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1. Pediatrics > Nephrology and Urology > Flashcards

Nephrology and Urology Flashcards

1
Q

Osmolality calculation: ___

A

Osm = 2[Na+] + glucose/18 + BUN/2.8

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2
Q

[Neph/Elec/Hyponatremia]

Types of Hypovolemic Hyponatremia (2) and treatment?

A
  1. Renal loss: Diuretics, Adrenal insufficiency, Salt wasting
  2. Non-renal loss: GI, 3rd spacing
  • Treatment: Normal saline
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3
Q

[Neph/Elec/Hyponatremia]

Types of Euvolemic Hyponatremia (4) and treatment?

A
  1. SIADH
  2. Psychogenic polydipsia
  3. Hypothyroidism
  4. Glucocorticoid deficiency
  • Treatment: Restrict water, 3% saline if symptomatic
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4
Q

[Neph/Elec/Hyponatremia]

Types of Hypervolemic Hyponatremia (2) and treatment?

A
  1. Edema: HF, Cirrhosis, nephrotic syndrome
  2. RF: ARF, CRF
  • Treatment: Diuretics, Restrict water and sodium
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5
Q

[Neph/Elec/Hypernatremia]

Types of Hypovolemic Hypernatremia (2) and treatment?

A
  1. Renal losses: Osmotic diuretics
  2. Non-renal: Sweating
  • Treatment: Water and normal saline
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6
Q

[Neph/Elec/Hypernatremia]

Types of Euvolemic Hypernatremia (1) and treatment?

A
  1. Diabetes insipidus: central, nephrogenic
  • Treatment:
    Central: ADH
    Nephrogenic: Thiazide
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7
Q

[Neph/Elec/Hypernatremia]

Types of Hypervolemic Hypernatremia (2) and treatment?

A
  1. Salt water drowning
  2. Resuscitation
  • Treatment: Diuretics
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8
Q

[Neph/DI]

Causes of nephrogenic DI (4)?

A
  1. Hereditary vasopressin receptor defect
  2. Hypercalcemia, chronic hypokalemia
  3. Intrinsic renal disease (Sjogren syndrome)
  4. Drugs: lithium
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9
Q

[Neph/Elec]

Which electrolyte imbalance?

Sx: weakness, paralysis
EKG: tall T, short QT interval, prolonged PR, QRS

A

Hyperkalemia

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10
Q

[Neph/Elec]

Which electrolyte imbalance?

Sx: decreased DTR, rhabdomyolysis
EKG: U waves

A

Hypokalemia

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11
Q

[Neph/Hyperaldosteronism]

Bartter vs Gitelman vs Liddle

Neonate with severe dehydration
Normal BP
High urine calcium (stones, hypocalcemia)
High aldosterone
High renin
Associated with deafness

A

Batter syndrome (Batter high urine calcium)
: in the thick ascending limb of the loop of Henle
-> cannot reabsorb sodium and chloride
-> Save Na+, Loses H+ and K+ in the distal tubules

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12
Q

[Neph/Hyperaldosteronism]

Bartter vs Gitelman vs Liddle

5-10 years old, tetany, muscle weakness (hypercalcemia)
Normal BP
Hypokalemia
Low urine calcium
High aldosterone
High renin

A

Gitelman syndrome (Gitel low urine calcium)
: in the distal convoluted tubule
-> defect of sodium-chloride cotransporter
-> Hypomagnesemia -> Hypocalcemia

-> Salt wasting -> High aldo, renin -> Hypokalemia

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13
Q

[Neph/Hyperaldosteronism]

Bartter vs Gitelman vs Liddle and its treatment?

Hypertension
Hypokalemia
Low renin/aldosterone

A

Liddle syndrome (Liddle HTN)
: in the collecting duct
-> enhanced sodium channel absorption (ENaC)
-> Hypertension, Hypokalemia, Low Renin & Aldo

  • Treatment: Amiloride, triamterene
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14
Q

[Neph/Elec]

Which electrolyte imbalance and its treatment?

Sx: Depression, confusion, constipation
EKG: short QT interval, ST-elevation

A

Hypercalcemia

  • Treatment: Calcitonin and bisphosphates
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15
Q

[Neph/Acid-base]

Calculation for
Serum anion gap: ___
Urine anion gap: ___

A

Serum AG: Na+ - Cl- - HCO3- (normal: 6-12)
Urine AG: Na+ + K+ - Cl- (normal: 0-10)

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16
Q

[Neph/Acid-base]

Calculation for
Respiratory compensation: ___
Metabolic compensation: ___

A

Resp: changes in CO2/10 * constant (1, 2, 4, 5) = HCO3-
Met: HCO3- + 15 = CO2
If HCO3- < 10, 1 Bicarb + 0.5 Bicarb + 8

17
Q

[Neph/Acid-base/MetAlk]

Types of Metabolic Alkalosis (2)

A
  1. Chloride Responsive (UCl < 10)
    GI loss
    Diuretics
    After hypercapnia, Cystic fibrosis
    1. Chloride Resistant (UCl > 10)
      With HTN: Cushing, Liddle, Primary aldosteronism
      Without HTN: Batter, Gitelman
18
Q

[Neph/Acid-base/MetAci]

Causes of High Anion Gap Metabolic Acidosis?

MUDPILES

A

Methanol
Uremia
Diabetic Ketoacidosis
Propylene glycol
Iron, Isoniazide, Inborn Error
Lactic acidosis
Ethanol/ethylene gycol
Salicylate

19
Q

[Neph/Acid-base/MetAci]

Causes of Normal Anion Gap Metabolic Acidosis (NAGMA) (2)?

A
  1. NAGMA + Hyperkalemia
    Type 4 RTA (Hypoaldosteronism)
  2. NAGMA + Hypokalemia
    GI loss (Urine AG negative)
    Type 1 or 2 RTA (Urine AGG positive)
20
Q

[Neph/GN]

Glomerulonephritis with hypocomplementemia (4)?

A
  1. PIGN (postinfectious GN)
  2. MPGN (membranoproliferative GN)
  3. SLE
  4. HUS (Hemolytic Uremic Syndrome, = complement-mediated TMA)
21
Q

[Neph/GN]

Complement levels in C3, C4 for differentials?

PIGN: C3 ___ C4 ___
SLE: C3 ___ C4 ___
MPGN: C3 ___ C4 ___

A

PIGN: C3 low (transient ~12w), C4 normal
SLE: C3 low, C4 low
MPGN: C3 low (persistent), C4 low, but not in C3 nephropathy

22
Q

[Neph/GN]

Which syndrome?

Hematuria
Hemoptysis

A

GoodPasture syndrome (GN and Pulmonary)

Renal: anti-GBM disease

23
Q

[Neph/GN]

Examples of nephrotic syndrome (3)?

A

FSGS (Focal segmental glomerulosclerosis)
Membranous nephropathy
MPGN (Membranoproliferative GN)

24
Q

[Neph/RTA]

Which type and causes (3)?

Urine pH > 5.5
Hypokalemia
Hypercalciuria
Stones, hearing loss

A

Type 1 RTA (Decreased H+ secretion)

  • Causes:
    Autoimmune (SLE, Sjogren, RA)
    Hereditary
    Drugs (Ampo B, lithium)
25
Q

[Neph/RTA]

Which type and causes (4)?

Urine pH < 5.5
Low or normal K+

A

Type 2 RTA (Increased HCO3- resorption)

  • Causes:
    Dr: Acetazolamide, ifosfamide, 6-MP
    Heavy metal: lead, copper, mercury
    Cystinosis
    Prematurity

If also low phos, low amino acids, PU; Fanconi syndrome
(Fanconi anemia = pancytopenia, short stature)

26
Q

[Neph/RTA]

Which type and causes (4)?

Urine pH < 5.5
Hyperkalemia

A

Type 4 RTA (hypoaldosteronism)

  • Causes:
    Obstructive uropathy
    Chronic interstitial nephritis
    Drugs: NSAIDs, ACEIs, spironolactone
27
Q

[Neph/NPH]

Which nephronophthisis?

Polyuria, polydipsia, FTT
Salt-waisting nephropathy without HU, PU
Cysts at corticomedullary border
Congenital oculomotor apraxia

A

Juvenile Nephronophthisis Type 1

Senior-Loken syndrome: with retinitis pigmentosa
Joubert syndrome: with cerebella aplasia and coloboma

28
Q

[Neph/AKI]

Drugs and kidney related side effects?

Amphtericin B: ___
Cisplatin: ___
Ifosfamide: ___
Mitoycin C: ___

A

Amphtericin B: type 1 RTA
Cisplatin: nephrotoxic, AIN
Ifosfamide: Fanconi syndrome
Mitoycin C: HUS

29
Q

[Neph/CKD]

Complications of renal transplantation (3)?

A
  1. Cataracts
  2. Posttransfusion hepatitis
  3. Aseptic necrosis of femoral heads (pain refers to knees)
30
Q

[Neph/Stones]

Infectious causes of struvite (4)?

SPPY

A

Staphylococcus
Proteus
Pseudomonas
Yeast

31
Q

[Neph/Enuresis]

Diagnostic criteria for nocturnal enuresis
Treatment after failed behavior modification

Children age > ___ years old and ≥ ___ times for ≥ ___ months

A

Children age > 5 years old and ≥ 2/week for ≥ 3 months

Treatment:
- Desmopressin

32
Q

[Uro/Torsion]

Diagnosis?
Treatment?

Between 7 and 14 years old
Blue dot in the upper pole

A

Testicular appendage torsion

  • Treatment:
    Spontaneous resolution, supportive care
33
Q

[Neph/PKD]

ARPKD vs ADPKD

Newborn or prenatal finding of enlarged echogenic kidneys
Potter syndrome (oligohydramniosis, pulmonary hypoplasia, flat face, club feet)

Later associated with Calori disease (intrahepatic bile duct dilatation), hepatic fibrosis, splenic squestration

A

ARPKD
(Autosomal Recessive Polycystic Kidney Disease)

34
Q

[Neph/PKD]

ARPKD vs ADPKD

Adolescent or adulthood
Cysts in kidney, liver, pancreas

Associated with cerebral aneurysm, valvular disease, abdominal wall hernia

A

ADPKD
(Autosomal Dominant Polycystic Kidney Disease)

35
Q

[Uro]

Diagnosis and treatment?

Dysuria, frequency, difficulty voiding, bleeding at the end of urination
“doughnut shaped” mass

A

Urethral prolapse

  • Treatment:
    Topical estrogen cream
36
Q

[Neph/Elect]

Complications for rapid correction?

Hyponatremia: ___
Hypernatremia: ___

A

Hyponatremia: osmotic demyelination syndrome, (central pontine myelinosis)
Hypernatremia: cerebral edema

1. Pediatrics (22 decks)

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