Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Nephrology > Flashcards

Nephrology Flashcards

1
Q

what is the GFR of a neonate and at what age does it mature to its full function?

A

20-30

reaches adult function of >90 by 2 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the 5 main kidney functions?

A 
waste handling 
water handling 
salt balance 
acid base control
endocrine - red cells, blood pressure, bone health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does glomerulopathy present?

A

proteinuria

haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

does nephrotic or nephritic syndrome cause intravascular overload?

A 
nephritic = intravascular overload 
nephrotic = intravascular depletion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what component of the glomerular filtration barrier is affected in minimal change disease?

A

epithelial cell (podocyte)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what component of the glomerular filtration barrier is affected in post-infective glomerulonephritis

A

basement membrane & endothelial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what component of the glomerular filtration barrier is affected in haemolytic uraemia syndrome?

A

endothelial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what component of the glomerular filtration barrier is affected in IgA nephropathy?

A

mesangial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how would you test for proteinuria?

A

dipsix
protein creatinine ratio
24 hour urine collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the normal protein creatinine ratio and what is the nephrotic range?

A

< 20mg/mmol

>250mg/mmol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the typical presentation of a child with nephrotic syndrome?

A 
swollen face in the mornings
periorbital and eyelid swelling in the morning 
pitting oedema 
ascites 
pale, dehydrated, low BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the clinical signs of nephrotic syndrome in a child?

A

frothy urine

ascites, small pleural effusion, pitting oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

a patient presents with signs of nephrotic syndrome. what investigations would you carry out?

A

urine dipstick
protein creatinine ration
urine Na (low)

blood;

  • Albumin (low)
  • Creatinine (normal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when would you consider a renal biopsy in a child who presented with nephrotic or nephritic syndrome?

A

steroid resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the treatment for nephrotic syndrome in a child?

A

prednisolone for 8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the side effects from high dose steroids?

A 
behaviour change 
sleep disturbance 
increased infection risk 
hypertension 
cushings
17
Q

after how long of no response are they considered steroid resistant?

A

> 4 weeks

18
Q

what is responsible for steroid resistance in nephrotic syndrome?

A

interaction between lymphocytes and podocytes

19
Q

what is the 1st and 2nd line treatment for nephrotic syndrome in children?

A

1st line - prednisolone

2nd line - immunosuppression

20
Q

when would you change treat with immunosuuppresion in nephritic syndrome?

A

steroid dependant and frequent relapses (>4/year)

21
Q

name an acquired cause of steroid resistant nephrotic syndrome?

A

focl segmental glomerulosclerosis (FSGS)

22
Q

what is the treatment for focal segmental glomerulonephritis (FSGF)?

A

immunosuppression i.e. cyclophosphamide

23
Q

how would you differentiate haemaglobinuria from microscopic haematuria?

A

haemaglobinuria is dipstick positive but microscopy negative

24
Q

what are causes of haematuria?

A 
systemic - clotting factors 
renal - glomerulonephritis 
tumour - wilm's nephroblastoma 
kidney cysts 
malignancies i.e. bladder cancer 
bladder/kidney stones 
UTI 
trauma 
urethritis
25
Q

what are the features of nephritic syndrome?

A 
haematuria and proteinuria 
hypertension
reduced GFR
- oliguria
- fluid overload (raised JVP, oedema)
- hypertension 
- AKI
26
Q

what are the features of nephrotic syndrome?

A

hypoalbuminaemia
hypoproteinuria
oedema

27
Q

is intravascular overload associated with nephrotic or nephritic syndrome?

A

nephritic syndrome

28
Q

a patient presents with haematuria. he was found to have nephritic syndrome.
what immunological tests will you carry out to approach a diagnosis?

A

renal USS
throat swab and ASOT (anti-streptolysin O test)
ANA, ANCA
complement C3 and C4

29
Q

a patient presents with haematuria. he was found to have nephritic syndrome.
what tests would you carry out to approach a diagnosis?

A 
FBC
U&amp;E
creatinine 
albumin 
urine culture (exclude UTI)
protein creatinine ratio (exclude nephrotic syndrome)
30
Q

what immunological test is diagnostic for post-streptococcal glomerulonephritis?

A

ASOT

anti-streptolysin O test

31
Q

what change in complement C3 and C4 is found in post-streptococcal glomerulonephritis ?

A

low C3

normal C4

32
Q

what is the treatment for post- infectious glomerulonephritis?

A

antibiotics
support electrolyte and/or acid base imbalance
correct overload/hypertension with diuretics

33
Q

what is the cause of IgA related vasculitis?

A

non-streptococcal post infectious glomerulonephritis

- any virus can cause this

34
Q

what are the diagnostic features of IgA related vasculitis?

A 
palpable purpura
\+ 1 of the following
- abdominal pain 
- renal involvement
- arthritis or arthralgia 
- biopsy (IgA deposition)
35
Q

is IgA vasculitis granulomatous or non-granulomatous inflammation?

A

non-granulomatous

36
Q

what is the treatment for IgA vasculitis?

A

treat symptomatically for mild disease

severe disease - immunosuppression with prednisolone or cyclophosphamide

37
Q

what are the clinical features of IgA nephropathy?

A

recurrent macroscopic haematuria
+/- chronic microscopic haematuria
varying degree of proteinuria

negative autoimmune workup
normal compliment levels
confirmation biopsy if unsure

38
Q

what is the treatment for mild and severe IgA nephropathy?

A

mild - ACE inhibitors (for proteinuria)

moderate/severe - immunosuppression

39
Q

mutations in which genes are responsible for acquired FSGS?

A

NPHS1 - nephrin

NPHS2 - podocin

Paediatrics (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions