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Pediatrics Rotation > Nephrology and Urology > Flashcards

Nephrology and Urology Flashcards

1
Q

2 phases of parenteral rehydration

A
  1. Emergency phase

2. Repletion phase

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2
Q

what is given during emergency phase

A 
normal saline (20)
lactated Ringers
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3
Q

Hypernatremic dehydration

A

done over 48 hours to minimize risk of cerebral edema

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4
Q

hyponatremic or isonatremid redehydration

A

over 24 hours

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5
Q

how does oral dehydration work

A

absorption of electrolytes is enhanced by active absorption of glucose

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6
Q

what can cause a false-negative result urinary dipstick

A

ascorbic acid ( vitamin C)

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7
Q

what does urinary dipstick detect

A

RBC, protein in urine

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8
Q

Most accurate method of detecting proteinuria? but in children….

A

24 hours urinary protein collection

- random spot urine total protein-to-creatine ration

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9
Q

orthostatic protienuria

A

protein excretion upright but not supine

- benign

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10
Q

what in the urine will indicate tubular proteinuria

A
  1. beta2-microglobulin

2. glucosuria and aminoaciduria

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11
Q

signs of acute nephritic syndrome

A
  • gross hematuria
  • hypertension
  • fluid overload from renal insufficiency
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12
Q

Less common causes of postinfectious glomerulonephritis are

A

HIV

Hep B and C

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13
Q

Low serum levels of what is found in post streptococcal glomerulonephritis

A

complement

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14
Q

renal biopsy for post streptococcal glomerulonephritis shows

A

mesangial cell proliferation

increased mesangial matrix

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15
Q

antibiotic use of Strep throat reduces the risk of what

A

rheumatic fever not kidney problem

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16
Q

most common chronic glomerulonephritis worldwide

A

IgA nephropathy

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17
Q

what ethnic groups get IgA nephropathy

A

Asia
Australia
Native Americans

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18
Q

clinical feature of IgA nephropathy

A

gross hematuria

respiratory infections

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19
Q

Management of IgA nephropathy

A

supportive

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20
Q

Henoch-Schonlein purpura

A

IgA-mediated vasculitis

  • palpable purpura on buttocks/ thigh
  • abdominal pain
  • arthritis
  • hematuria
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21
Q

Membranoproliferative glomerulonephritis

A

lobular mesangial hypercellularity

thickening of glomerular basement membrane

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22
Q

Membranoproliferative glomerulonephritis management

A

no definitive treatment

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23
Q

most common cause of primary nephrotic syndrome

A

minimal change disease

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24
Q

clinical feature of nephrotic proteinuria

A

edema followed by upper respiratory infection

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25
nephrotic proteinuria increase their risk for what type of infection
- encapsulated organisms | - predisposed to infection
26
what values must be ruled out to diagnose nephrotic proteinuria
C3 ANA antistreptococcal antibodies
27
drug of choice for minimal change disease
steroids
28
children who have nephrotic proteinuria and are sensitive to steroids can develop what
focal sclerosing glomerulosclerosis
29
do you give antibiotics to HUS caused by e. coli
no
30
prognosis for HUS by e. coli
good bad signs: high WBC and prolonged oliguria complication: toxic megacolon
31
Alport syndrome
progressive hereditary nephritis | defect in type IV collagen
32
how is Alport syndrome inherited
X-linked dominant
33
clinical manifestations of Alport syndrome
hematuria Hearing loss ocular: lens and retina
34
treatment of Alport syndrome
treat hypertension with ACE inhibitor
35
most common cause of renal mass in newborn
multicystic renal dysplasia
36
clinical feature of autosomal recessive polycystic kidney disease
- oligohydramnios - pulmonary hypoplasia - enlarged kidneys - servere hypertension
37
prognosis for autosomal recessive polycystic kidney disease
eventually need transplant
38
when does autosomal dominant polycystic kidney disease
adulthood
39
most hypertension in childhood is what type
secondary hypertension
40
too small of a cuff will give
elevated blood pressure
41
PE for hypertension
four limb blood pressure | funduscopic examination
42
goal of chronic hypertension
maintain BP level below 90th percentile
43
Renal tubular acidosis
inability of kidney to maintain normal acid-base balance - defects in bicarbonate conservation - defects in excretion of hydrogen ions
44
classic electrolyte presentation for RTA
hyperchloremic metabolic acidosis normal anion gap
45
positive urine anion gap is seen in what RTA
distal RTA
46
Management for renal failure
- intravascular volume restored first | - total fluid intake should be restricted to insensible loses and ouput replacement
47
what diet should be restricted in renal failure
protein intake
48
what type of dialysis is preferred for infants and children
Peritoneal dialysis
49
Preferred treatment for children with end stage renal disease
kidney transplant
50
2 causes of bladder outlet obstruction
1. posterior urethral valves in males | 2. prune belly syndrome
51
Vesicoureteral reflux
urine refluxing from urinary bladder into ureters and renal collecting system
52
what causes Vesicoureteral reflux
ureterovescial junction abnormality
53
how is Vesicoureteral reflux inherited
autosmal dominant
54
diagnose Vesicoureteral reflux
voiding cystourethrogram
55
management for Vesicoureteral reflux
lost dose prophylactic antibiotics
56
what should you think when a child has urolithiasis
metabolic disorders
57
when should VCUG and renal ultrasound be done for a UTI
- pyelonephritis | - recurrent UTI in all males, and all girls younger than 4 cystitis
58
gold standard diagnosis for UTI
urine culture
59
pyelonephritis
upper tract infection
60
cystitis
lower tract infection
61
how do you get urine from neonates and infants
- suprapubic aspiration of urinary bladder | - sterile urethral catherterization
62
how do you get urine from older children
clean catch urine sample

Pediatrics Rotation (19 decks)

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