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Paediatrics > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What is the main sign in nephrotic syndrome?

A

Proteinuria

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2
Q

What is the main sign in nephritic syndrome?

A

Haematuria

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3
Q

What are some acquired glomerulopathies?

A

Minimal change disease
Post-infectious glomerulonephritis
Haemolytic uraemia syndrome
IgA nephropathy

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4
Q

What are some congenital glomerulopathies?

A

Congenital nephrotic syndrome
Alport syndrome
Thin basement membrane disease
Complement regulatory proteins

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5
Q

What is the most common cause of post-streptococcal glomerulonephritis?

A

Beta-haemolytic streptococcal infection

Eg - strep throat, impetigo

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6
Q

When do symptoms of post-streptococcal glomerulonephritis present?

A

Throat - 2-7 days

Skin 2-3 weeks

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7
Q

What are the signs of post-streptococcal glomerulonephritis?

A 
Frank haematuria
Oedema
Hypertension
Fever
Abdominal pain
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8
Q

How is post-streptococcal glomerulonephritis investigated?

A

Urine dipstick - proteinuria, RBC casts, oliguria
Bloods - increased urea and creatinine, decreased C3
Anti-streptolysin raised
Bacterial culture

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9
Q

How is post-streptococcal glomerulonephritis treated?

A

Diuretics
Anti-hypertensive
Penicillin - 10 days

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10
Q

What type of glomerulonephritis is IgA nephropathy?

A

Nephritis

Most common glomerulonephritis

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11
Q

What is the pathology of IgA nephropathy?

A

IgA deposits in the nephrons of the kidneys causes inflammation

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12
Q

What are the signs of IgA nephropathy?

A

Frank haematuria

Abdominal swelling

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13
Q

How is IgA nephropathy investigated?

A

Urine dipstick

Biopsy

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14
Q

How is IgA nephropathy treated?

A

Steroids

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15
Q

What is the pathology of Henoch Schonlein purpura IgA related vasculitis?

A

Inflammation and leaking of blood from small blood vessels

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16
Q

What are the signs of Henoch Schonlein purpura IgA related vasculitis?

A

Purpura - legs
Joint pain
Abdominal pain
IgA nephritis

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17
Q

How is Henoch Schonlein purpura IgA related vasculitis investigated?

A 
FBC, CRP
Blood film
Blood culture
Urine dipstick
BP
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18
Q

How os Henoch Schonlein purpura IgA related vasculitis treated?

A

Analgesia

Hydration

19
Q

What type of glomerulonephritis is minimal change disease?

A

Nephrosis

20
Q

What is the classic triad of minimal change disease?

A

Low serum albumin
Proteinuria
Oedema

21
Q

What are the signs of minimal change disease?

A 
Oedema - peri-orbital
Anorexia
GI disturbance
Irritability
Ascites
Oliguria
22
Q

How is minimal change disease investigated?

A

Urine dipstick - frothy

Blood - decreased albumin

23
Q

How is minimal change disease treated?

A

Steroids - prednisolone

If steroid resistant - cyclophosphamide

24
Q

What is the pathology of haemolytic uraemia syndrome?

A

Thrombosis in small vessels throughout the body

25
Q

What is the classic triad of haemolytic uraemia syndrome?

A

Haemolytic anaemia
Acute kidney injury
Thrombocytopenia

26
Q

What causes haemolytic uraemia syndrome?

A

Typical - post-diarrhoea (Shiga toxin from E. Coli)
Pheumococcal infection
Drugs
(risk period - 2 weeks)

27
Q

What are the signs of haemolytic uraemia syndrome?

A 
Bloody diarrhoea
Oliguria
Haematuria
Hypertension
Abdominal pain
Lethargy
Irritability
28
Q

How is haemolytic uraemia syndrome treated?

A

Monitor 5 kidney functions

Maintain IV fluids

29
Q

What are the causes of acute kidney injury?

A

Rapid rise in creatinine or development of oliguria/anuria
Causes:
Diarrhoea/dehydration
Glomerulonephritis
Drug induced haemolysis
Secondary to – cardiac surgery, bone marrow transplantation, toxicity (NSAIDs, aminoglycosides, vancomycin etc)

30
Q

What are the causes of chronic renal failure?

A 
Congenital dysplastic kidneys
Pyelonephritis
Glomerulonephritis 
Recurrent infection
Reflux nephropathy
AKI leading to cortical necrosis
31
Q

What are the signs of UTI in a baby?

A 
Non-specific
Fever
Lethargy
Irritability
Vomiting
Poor feeding
Frequency
Smelly urine
32
Q

What are the signs of UTI in an infant?

A

Fever
Abdominal/suprapubic pain
Dysuria
Frequency

33
Q

How is UTI investigated?

A 
Urine sample (clean catch) - high nitrates and leukocytes
Urine culture - mid-stream
34
Q

How are UTIs treated?

A

Lower tract - trimethoprim

Upper tract - 3rd generation cephalosporins

35
Q

When should UTIs be investigated further and what would be done?

A

If recurrent:
Ultrasound
Dimercapto-succinic acid scan (DMSA)
Micturating cystourethro-gram (for vesico-ureteric reflux)

36
Q

When do infants have normal kidney function?

A

By age 2/3 - maturation over time

37
Q

What are the functions of the kidneys?

A 
Waste handling
Water handling
Salt balance
Acid base control
Endocrine - red cells, BP, bone health
38
Q

What makes up the glomerular filtration barrier?

A

Endothelial cell
GBM - type IV collagen and laminin
Podocytes
Mesangial cells

39
Q

What part of the nephron is affected in minimal change disease?

A

Epithelial cell (podocyte)

40
Q

What part of the nephron is affected in post-streptococcal glomerulonephritis?

A

Basement membrane

41
Q

What part of the nephron is affected in haemolytic uraemia syndrome?

A

HUS

42
Q

What part of the nephron is affected in IgA nephropathy?

A

Mesangial cell

43
Q

What are the causes of chronic kidney disease?

A

Congenital anomalies of the kidney and urinary tract (CAKUT) - 55% (reflux nephropathy, dysplasia, obstructive uropathy)
Hereditary - 17%
Glomerulonephritis - 10%

Paediatrics (17 decks)

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