Nephrology

Question 1

Most common glomerular disease in children

Answer 1

IgA nephropathy

Question 2

Presents within 1-2 days of URTI with gross hematuria

Answer 2

IgA nephropathy

Question 3

Labs in IgA nephropathy

Answer 3

Normal C3/C4

Question 4

What increased risk of poor prognosis in IgA nephropathy

Answer 4

persistent HTN, diffuse mesangial proliferation, extensive glomerular crescents and glomerular sclerosis

Question 5

Most common vasculitis of childhood

Answer 5

HSP

Question 6

leukocytoclastic vasculitis

Answer 6

HSP

Question 7

Who is at increased risk for HSP

Answer 7

eriodic fever syndromes, complement deficiencies

Question 8

Diagnosis of HSp

Answer 8

Palpable prurpuric rash and one of abdo pain, arthritis, biopsy with IgA deposition, renal involvement

Question 9

What % with HSP progress to ESRD

Answer 9

1-2%

Question 10

Labs in HSp

Answer 10

can be normal, can have increased WBC, increased plt, mild anemia, increased ESR and CRP

Question 11

How to treat HSP

Answer 11

Supportive
steroids can be used for severe GI involvement but doesn’t alter prognosis for nephritis
IVIG if severe

Question 12

What is recurrence risk in HSP

Answer 12

15-60%, usually wihtin 4-6 mo

Question 13

Monitoring in HSp

Answer 13

should have weekly ua during active disease nad then monthyl for 6mo

Question 14

Causes of renal vein thrombosis in bbs

Answer 14

asphyxia, dehydration, shck, sepsis, hypercoagulability, central venous catheters, maternal DM or preeclampsia

Question 15

Causes RVT in kids

Answer 15

nephrotic syndroe, cyanotic heart disease, coaguloapthies, post kidnt transplant, contrast

Question 16

How does RVT present

Answer 16

sudden onset gross hematuria and unilateral or bilateral flank masses

Question 17

Treatment for RVT

Answer 17

bilateral then treat with tpa and unfractionated heparain
unilateral no consensus on whether to treat or not

Question 18

predominant renal lesion in TS

Answer 18

renal angiomyolipoma

Question 19

Hypercalciuria, hypokalemia, osteoenia and FTT

Answer 19

Distal (Type 1) RTA

Question 20

Causes of proximal RTA

Answer 20

cytinosis, tyrosinemia, galactosemia, hereditary fructos intolerance, Wilson disease, Lowe syndrome, mitochondrial disease), medications (aminoglycosides, alkylating agents), toxins

Question 21

Rapid correction of hypoNa= risk for

Answer 21

central pontine myelnolysis

Question 22

Rapid correction of rhyperntremia = risk of

Answer 22

cerebral edema

Question 23

Symptoms of hypernatremia

Answer 23

lethargy, irritability, nuchal rigidity, seizures,c oma
intracranial hemorrhage may occur due to rapid shift of water from brain cells with associated cerebral cessel distension

Question 24

Calculation for free water deficity

Answer 24

weight x TBW (0.7 in infant, 0.65 n child) x measured Na=145/145

Question 25

How much to correct sodium

Answer 25

6-8 in 24 h, notmore than 12

Question 26

What % of cardiac output goes to your kidney

Answer 26

25%