Nephrology Flashcards
What is the daily fluid requirement for 15kg baby?
A. 1000
B. 1200
C. 1400
D. 1600
Answer: b
For the first 10 kg we give 100 ml per each kilo
For the second 10 kg (from 10 to 20 kg) we give 50 ml per each kilo
For every kilo after 20 kg we give 20 ml per each kilo
So this baby is 15 kg which will be (1000 ml from the first 10 kg) and (5 kg multiplied by 50 = 250 ml) so the baby’s daily requirement will be 1250 ml per day.
Answer: 15Kg = 1250 . 1Kg = 2.2lbs.
What is the most common intra-abdominal tumor in children?
A. Hepatoma (scc)
B. Rhabdomyosarcoma
C. Ewing tumor
D. Wilms tumor
Answer: d Explanation: although other tumors may occur at such age, wilm’s tumor of the kidney is the most common intra abdominal malignancy of childhood.
But the most common pediatric tumor in general is leukemia
Baby came to the emergency with abnormal movement and teeth delay.
Glucose is 5 (normal range from (5-10) , Calcium is low Magnesium is low , Phosphate is high What is the best management ?
A. Ca
B. Mg
C. Ringer
D. Glucose
Answer : a
Child with fever, general swelling and dark colored of urine which best evaluate for this pt:
A. Us
B. Rft
C. Urine culture
D. Urine specimen
Answer: d
this Q there is hematuria we will do Urine analysis to confirm hematuria and to look for microscopic examination and also will give us a hint about the origin of hematuria ( is it glomerular or non glomerular ) then if it is glomerular hematuria requires more extensive evaluation (renal ultrasound; CBC; complement levels; antinuclear antibody (ANA), antineutrophilic cytoplasmic antibody (ANCA), and ASO titers; hepatitis B )
urinalysis and sediment examination are crucial in the evaluation of patients with acute nephritic syndrome. Look for the following: • Protein • Blood • Red blood cells (rbcs) • White blood cells (wbcs) • Dysmorphic rbcs • Acanthocytes • Cellular (ie, rbc, wbc) casts • Granular casts • Oval fat bodies
Child with aspirin intake overdose … what kind of acid-base balance:
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer : b
The net effect of these changes in most adults is respiratory alkalosis or a mixed respiratory alkalosis-metabolic acidosis. Pure metabolic acidosis is unusual in adults, but is more common in children .
Children with mild to moderate acute salicylate poisoning lose the respiratory drive and are more likely to present with mixed metabolic and respiratory acidosis . Respiratory alkalosis first in oncent then metabolic acidosis.
Baby thirsty with tachycardia, sunken eye. Volume loss
A. 1%
B. <3%
C. 5-9%
D. 9%
Answer: d ?
Typical case of Poststreptococcal glomerulonephritis (PSGN). What will you do to confirm diagnosis?
Answer:?
Occurs 1-3 wk following initial primary GAS infection of pharynx or skin.
If the Glomerular involvement occurred in less than a week after URTI it’s due to IgA Nephropathy ( normal complement )
Post-Streptococcal Glomerulonephritis (PSGN) :
results in dark urine, described as “tea colored” or “cola colored.” Periorbital edema and hypertension also occur.
both throat and skin infections can lead to PSGN.
Diagnostic Testing
· Best initial test: Antistreptolysin O (ASLO), anti-DNase, antihyaluronidase in blood. Complement levels c3 are low.
· Most accurate test: Although biopsy is the most accurate test, it should not be done routinely, because the blood tests are most often sufficient. Biopsy shows subepithelial deposits ( humps ) of IgG and C3.
Treatment
· Penicillin and other antibiotics for the infection should be given, although they do not clearly reverse the disease.
· Control the hypertension and fluid overload with diuretics.
7 y child and an U & L respiratory tract infection since birth with generalized joint pain aches his uncle and brother have the same condition labs show high creatinine and BUN and +ve urine protein. repeated
A. idiopathic fibrosis
B. Autoimmune
Answer: B. Autoimmune (** With broad DDx like HSP , WG , SLE and also glomerulonephritis)
Wegener’s Granulomatosis ( GPA ) Upper respiratory problems such as sinusitis and otitis are the key to diagnosis. Lung problems (cough, hemoptysis, abnormal chest x-ray) are present as well. Wegener’s is a systemic vasculitis, so joint, skin, eye, brain, and GI problems are also present, but the key is both upper and lower respiratory involvement in addition to renal involvement.
Diagnostic Testing
·Best initial test: c-ANCA (antineutrophil cytoplasmic antibodies) ·
Most accurate test: Biopsy of kidney
Treatment : The best initial therapy is cyclophosphamide and steroids.
baby with bilateral renal agenesis:
Answer: with bilateral renal agenesis: (oligohydramnios which is a sign for the disease during prenatal diagnosis)
child alert, anterior fontanelle depressed, how much dehydration:
A. 5 - 9
B. >9
Answer: A
Mild 5% : normal fontanelle
moderate 6-10% : Sunken slightly
severe >10 % : Sunken significantly
boy with glomerulonephritis after week he developed hemoptysis :
A. HSP
B. goodpasture syndrome
C. rapid deterotion
Answer : B
3 year old child with UTI admitted what investigation to be done ?
- US
- Cystoscope
Answer:
First you should do analysis and culture if not in the choices go for US
guideline recommend routine ultrasonography of the urinary tract after first febrile UTI in children aged from 2 -24 years
