RBC casts

dysmorphic EBCs (acanthocytes)

A

GLOMERULAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

leukocytes or renal tubular casts

A

TUBULAR SYSTEM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Documentation of prior strep infection

A

ASO - throat

DNAse B antigen - skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Serotype ff throat infection

A

1,2,4,12,18,25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Serotype ff THROAT infection

A

49,55,57,60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Patient develops nephritic syndrome how many weeks after throat infection

A

1-2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Patient develops nephritic syndrome how many weeks after skin infection

A

3-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Poststreptococcal Glomerulonephritis

5-12 y/o
RARE before 3 y/o

A

LM: diffuse proliferation

IF: granular IgG, C3

EM: subepithelial humps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Laboratory findings Poststreptococcal Glomerulonephritis

A

INCREASED ASO titers
(+) streptozyme
decreased C3-C9; normal C1,C4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When will the abnormalities resolve

A

urinary protein excretion and HPN - 4-8 weeks

acute phase - 6-8 weeks
C3 level - 6-8 weeks

microscopic hematuria - 1-2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The only causes of renal insufficiency that cause DECREASED C3

A

PSGN
MPGN
Lupus Nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Indications for Renal Biopsy in APSGN

A 
acute renal failure
nephrotic syndrome
(-) evidence of strep infection
normal complement level
hematuria and proteinuria
low C3 that persists > 2 mos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bilateral sensory hearing loss

Anterior lenticonus (pathognomonic)

macular flecks, corneal erosions

A

Alport Syndrome (Hereditary Nephritis)

(+) hematuria
2 of the ff
*macular flecks
*recurrent corneal erosions
*GBM thickening or thinning
*sensorineural deafness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

(+) hematuria, HPN
signs of renal insufficiency

history of hemoptysis and severe RDS

A

Goodpasture syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

(+) hematuria, HPN
signs of renal insufficiency

(+) SVI 3 weeks ago

purpuric rash (buttocks)
pain in the joints
A

Henoch Schonlein Purpura (HSV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

(+) hematuria, HPN
signs of renal insufficiency

vomiting, bloody diarrhea and fever
history of eating hamburger

dehydrated hepatosplenomegaly

A

hemolytic uremic syndrome (HUS )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Sudden onset of gross hematuria

febrile with LRTI or GIT infection

normal C3

A

IgA nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Sudden onset of gross hematuria

History of strep throat or pyoderma

severely depressed C3

A

APSGN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

asymptomatic microscopic hematuria

wears thick glasses and hearing aid

has uncles with the same condition

A

Alport Syndrome (Hereditary Nephritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

IgA nephropathy

10-35 y/o

follows viral syndrome

INCREASED serum IgA

A

LM: focal proliferation

IF: diffuse mesangial IgA

EM: mesangial deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Goodpasture syndrome

15-30

pulmonary hemorrhage; IDA

(+) anti GBM antibody

A

LM: focal –> diffuse proliferation w/ crescents

IF: linear IgG, C3

EM: (-) deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Idiopathic Rapidly Progressive Glomerulonephritis

adults

(+) ANCA (in some)

A

LM: crescentic GN

IF: (-) immune deposits

EM: (-) deposits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

3 mechanisms of proteinuria

A

Glomerular proteinuria – ineffective filtration

Tubular proteinuria – ineffective reabsorption

Increase plasma protein – i.e. rhabdomyolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Urine dipstick

A

3+ - 300 mg/dL

4+ - >2g/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Nonpathologic causes of proteinuria

A

Postural
Febrile (>38 C)
Exercise - resolves after 48 h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

24 hr urine protein determination

A

NEPHROTIC RANGE > 40 mg/m2/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Urine protein: Creatinine ratio

A

NEPHROTIC RANGE >2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Causes of Transient Proteinuria

A 
Fever
Exercise
Dehydration
Cold Exposure
CHF
Seizure 
Stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Idiopathic Nephrotic Syndrome

A

MInimal Change Disease
Focal Segmental Glomerulosclerosis
Mesangial Proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Glomerular Diseases

A

Membranous Nephropathy

Membranoproliferative Glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

3+ or 4+ proteinuria

urine protein/ creatinine ratio >2

urinary protein excretion > 3.5 h/24 hr in adults and 40 mg/m2/hr in children

normal C3 and C4

A

Nephrotic Syndrome (Minimal Change Disease)

increased permeability of glomerular capillary wall – proteinuria and hypoalbuminemia

PODOCYTES – EFFACEMENT of foot process, decrease number of podocytes and altered slit diaphragm – LEAKY MEMBRANES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Remission attained w/n initial 4 weeks

A

RESPONSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

UPCR <0.2 or < +1 protein on dipstick for 3 consecutive days

A

REMISSION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

UPCR > 2 or > 3 dipstick for 3 consecutive days

A

RELAPSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Relapse w/n 28 days of stopping prednisone therapy

A

NON RESPONDERS

Steroid Dependent

39
Q

Patient who respond well to prednisone therapy but relapse 4 or more tie in a 12 mo period

A

NON RESPONDERS

Frequent relapser

40
Q

Children who fail to respond to prednisone therapy w/n 8 weeks

A

NON RESPONDERS

Steroid dependent

41
Q

Children who continue to have proteinuria (+2 or greater) after 8 weeks of steroid therapy

A

NON RESPONDERS

Steroid resistant

42
Q

Major complication of nephrotic syndrome

A

Infection

43
Q

The most frequent type of infection in nephrotic syndrome

A

Spontaneous bacterial peritonitis

44
Q

The MC organism causing peritonitis

A

Pneumococcus

45
Q

LM: Diffuse thickening of glomerular capillary walls

IF: granular IGG and C3

EM: subepithelial deposits of electron dense material

SPIKE AND DOME APPEARANCE

A

Membranous Glomerulonephritis

46
Q

LM: normal

EM: effacement of epithelial foot processes, (-) deposits

A

MInimal Change Disease

47
Q

LM: Large hypercellular glomeruli
Increased mesangial matrix

DOUBLE CONTOUR OR TRAM TRACK APPEARANCE

A

Membranoproliferative Glomerulonephritis

48
Q

LM: focal segmental sclerosis and hyalinosis

EM: loss of foot process, epithelial denudation

A

Focal Segmental Glomerulosclerosis

49
Q

Prevalence of UTI

A

1st year of life - MALE

beyond 1-2 y/o - FEMALE

50
Q

3 basic forms of UTI

A

Pyelonephritis
Cystitis
Asymptomatic bacteriuria

51
Q

Colonic bacteria that cause UTI

A

E. coli
Klebsiella
Proteus

52
Q

abdominal, back or flank pain, fever, malaise, nausea, vomiting and diarrhea (occasional)

A

Pyelonephritis

53
Q

(-) fever
(-) permanent renal damage

dysuria, urgency, frequency, suprapubic pain, incontinence and malodorous urine

A

Cystitis

54
Q

(+) urine culture (-) manifestation of infection

A

Asymptomatic Bacteriuria

55
Q

Recurrent UTI

A

2 or more acute pyelonephritis/presumptive UTI

OR

3 or more cystitis

OR

1 pyelonephritis + 1-2 cystitis

56
Q

Presumptive UTI

A

Clinical symptoms + urinalysis findings suggestive of UTI not supported by urine culture

57
Q

Indications of urine culture in UTI

A

significant urinalysis findings
complicated UTI
seriously ill children
recurrent UTI

58
Q

Gold standard in a properly collected sample

A

Urine Culture

59
Q

Collection of urine

A

< 2 y/o - clean catch urine collection

> 2 y/o - mid-stream sample

60
Q

Indications for KUB Ultrasound with post void study

A

Culture proven pyelonephritis
Febrile presumptive UTI
Recurrent UTI

61
Q

Nitrite +

Leukocyte +

A

Urine CS

Treat as UTI

62
Q

Nitrite +

Leukocyte -

A

Urine CS

Treat as UTI

63
Q

Nitrite -

Leukocyte +

A

Urine CS

Treat if with symptoms

64
Q

Nitrite -

Leukocyte -

A

NOT UTI

65
Q

Pyuria

A

CENTRIFUGED
>5 /HPF

UNCENTRIFUGED
>10/uL

66
Q

Bacteriuria +

Pyuria +

A

Urine CS

Treat as UTI

67
Q

Bacteriuria +

Pyuria -

A

Urine CS

Treat as UTI

68
Q

Bacteriuria -

Pyuria +

A

Urine CS

Treat if with symptoms

69
Q

Bacteriuria -

Pyuria -

A

NOT UTI

70
Q

Management of CYSTITIS

A

Co-trimoxazole and Amoxicillin – high rate of resistance

Nitrofurantoin

71
Q

Management of ACUTE PYELONEPHRITIS

A

Ceftriaxone
Cefotaxime
Ampicillin + Aminoglycoside

72
Q

Management of PSEUDOMONAS

A

Aminoglycoside

Fluoroquinolone (Ciprofloxacin)

73
Q

DOH RECOMMENDATION (UTI)

E. coli
Klebsiella
Enterobacter
Enterococcus
Group B Strep
A

< 2 mos - Cefotaxime PLUS Amikacin - 10-14 days

> 2 mos - 18 y/o (7-10 days)

Oral Co-Amoxiclav
Cefuroxime
Nitrofurantoin
Ampicillin Sulbactam

74
Q

DOH RECOMMENDATION (UTI)

Recurrent UTI
Catheter related comorbidities

A

Ceftriaxone and/or Amikacin for 7-14 days

75
Q

DOH RECOMMENDATION (UTI)

Antibiotic Switch

A

If culture shows different sensitivity pattern and/or poor response after 48-72 hrs

76
Q

Acute Kidney Injury

A

Abrupt loss of kidney function – rapid decline in the glomerular filtration rate (GFR), accumulation of waste products such as BUN and CREA, and dysregulation of extracellular volume and electrolyte homeostasis

77
Q

KDIGO (Kidney Disease Improving Global Outcomes) Definition of AKI

A

INCREASE in CREA by >/= 0.3 mg/dL from baseline w/n 48 hrs

INCREASE in CREA by >/= 1.5 mg/dL from baseline w/n the prior 7 days

URINE VOLUME = 0.5 ml/kg/hr for 6 hrs

78
Q

Categories of AKI

A

Pre renal
Intrinsic
Post renal

79
Q

Diminished effective circulating arterial volume – inadequate renal perfusion

A

PRERENAL

dehydration
sepsis
hemorrhage
hypoalbuminemia
cardiac failure
80
Q

Renal parenchymal damage including sustained hypoperfusion and ischemia

A

INTRINSIC

glomerulonephritis
acute tubular necrosis

ENDOGENOUS - myoglobin, hemoglobin

EXOGENOUS - medications, poisons, radioactive materials

81
Q

Obstruction of urinary tract

A

POST RENAL

congenital conditions - posterior urethral valve, uteropelvic junction obstruction

urolithiasis, tumors

82
Q

Chronic Kidney Injury (NKF KDOQI)

A

Kidney damage for >3 mo - structural or functional abnormalities of the kidney w/ or w/o decreased GFR manifested by one or more of the ff features

  • abnormalities in the composition of the blood or urine
  • abnormalities in imaging tests
  • abnormalities on kidney biopsy

GFR <60 mL/min/1.73 m2 for 3 mo w/ or w/o the other signs of kidney damage described above

83
Q

One of the MCC of acute renal failure in young children

Caused by infection, genetics, drugs (calcineurin inhibitors, cytotoxic agents, clopidogrel, ticlopidine, quinine) SLE, HELLP

A

Hemolytic Uremia Syndrome (HUS)

sudden onset of pallor, irritability, weakness, lethargy and oliguria usually occurs 5-10 days after the initial gastroenteritis or respiratory illness

dehydration, petechiae, hepatosplenomegaly, marked irritability

84
Q

RAT

Renal insufficiency
Anemia (microangiopathic)
Thrombocytopenia

A

Hemolytic Uremia Syndrome (HUS)

85
Q

MC form of HUS

A

EHEC

86
Q

Characteristic of all forms of HUS

A

Microvascular with endothelial cell damage

87
Q

Laboratory criteria for diagnosis of HUS

A

anemia (acute onset) with microangiopathic changes - schistocytes, burr cells, helmet cells

renal injury evidenced by hematuria, proteinuria, or elevated creatinine level

88
Q

Presents similarly with PSGN but the throat infection coincides with appearance of renal symptoms

A

IgA Nephropathy

89
Q

Triad of HUS

A

Renal insufficiency
Anemia (microangiopathic)
Thrombocytopenia

90
Q

HSP Tetrad

A

Palpable purpura
Arthritis
Abdominal pain
Glomerulonephritis

91
Q

Pathognomonic for Alport Syndrome

A

Anterior lenticonus

92
Q

Clinical Manifestations that differentiate TTP from HUS

A

CNS Involvement

Fever

93
Q

HPN for children 1-13 y/o

A

elevated BP >90th to <95 OR 120/80 mmHg (whichever is lower)

Stage 1 >95th to <95th + 12 mmHg OR 130/80 mmHg - 139/89 mmHg (whichever is lower)

Stage >95th + 12 mmHg OR >140/90 mmHg (whichever is lower)

Pedia (63 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions