Nephrology Flashcards
Next step for microscopic hematuria
Repeat UA in few weeks
Next step for persistent microscopic hematuria
Urine Ca/Cr ratio
If elevated, check 24hr total Ca excretion
If > 4 mg/kg/day — confirmed hypercalciuria
Red/pink discoloration in diaper
Urate crystals
Not hematuria
Myoglobinuria
Rhabdomyolysis
Differential for gross hematuria (+ microscopy and red)
HSP and Hereditary nephritis
Benign familial hematuria
MPGN
Alport and IgA nephropathy
Trauma
UPJ obstruction
Renal stones and crystals
Infectious
Abnormal cells
Most common renal stone in children
Calcium
Most sensitive modality to confirm renal stone
Non contrast CT
Predisposing factors of renal stones in IBD
Hyperoxaluria
Hypocitraturia
Best way to decrease urinary calcium excretion and prevent stone formation in urine
Thiazide diuretic
Mechanism of added calcium for renal stones
Decrease absorption of oxalate
Renal stone
Distal RTA 1
Ca phosphate
Orthostatic proteinuria
Proteinuria present during day but disappears when lying down
Best test for orthostatic proteinuria
First void spot urine
If protein disappears when lying down, check sCr. If sCr normal, f/u 3 mo
If protein does not disappear, check Ur p/c ratio. > 0.2 means renal disease
Renal failure
Persistent microscopic hematuria
Sensorineural hearing loss
Ocular defects
X-linked
Alport syndrome (familial nephritis)
Most commonly palpated masses in infants
Hydronephrotic kidneys (from UPJ obstruction)
Multicystic dysplastic kidneys
Diagnosing MCDK
Renal ultrasound
Associated anomalies with MCDK
UPJ obstruction
Vesiclureteral reflex
Posterior urethral valves
Megaureter and duplication
Bilateral flank mass
Oligohydramnios
Chronic portal HTN
Congenital hepatic fibrosis
Autosomal recessive polycystic kidney disease
Renal disease
Cerebral aneurysms
Autosomal dominant polycystic kidney disease
Most common pediatric kidney tumor
Wilms tumor
Asymptomatic abdominal mass
HTN
gross hematuria
Aniridia
Hemihypertrophy
Does not calcify
Wilms tumor (nephroblastoma)
Calcification on abdominal mass Xray
Neuroblastoma
Complications of nephrotic syndrome
Edema
High LDL/HDL ratio
Hypercoagulability, thrombosis
Immunodeficiency, hypogammaglobulinema
Invasive pneumococcal disease
HypoCa, HypoNa
Functional hypothyroidism
Hematuria
Oliguria
Proteinuria
HTN
Azotemia
Nephritic syndrome
Recurrent painless hematuria
URI < 1 week
> 10 yo
Normal complement
IgA nephropathy (Berger’s disease
Correlates with worsening IgA nephrology
Persistent proteinuria
African American
HIV
Heroin
Sickle cell
obesity
Normal complement
Focal segmental glomerulosclerosis (FSGS)
SLE
Hep B, C
Cryoglobulinemia
SBE
Low C3
Membranoproliferative glomerulonephritis (MPGN)
Strep throat 1-3 weeks
Impetigo 3-6 weeks
Tea/coca-colored urine
Transient low C3
Normal C4
Low serum albumin (hemodilution)
Post strep glomerulonephritis (PSGN)
Hemolytic anemia
Uremia
Thrombocytopenia
Hemolytic uremic syndrome (HUS)
FeNa
[(UrNa x sCr) / (UrCr x sNa)] x 100
Indication for erythropoietin in CKD
Hgb < 8
Secondary hyperparathyroidism
CKD
Decrease production in 1,25 dihydroxy vitamin D3 (active vitamin D)
Decrease Ca absorption
Elevated PTH
Effects of increased Phos in CKD
Suppress calcitriol production
Additional Ca loss
Increased PTH
Age which GFR reaches adult value
2 yo
Time it takes for creatinine to decrease to neonatal level from adult/maternal level
1-2 weeks
Hypertension
BP > 95th percentile for age and sex
Taken on 3 separate occasions
Causes of pediatric HTN
Polycystic kidney disease
11 and 17 hydroxylase deficiencies
Urinary reflux nephropathy
Renal artery stenosis
Neurofibromatosis
Coarctation of aorta
Pheochromoxytoma
Lupus
Hyperthyroidism
Cushings
Renin level in renal stenosis as a renal cause for HTN
Elevated
