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Year 3 Paeds > Nephrology > Flashcards

Nephrology Flashcards

1
Q

5 kidney functions

A 
waste handling - urea and creatinine 
water handling 
salt balance 
acid base control - HCO3
Endocrine - bp,bone, activate vit D, erythropoeitin
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2
Q

3 parts of glomerular filtration barrier

A

fenestrated endothelium
GBM
podocytes
(mesangial cells)

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3
Q

proteinuria signifies…

A

glomerular injury

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4
Q

What is nephrotic syndrome?

A

nephrotic range proteinuria
hypoalbuminaemia
oedema

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5
Q

nephrotic syndrome in terms of starlings forces

A

oncotic vs hydrostatic

lose protein which keeps water in

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6
Q

typical presentation of nephrotic syndrome

A 
swollen face and legs
gastroenteritis 10 days prior
periorbital and pitting oedema
ascites 
frothy urine
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7
Q

testing for proteinuria

A

dipstix - >3
protein creatinine ration
24 hour urine collection

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8
Q

patient diagnosis of nephrotic syndrome

A

oedema
proteinuria
bloods - low albumin

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9
Q

Nephrotic syndrome types

A

MINIMAL CHANGE

FSGC/MPGN

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10
Q

typical features of minimal change disease

A

age 2-5 years
normal blood pressure
resolving microscopic haematuria
normal renal function

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11
Q

atypical features of minimal change disease

A

autoimmune
abnormal renal function
steroid resistant

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12
Q

When to consider renal biopsy with MCD

A

atypical features

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13
Q

Treating nephrotic syndrome

A

prednisolone for 8 weeks

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14
Q

side effects from glucocorticoids

A

cushings syndrome

BEHAVIOUR

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15
Q

Pathogenesis of nephrotic syndrome

A

interaction between lymphocytes and podocytes

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16
Q

Outcome of nephrotic syndrome

A

95% remission in 2-4 weeks
80% relapse
immunosuppression

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17
Q

steroid resistant nephrotic syndrome

A

acquired = FSGS

congenital

18
Q

persistent haematuria and proteinuria =

A

glomerular disease

19
Q

Nephritic syndrome presentation

A 
haematuria and proteinuria 
reduced GFR - oliguria
fluid overload - high JVP, oedema 
hypertension 
AKI
20
Q

Causes of nephritic syndrome

A

post infectious
IgA nephropathy
lupus nephritis
membranoproliferative

21
Q

diagnosing nephritic syndrome

A

Renal USS
ASOT, throat swab, low complement
immune disease - ANCA -ve

22
Q

Usual cause of PIGN

A

beta haemolytic group A strep

throat or skin infection

23
Q

Treating PIGN

A

antibiotic

diuretics

24
Q

IgA nephropathy presentation

A 
1-2 days after URTI 
older children and adults 
recurrent macroscopic haematuria 
chronic microscopic haematuria 
varying proteinuria
25
Q

Diagnosing IgA nephropathy

A

confirmation biopsy
normal complement
negative autoimmune

26
Q

treating IgA nephropathy

A

mild disease - proteinuria with ACEI

mod-severe = immunosuppression

27
Q

mandatory clinical diagnosis for IgA related vasculitis (HSP)

A

palpable purpura

28
Q

4 of the other criteria for HSP

A

abdominal pain
renal involvement
arthritis/arthralgia
biopsy - IgA deposition

29
Q

Treating IgA vasculitis

A

symptomatic - joints, gut
immunosuppression
glucocorticoids
hypertension and proteinuria screening

30
Q

AKI

A

Anuria/oliguria (<0.5ml/kg/hr)
hypertension with fluid overload
rapid rise in creatinine more than 1.5 times normal

31
Q

HUS

A

post diarrhoea - bloody
vero/shiga toxin
E coli 0157

32
Q

HUS triad

A

microangiopathic haemolytic anaemia
thrombocytopenia
AKI

33
Q

AKI long term consequences

A

Blood pressure
proteinuria monitoring
evolution to CKD

34
Q

CKD causes - paeds

A

reflux nephropathy
PKD
Dysplasia
glomerulonephritis

35
Q

UTI definition

A

clinical signs plus bacteria from MSSU

36
Q

obtaining urine specimen

A

MSSU
collection pads?
suprapubic aspiration
catheter

37
Q

diagnosing UTI

A

dipstix - leucocytes, nitrites
microscopy = pyuria, bacteria
culture

38
Q

imaging renal tract

A

USS
MAG3 and micturating CUG
= reflux
DMSA - scar

39
Q

treating UTI

A

3 days oral antibiotic - lower
7-10 days if upper
prevent = fluids, hygiene

40
Q

Factors affecting progression of CKD

A 
hypertension 
proteinuria 
acidosis 
bone health 
high intake of salt
41
Q

Blood pressure

A

doppler
sphigmanometer
oscillometry
ABPM

42
Q

Treating metabolic bone disease

A

phosphate binders
activated vitamin D
low phosphate diet

Year 3 Paeds (14 decks)

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