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Pediatrics > Nephrology/Urology > Flashcards

Nephrology/Urology Flashcards

1
Q

Electrolyte requirements

A

Na - 1 mEq/kg
K - 2 mEq/kg
Cl - 3 mEq/kg

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2
Q

Volume of distribution

A

0.6 x wt x 1L/kg

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3
Q

Osmolarity calculation

A

2NA + BUN/2.6 + glucose/18

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4
Q

Electrolyte disturbances in hypernatremic dehydration

A

Hyperglycemia, hypocalcemia

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5
Q

FENa calculation

A

(Una x Pcr)/(Ucr x Pna)

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6
Q

FENa in prerenal AKI

A

< 1%

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7
Q

RAS stimulation

A

decreased renal perfusion

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8
Q

Angiotensin II effects

A

vasoconstriction, renal effects (efferent vasoconstriction, Na reabsorption, aldosterone secretion), ADH secretion

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9
Q

Aldosterone effects

A

Na reabsorption, K secretion

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10
Q

ANP effects

A

vasodilation, renal effects (dilates afferent/constricts efferent, decrease Na reabsorption, decrease RAS)

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11
Q

Diagnosis of nephrotic syndrome

A

Proteinuria (> 40 mg/mg2/hr)
Edema
Elevated cholesterol

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12
Q

False positive for protein on UA

A

pH > 7.5

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13
Q

FSGS diagnosis

A

Nephrotic syndrome NOT responsive to steroids

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14
Q

FSGS prognosis

A

50-70% progress to CKD (30% relapse in transplant)

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15
Q

Nephrotic syndrome causes

A

Primary (90%) - MCD&raquo_space;> FSGS > MPGN

Secondary (10%) - HSP, SLE, HUS

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16
Q

Renal disease with decreased C3

A

PSGN, MPGN, SLE nephritis

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17
Q

Congenital nephrotic syndrome genetics

A

AR

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18
Q

Congenital nephrotic syndrome findings

A

Oligohydramnios, large placenta, presentation < 1 yo, death by E. coli sepsis

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19
Q

MCD age group

A

preschool

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20
Q

Complications of MCD

A

peritonitis (s. pneumo, e. coli), thrombosis

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21
Q

Treatment of refractory MCD

A

cyclophosphamide, cyclosporine

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22
Q

Most common vasculitis in children

A

HSP

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23
Q

HSP pathogenesis

A

IgA deposition

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24
Q

HSP findings

A

Palpable purpura, abdominal pain (intussusception), arthralgia/arthritis, renal dz

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25
Q

HSP diagnosis

A

clinical (biopsy reserved for atypical cases)

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26
Q

Indications for glucocorticoids in HSP

A

abdominal pain (NOT indicated for renal dz)

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27
Q

Recurrence rate of HSP

A

up to 1/3 (screen with UA every 6 mo)

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28
Q

HUS findings

A

microangiopathic hemolytic anemia, AKI, thrombocytopenia

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29
Q

HUS prognosis

A

5% mortality, 5% complictions

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30
Q

Risk factors for development of HUS

A

antimobility agents, vomiting (if < 5.5 yo), WBC > 13 K

31
Q

ARPKD presentation

A

Infant - enlarged kidney, pulmonary hypoplasia, highest mortality
Children - liver fibrosis, less renal dz

32
Q

Most common cause of congenital hydronephrosis

A

UPJ obstruction

33
Q

Prophylactic antibiotics in VUR

A

For patients 2-24 mo

34
Q

Prune belly syndrome eponym

A

Eagle-Barrett syndrome

35
Q

Prune belly syndrome findings

A

lack of abd. muscles, cryptorchidism, GU abnormalities

36
Q

RTA type 1

A

Distal - inability to secrete H+ causes severe acidosis

37
Q

RTA type 2

A

Proximal - inability to reabsorb HCO3

38
Q

RTA type 4

A

Deficiency or resistance to aldosterone (decreased K+, mild acidosis

39
Q

Alport genetics

A

X-linked

40
Q

Alport defect

A

type IV collagen

41
Q

Alport findings

A

Glomerulonephritis, hearing loss, ocular abnormalities

42
Q

Cystinosis genetics

A

AR

43
Q

Cystinosis defect

A

defect in lysosomal transport

44
Q

Liddle syndrome genetics

A

AD

45
Q

Liddle syndrome defect

A

“gain on function” of aldosterone sensitive Na channels –> HTN, hypokalemia, alkalosis

46
Q

Membranous glomerulonephritis association

A

HBV

47
Q

Diagnosis of metabolic syndrome

A

3/5 of obesity, HTN, insulin resistance, hyperlipidemia, hyperglycemia

48
Q

Most common cause of severe HTN in childhood

A

renal artery stenosis

49
Q

Lethal side effect of metformin

A

lactic acidosis

50
Q

Causes of anion gap acidosis

A

Methanol, Uremia, DKA, Paraldehyde, Inborn EM, Lactic acidosis, Ethylene glycol, Salicylate

51
Q

Ammonium chloride (acid load) test

A

Expect acidification (pH < 5.5) of urine (does NOT happen in RTA type 1)

52
Q

Diagnosis of RTA type 2

A

24-hour urine collection (?Fanconi syndrome)

53
Q

Unilateral cystic kidney

A

Multicystic dysplastic kidney

54
Q

Multiscystic dysplastic kidney association

A

VUR (40%)

55
Q

PSGN treatment

A

symptomatic - ie diuretic if HTN

56
Q

Hypokalemia metabolic acidosis

A

Bartter syndrome, Gitelman syndrome

57
Q

Bartter syndrome

A

Hypercalciuria, nephrocalcinosis, polyhydramnios

58
Q

Gitelman syndrome

A

Hypocalcemia, hypomagnesemia, salt-wasting

59
Q

Most common cause of abdominal mass in a newborn

A

multicystic dysplastic kidney

60
Q

Management of UPJ obstruction

A

surgical intervention if decreased ipsilateral function on renal scan

61
Q

2nd most common cause of prenatal hydronephrosis

A

megaureter

62
Q

Management of hypospadias and unilateral undescended testicle

A

karyotype - possible mixed gonadal dysgenesis (45 XO, 46 XY)

63
Q

Radiographic evaluation of undescended testicle

A

unnecessary

64
Q

Age of orchidopexy

A

6-12 months

65
Q

Rate of foreskin retraction

A

1 yr - 50%, 5 yr - 90%

66
Q

Balanoposthitis

A

inflammation of prepuce and glans

67
Q

Paraphimosis

A

foreskin stuck in retracted position

68
Q

Most common complication of circumcision

A

meatitis leading to meatal stenosis

69
Q

Hypospadias location

A

ventral side (underside)

70
Q

Medical management of bladder instability

A

oxybutynin (SE: dry mouth, facial flushing, constipation)

71
Q

Management of enuresis

A

bedwetting alarm, desmopressin, imipramine

72
Q

Indication for management of varicocele

A

ipsilateral testicular hypotrophy

73
Q

Management of torsion of appendix testis

A

NSAIDs

74
Q

Age range for testicular torsion and torsion of appendix testis

A

appendix testis - pre-pubertal

testicular torsion - pubertal boys

Pediatrics (14 decks)

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