Nephrology and Urology

Question 1

Normal systolic values for neonate, 1yr, 5yr, 12 yr

Answer 1

70mmKg, 90, 95, 100

Question 2

Which broad categories should be included in the DDx of hypertension in peds?

Answer 2

Renal dz, Endocrine, neurologic, psychologic, vascular, drugs

Question 3

Which is more common in peds, primary or secondary HTN?

Answer 3

Secondary HTN

Question 4

Labs show red urine w/evidence of blood, but no RBCs on microscopy, think:

Answer 4

free hgb (hemolysis, DIC) or free myoglobin (crush injury, burns, myositis)

Question 5

Labs show evidence of blood but no RBC casts, think:

Answer 5

bleeding from urinary tract distal to renal tubules

Question 6

Labs show red urine w/RBCs and Casts, think:

Answer 6

glomerular dz: post-strep glomerulonephritis, Allport syndrome, vascular injury

Question 7

When is a renal biopsy indicated?

Answer 7

persistent hematuria, hematuria + decreased renal fxn, proteinuria >150mg/24hrs, 2nd+ episode

Question 8

What are s/sx’s of post-streptococcal glomerulonephritis?

Answer 8

5-21d after infxn, gross hematuria, edema, HTN/HA/vision change. Labs show increased ASO, + GAS, decreased C3

Question 9

What is the tx for post-strep glomerulonephritis?

Answer 9

abx, anti-HTN meds, diuretics, reduce salt

Question 10

How does IgA nephropathy (Berger dz) present?

Answer 10

gross hematuria/brown urine post URI, acute renal failure, proteinuria, HTN, ESRD 20 yrs later! Usually resolves on own

Question 11

How does systemic lupus erythematosus present?

Answer 11

malar rash, photosensitivity, oral ulcers, arthritis, renal dz, hematologic dz, serositis, seizure, + ANA

Question 12

What is the definition of proteinuria?

Answer 12

Protein loss of 50mg/kg/24hrs

Question 13

What are signs of nephrotic syndrome?

Answer 13

Proteinuria, hyperlipidemia, edema, hypoalbuminemia. acute wt gain, acsites, pitting edema (facial edema 1st), fatigue

Question 14

What should be in the DDx for nephrotic syndrome?

Answer 14

transient proteinuria, orthostatic proteinuria, glomerular proteinuria, minimal change disease, 
congenital nephrotic syndrome,
focal segmental glomerulosclerosis,
mesangial nephropathy,
membranous nephropathy

Question 15

What is the MCC nephrotic syndrome in peds?

Answer 15

Minimal-change disease

Question 16

Tx of nephrotic syndrome?

Answer 16

corticosteroids, low salt diet, immunosuppressants

Question 17

What is the MCC of neonatal ascites?

Answer 17

Posterior urethral valves

Question 18

What is the MCC of acute renal failure in peds?

Answer 18

Hemolytic Uremic Syndrome (HUS)

Question 19

What are the 3 MC organisms in bacterial peritonitis?

Answer 19

Strep pneumoniae, E. coli, Klebsiella

Question 20

What is Henoch Schonlein Purpura?

Answer 20

IgA mediated inflammatory d/o charachterized by general vasculitis of skin, GI tract, joints, kidneys.

Question 21

What are the s/sx’s of HSP?

Answer 21

hematuria, edema, HTN, rash/purpura, abd pain, arthralgias, vomiting, renal failure (NAPA = nephritis, arthralgias, purpura, abdominal pain)

Question 22

What are s/sx’s of HUS?

Answer 22

anemia, uremia, renal failure, thrombocytopenia, abd pain, diarrhea, prev illness or recent beef consumption, neuro changes

Question 23

What is the DDx of hematuria (DOGSHIT)?

Answer 23

Drugs, oncologic, glomerulonephritis, stones, hematologic, infxn/iatrogenic, trauma

Question 24

HUS most commonly follows infxn w/what pathogen?

Answer 24

E. coli O157:H7

Question 25

What are characteristics of nephrotic syndrome?

Answer 25

Proteinuria >3g/d, hypoalbuminemia, hyperlipidemia, edema

Question 26

What are characteristics of nephritis syndrome?

Answer 26

Hematuria, RBC casts, HTN, oliguria, inflammation (-itic sounds like -itis)