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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
Q

nephrotic proteinuria increase their risk for what type of infection

A
  • encapsulated organisms

- predisposed to infection

26
Q

what values must be ruled out to diagnose nephrotic proteinuria

A

C3
ANA
antistreptococcal

antibodies

27
Q

drug of choice for minimal change disease

A

steroids

28
Q

children who have nephrotic proteinuria and are sensitive to steroids can develop what

A

focal sclerosing glomerulosclerosis

29
Q

do you give antibiotics to HUS caused by e. coli

A

no

30
Q

prognosis for HUS by e. coli

A

good
bad signs: high WBC and prolonged oliguria
complication: toxic megacolon

31
Q

Alport syndrome

A

progressive hereditary nephritis

defect in type IV collagen

32
Q

how is Alport syndrome inherited

A

X-linked dominant

33
Q

clinical manifestations of Alport syndrome

A

hematuria
Hearing loss
ocular: lens and retina

34
Q

treatment of Alport syndrome

A

treat hypertension with ACE inhibitor

35
Q

most common cause of renal mass in newborn

A

multicystic renal dysplasia

36
Q

clinical feature of autosomal recessive polycystic kidney disease

A
  • oligohydramnios
  • pulmonary hypoplasia
  • enlarged kidneys
  • servere hypertension
37
Q

prognosis for autosomal recessive polycystic kidney disease

A

eventually need transplant

38
Q

when does autosomal dominant polycystic kidney disease

A

adulthood

39
Q

most hypertension in childhood is what type

A

secondary hypertension

40
Q

too small of a cuff will give

A

elevated blood pressure

41
Q

PE for hypertension

A

four limb blood pressure

funduscopic examination

42
Q

goal of chronic hypertension

A

maintain BP level below 90th percentile

43
Q

Renal tubular acidosis

A

inability of kidney to maintain normal acid-base balance

  • defects in bicarbonate conservation
  • defects in excretion of hydrogen ions
44
Q

classic electrolyte presentation for RTA

A

hyperchloremic
metabolic acidosis
normal anion gap

45
Q

positive urine anion gap is seen in what RTA

A

distal RTA

46
Q

Management for renal failure

A
  • intravascular volume restored first

- total fluid intake should be restricted to insensible loses and ouput replacement

47
Q

what diet should be restricted in renal failure

A

protein intake

48
Q

what type of dialysis is preferred for infants and children

A

Peritoneal dialysis

49
Q

Preferred treatment for children with end stage renal disease

A

kidney transplant

50
Q

2 causes of bladder outlet obstruction

A
  1. posterior urethral valves in males

2. prune belly syndrome

51
Q

Vesicoureteral reflux

A

urine refluxing from urinary bladder into ureters and renal collecting system

52
Q

what causes Vesicoureteral reflux

A

ureterovescial junction abnormality

53
Q

how is Vesicoureteral reflux inherited

A

autosmal dominant

54
Q

diagnose Vesicoureteral reflux

A

voiding cystourethrogram

55
Q

management for Vesicoureteral reflux

A

lost dose prophylactic antibiotics

56
Q

what should you think when a child has urolithiasis

A

metabolic disorders

57
Q

when should VCUG and renal ultrasound be done for a UTI

A
  • pyelonephritis

- recurrent UTI in all males, and all girls younger than 4 cystitis

58
Q

gold standard diagnosis for UTI

A

urine culture

59
Q

pyelonephritis

A

upper tract infection

60
Q

cystitis

A

lower tract infection

61
Q

how do you get urine from neonates and infants

A
  • suprapubic aspiration of urinary bladder

- sterile urethral catherterization

62
Q

how do you get urine from older children

A

clean catch urine sample

Pediatrics Rotation (19 decks)

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