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Pediatric Questions > NEPHROLOGY > Flashcards

NEPHROLOGY Flashcards

1
Q

A 5-year-old hospitalized and receiving penicillin IV for 10 days, developed rash, eosinophilia,
eosinophiluria, pyuria (sterile), hematuria, moderate proteinuria (usually < 1 g/day)

A

Antibiotic-induced allergic interstitial
nephritis

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2
Q

A 4-year-old had throat infection 2 weeks ago, teacolored urine, BP is slightly elevated, RBC casts in urine, low C3 and normal C4

A

Postinfectious glomerulonephritis

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3
Q

History of impetigo, tea-colored urine, hypertension, periorbital edema, C3 is low, normal C4, azotemia, normal ASO titer, positive anti-DNAse, oliguria, and RBC casts in urine

A

Postinfectious glomerulonephritis

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4
Q

Low C3 and cola-colored hematuria (RBC casts)
2–3 weeks after upper respiratory tract infection

A

Postinfectious glomerulonephritis

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5
Q

Normal C3 and episodic gross hematuria (RBC casts) during acute upper respiratory tract infection

A

IgA nephropathy

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6
Q

The most common cause of gross hematuria in
children

A

IgA nephropathy

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7
Q

Can antibiotics prevent acute postinfectious
glomerulonephritis?

A

No

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8
Q

Can antibiotics prevent acute rheumatic fever?

A

Yes

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9
Q

After poststreptococcal glomerulonephritis (PSGN) does the C3 level normalize immediately after the illness?

A

No—at least 6 weeks before C3 levels return
to normal

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10
Q

Are steroids indicated in PSGN?

A

No—only supportive care measures and BP
control as needed

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11
Q

Adolescent female with rapidly progressive
glomerulonephritis, hypertension, and both C3 and C4 are decreased

A

Lupus nephritis

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12
Q

A healthy child with proteinuria, morning specimen is negative for proteinuria

A

Benign orthostatic proteinuria

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13
Q

A 3-year-old, swelling of the face and generalized edema, normal blood pressure, 4+ proteinuria, no hematuria, hyperlipidemia, hypoalbuminemia, normal C3 and C4, urine is negative for protein after 3 weeks of steroid therapy

A

Nephrotic syndrome due to minimal change
disease

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14
Q

Child with nephrotic syndrome not responding to treatment and progressing to chronic kidney disease

A

Focal segmental glomerulosclerosis

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15
Q

Adolescent with nephrotic syndrome, microscopic hematuria, and hypertension

A

Focal segmental glomerulosclerosis

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16
Q

Child develops acute kidney injury and within 4 weeks progresses to end-stage renal disease, renal biopsy shows crescents formation in most glomeruli

A

Rapidly progressive (crescentic)
glomerulonephritis

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17
Q

A 5-year-old has blood in urine, urine is positive for hematuria, RBC casts, renal function is normal, no hypertension, positive family history of hematuria with every generation affected

A

Familial thin basement membrane
nephropathy (autosomal dominant)

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17
Q

Adolescent presents with proteinuria, hematuria, hypertension, persistent low C3, hyperlipidemia, renal failure

A

Membranoproliferative glomerulonephritis

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18
Q

Child presents with persistent proteinuria, history of hepatitis B virus infection

A

Membranous glomerulonephritis

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19
Q

Which serologic marker can be positive in rapidly progressive glomerulonephritis?

A

P-ANCA

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20
Q

Boy with a sensorineural hearing loss, proteinuria, mother’s brother died from renal failure

A

Alport syndrome (X-linked disease)

20
Q

Microhematuria, proteinuria, absent patella, dystrophic nails, dysplasia of elbows

A

Nail-patella syndrome (autosomal dominant)

20
Q

A 7-year-old, failure to thrive, polyuria, polydipsia, anemia, ocular apraxia, retinitis pigmentosa, coloboma, nystagmus, aplasia of the cerebellar vermis, loss of differentiation between cortex and medulla on renal US

A

Juvenile nephronophthisis

21
Q

Upper respiratory infection a week ago, now with petechiae on the buttocks and lower extremities, abdominal pain, arthralgia, and hematuria

A

Henoch-Schönlein purpura

22
Q

Bloody diarrhea, which resolves, but then the child becomes pale and tired and is found to have hemolytic anemia, thrombocytopenia, elevated BUN and creatinine. A stool culture is positive for Escherichia coli (E. coli) O157: H7

A

Hemolytic uremic syndrome

23
Q

The most common causes of oliguric acute kidney injury requiring dialysis in children

A

Nephrotoxins and rhabdomyolysis

23
Q

Child on amphotericin B developed kidney stones, and blood work showed non-anion gap metabolic acidosis. What is the most likely cause?

A

Renal tubular acidosis (RTA) type 1

24
Q

Child with polyuria, polydipsia, dehydration, growth failure, non-anion gap metabolic acidosis, hypokalemia, hypophosphatemia, proteinuria, glucosuria

A

Fanconi syndrome

25
Q

Type of renal tubular acidosis associated with
hyperkalemia

A

RTA type 4

26
Q

Type of renal tubular acidosis associated with Fanconi syndrome

A

RTA type 2

26
Q

Hemoptysis, hematuria, proteinuria, positive antiglomerular basement membrane antibodies
(anti-GBM)

A

Goodpasture syndrome

27
Q

Child on Lasix, presents with oliguria, elevated
creatinine; urine osmolality is > 400 mOsm/L, urine Na < 20, FeNa < 1%, urine is positive for hyaline cast

A

Prerenal acute kidney injury

28
Q

A male infant with posterior urethral valves, born prematurely and is found to have high BUN/Cr, elevated FeNa, normal urine osmolality, elevated urine Na

A

Postrenal acute kidney injury

28
Q

Child after a car accident and crush injury presents with high BUN/Cr, oliguria, urine osmolality 300 mOsm/L. FeNa > 1%, urine Na > 20, large muddy brown granular cast

A

Acute tubular necrosis (intrarenal acute
kidney injury)

29
Q

Status post-cardiac arrest, BUN and creatinine are elevated, hyperkalemia, hyponatremia,
hyperphosphatemia, hypocalcemia, urine shows
muddy brown, and granular casts

A

Acute tubular necrosis secondary to ischemia

30
Q

Adolescent with severe muscle cramps, numbness, low blood pressure, fatigue, metabolic alkalosis, hypochloremia, hypokalemia, hyponatremia, hypomagnesemia, polyuria, low urine calcium, and high urinary chloride 70 mEq/L. High aldosterone and renin levels

A

Gitelman syndrome (metabolic alkalosis and
high urine chloride, low serum Mg, and low
urine Ca)

31
Q

An infant with failure to thrive, dehydration, low blood pressure, metabolic alkalosis, hypochloremia, hypokalemia, hyponatremia, normal serum magnesium level, polyuria, normal urine calcium, and high urinary
chloride 70 mEq/L. High aldosterone and renin levels. High urinary prostaglandin level

A

Bartter syndrome (metabolic alkalosis and
high urine chloride, normal serum Mg, and
normal or high urine Ca)

32
Q

Child with a positive family history of hypertension (parents) presenting with headache, hypertension, hypokalemia, metabolic alkalosis, and high urinary
chloride

A

Liddle syndrome (autosomal dominant)

33
Q

Adolescent with mild glomerulonephritis, history of allergies/asthma with elevated eosinophil levels on CBC

A

Churg Strauss syndrome

34
Q

An older child with a prolonged history of fever,
weight loss, hematuria, and hemoptysis. Radiograph shows necrotizing granuloma and C-ANCA positive

A

Granulomatosis with polyangiitis (formerly
Wegner granulomatosis)

35
Q

A young child with palpable kidneys bilaterally,
hypertension, and associated with a history of
oligohydramnios

A

Autosomal recessive polycystic kidney
disease

36
Q

The predominant type of polycystic kidney disease seen in adults

A

Autosomal dominant polycystic kidney
disease

37
Q

How is hypertension defined in children?

A

BP > 95th percentile for age, height, and gender on 3 different occasions or greater than 130/90 mmHg in children aged 13 years and older

38
Q

How is elevated blood pressure defined in children?

A

BP ≥ 90th (≥ 13 years BP > 120/80 mmHg
matching new adult guideline)

39
Q

Adolescent with severe muscle weakness after
exercise, hypophosphatemia, hypokalemia and
elevated CPK with myoglobinuria

A

Rhabdomyolysis—heme positive urine but
no RBC

40
Q

Child with nausea, severe flank pain, and hematuria

A

Renal stone

41
Q

The most common type of stones in children

A

Calcium oxalate

42
Q

Type of kidney stone associated with staghorn calculi and Proteus?

A

Struvite stones

43
Q

Type of stone associated with an autosomal recessive pattern

A

Cystine stones

44
Q

First-line therapy for children with primary
monosymptomatic nocturnal enuresis

A

Bedwetting alarm and desmopressin (both)

45
Q

Recommended lifestyle changes in all cases of
monosymptomatic nocturnal enuresis

A

Adequate hydration during the day
Limit fluids before bed (≤ 200 mL)
Void before bed
Regular sleep and wake schedule

46
Q

Diurnal enuresis after continence

A

Requires prompt evaluation

Pediatric Questions (31 decks)

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