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Paediatrics > Nephrology > Flashcards

Nephrology Flashcards

1
Q

What does proteinuria mean in glomerular disease?

A

Glomerular injury

Nephrotic syndrome

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2
Q

What causes haemolytic uraemic syndrome?

A

Acute kidney injury

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3
Q

What are 5 functions of the kidneys?

A 
Waste handling
Water handling
Salt balance
Acid/base control
Endocrine
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4
Q

What are some endocrine functions of the kidneys?

A

Red cells
Blood pressure
Bone health

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5
Q

What are podocytes?

A

Specialized epithelial cells that cover the outer surfaces of glomerular capillaries

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6
Q

What do podocytes produce?

A

Podocin

Nephrin

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7
Q

What is the GBM?

A

Glomerular basement membrane (GBM) is the extracellular matrix component of the selectively permeable glomerular filtration barrier
Made of type IV collagen and laminin

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8
Q

What does the GBM do?

A

Separates vasculature from urinary space

Synthesis of podocytes and endothelial cells

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9
Q

What do mesangial cells do?

A

Glomerular structural support
Embedded in GBM
Regulates blood flow of the glomerular capillaries

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10
Q

What are some signs of nephritic syndrome?

A

Increasing haematuria

Intravascular overload

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11
Q

What are some signs of nephrotic syndrome?

A

Increasing proteinuria

Intravascular depletion

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12
Q

Which component is affected in minimal change disease?

A

Epithelial cell

Podocyte

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13
Q

Which component is affected in post infectious glomerulonephritis (PIGN)?

A

Basement membrane

Endothelial cell

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14
Q

Which component is affected in haemolytic uraemic syndrome (HUS)?

A

Endothelial cell

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15
Q

Which component is affected in HSP or IgA nephropathy?

A

Mesangial cells

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16
Q

What is a drawback of dipstix for measuring proteinuria concentration?

A

False positives and negatives

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17
Q

What is the gold standard for measuring proteinuria concentration?

A

24hr urine collection

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18
Q

What is the nephrotic range in protein creatinine ratio testing?

A

> 250mg/mmol

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19
Q

How does nephrotic range proteinuria affect fluid?

A

Hypoalbuminaemia

Results in oedema and increasing 3rd space fluid volume

20
Q

How might nephrotic range proteinuria present?

A 
Pale
Inflated weight
Periorbital oedema
Pitting oedema
Ascites
Pleural effusion
Low BP
Frothy urine
21
Q

How would bloods be affected in nephrotic syndrome?

A

Normal creatinine

Low albumin

22
Q

How do we manage nephrotic syndrome?

A

Prednisolone 8 weeks

23
Q

What are some possible causes of haematuria?

A 
Clotting disorders
Glomerulonephritis
Wilm's tumour
Cyst
Sarcoma
Stones
UTI
Trauma
Urethritis
24
Q

What are some consequences/features of nephritic syndrome?

A 
Haematuria
Proteinuria
Reduced GFR
Oliguria
Fluid overload
HT
25
Q

What are the usual causes of acute post-infectious glomerulonephritis?

A

Usually group A strep

Beta hemolytic

26
Q

What is the go-to imaging technique for glomerulonephropathy?

A

Renal USS

27
Q

How is Acute Post-Infectious Glomerulonphritis diagnosed?

A

Bacterial culture
Positive ASOT
Low C3 normalises

28
Q

How is Acute Post-Infectious Glomerulonphritis managed?

A

Self-limiting
Antibiotic
Electrolytes to support renal function
Diuretics to help fluid overload

29
Q

What is the most common glomerulonephritis?

A

IgA nephropathy

30
Q

How do we diagnose IgA nephropathy?

A

Negative autoimmune workup

Confirmation biopsy

31
Q

How do we treat proteinuria in IgA nephropathy?

A

ACEi

32
Q

What is KDIGO?

A

KDIGO defines AKI as any of the following:

Increase in serum creatinine by 0.3mg/dL or more within 48 hours or

Increase in serum creatinine to 1.5 times baseline or more within the last 7 days or

Urine output less than 0.5 mL/kg/h for 6 hours

33
Q

What is Henoch Schonlein purpura?

A

IgA related vasculitis

34
Q

How does Henloch Schonlein purpura present?

A

Abdominal pain
Renal involvement
Arthritis/arthralgia
4-6 weeks duration

35
Q

How does AKI present?

A

Anuria/oliguria
HT with fluid overload
Rapid rise in plasma creatinine

36
Q

What are some features of HUS?

A

Haemolysis
Thrombocytopenia
AKI

37
Q

What are 5 things to monitor in HUS?

A 
Fluid balance
Electrolytes
Acidosis
Waste
Hormones
38
Q

Which factor may cause presentation of CKD to vary?

A

Kidney functions affected

39
Q

How might a uraemic cause of CKD present?

A

Weight loss
Loss of appetite
Itch

40
Q

How might a water handling problem causing CKD present?

A

Polyuria

41
Q

Which functions may be affected when CKD presents with lethargy?

A

Salt balance

Acid/base

42
Q

How might an endocrine caused CKD present?

A

Lethargy

Reduced effort tolerance

43
Q

Why is papilla shape significant in UTI?

A

Concave associated with intra renal reflux and found in the renal poles
The most common place for renal scaring

44
Q

What are some useful antibiotics if UTI causing HUS?

A

Trimethoprim
Co-amoxiclav
Cephalosporin

45
Q

What are some bloods in metabolic bone disease?

A

High phosphate
Increase PTH
High PTH causes metabolic bone disease and CV disease

46
Q

What are some treatment principles of metabolic bone disease?

A

Low phosphate diet
Phosphate binders
Active Vitamin D

Paediatrics (25 decks)

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