Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Paediatric Nephrology > Flashcards

Paediatric Nephrology Flashcards

1
Q

What is the normal GFR for a neonate and a 2yr old?

A
  • Neonate: 20-30ml /min/1.73m2

- 2yrs: equals adult 90-120

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the five functions of the kidneys?

A
  • Waste handling
  • Water handling
  • Salt balance
  • Acid base control
  • Endocrine: red cells/ blood pressure/ bone health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the components of the glomerular filtration barrier

A
  • Endothelial cell
  • GBM
  • Podocyte
  • Mesangial cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is proteinuria a sign of?

A

Glomerular injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the features of nephritic syndrome?

A
  • Increasing haematuria

- Intravascular overload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the features of nephrotic syndrome?

A
  • Increasing proteinuria

- Intravascular depletion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name some of the common acquired glomerulopathies and which component they affect

A
  • Minimal change disease: podocytes
  • Post infectious glomerulonephritis: basement membrane and endothelial cell
  • Haemolytic uraemic syndrome: endothelial cell
  • HSP/IgA nephropathy: mesangial cell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name some of the congenital (rare) glomerulopathies

A
  • Congenital nephrotic syndrome
  • Alport syndrome
  • Thin basement membrane disease
  • Membranoproliferative glomerulonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How can proteinuria be measured and how much is abnormal?

A
  • Dipstix: > 3+
  • Protein creatinine ration >250mg/mmol is nephrotic
  • 24hr urine collection > 1g/m2/24hrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the features of nephrotic syndrome?

A
  • Nephrotic range proteinuria
  • Haematuria (not frank)
  • Hypoalbuminaemia
  • Oedema
  • Low albumin
  • Normal creatinine, blood pressure and renal function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the atypical features of nephrotic syndrome?

A
  • Suggestion of autoimmune disease
  • Abnormal renal function
  • Steroid resistance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can nephrotic syndrome be treated?

A

Prednisolone for 8 weeks (if typical features)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the side effects of high dose glucocorticoids?

A
  • Personality changes
  • Hypertension
  • Increased in GI acid
  • Reduced growth
  • Increased susceptibility to infection (think of varicella status, pneumovax and antibiotic prophylaxis)
  • Sleep disturbance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of steroid resistant nephrotic syndrome

A
  • Acquired: focal segmental glomerulosclerosis

- Congenital: infant presentations, NPHS1/2 and podocyte loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of haematuria?

A
  • Clotting disorders
  • Glomerulonephritis
  • Tumours
  • Cysts
  • Stones
  • UTI
  • Trauma
  • Urethritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can frank haematuria be investigated?

A
  • Bloods: creatinine, U&Es, FBC and albumin

- Urine: urine culture and protein creatinine ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the features of nephritic syndrome?

A
  • Haematuria
  • Proteinuria
  • Oliguria
  • Fluid overload: raised JVP and oedema
  • Hypertension
  • Self limiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can post infectious glomerulonephritis be investigated?

A
  • Renal USS
  • ASOT
  • Throat swab fro group A strep
  • C3
  • Autoimmune immunology
  • Biopsy is not required
19
Q

How can acute post infectious glomerulonephritis be treated?

A
  • Antibiotics
  • Support of renal function (electrolyte and acid base)
  • Diuretics (overload/hypertension)
20
Q

What are the features of IgA related vasculitis (Henoch Schonlein purpura)?

A
  • Non strep post infectious GN (1-3 days after infection)
  • Palpable purpura plus one of:
  • Abdo pain
  • Renal involvement
  • Arthritis or arthralgia
  • Biopsy
21
Q

How can IgA vasculitis be treated?

A
  • Symptomatic
  • Glucocorticoid (not in mild)
  • Immunosuppression
  • Long term hypertension and proteinuria screening
22
Q

How does IgA nephropathy present?

A
  • Older children and adults
  • Recurrent macroscopic haematuria +/- chronic microscopic haematuria
  • Varying degree of proteinuria
23
Q

How can IgA nephropathy be diagnosed?

A
  • Clinical picture
  • Negative autoimmune workup
  • Confirmation biopsy
24
Q

How can IgA nephropathy be treated?

A
  • Mild: ACE inhibitors

- Moderate to severe: immunosuppression

25
Q

What is the definition of an acute kidney injury?

A

Abrupt loss of kidney function, resulting in the retention of urea and other nitrogenous waste products and in the dysregulation of extracellular volume and electrolytes

26
Q

What are the features of acute renal failure?

A
  • Anuria/oliguria
  • Hypertension with fluid overload
  • Rapid rise in plasma creatinine
27
Q

Describe the stages in the AKI warning score

A
  • AKI 1: creatinine > 1.5-2x reference
  • AKI 2: creatinine 2-3x reference
  • AKI 3: creatinine > 3x reference
28
Q

How can AKI be prevented?

A
  • Monitor: paediatric early warning scores, urine output and weight
  • Maintain good hydration
  • Minimise drugs
29
Q

What are the causes of AKI?

A
  • Perfusion problem
  • HUS and GN
  • Acute tubular necrosis (hypoperfusion and drugs)
  • Interstitial nephritis (NSAIDs, autoimmune and drugs)
  • Obstructive uropathies
30
Q

What are the causes of haemolytic-uraemic syndrome?

A
  • Post diarrhoea
  • E coli (entero-haemorrhagic or verotoxin) or shiga toxin
  • Other causes: pneumococcal infection and drugs
  • Atypical HUS
31
Q

How does haemolytic uraemic syndrome present?

A
  • Microangiopathic haemolytic anaemia
  • Thrombocytopenia
  • AKI/Acute renal failure
32
Q

How can haemolytic uraemic be managed?

A
  • Monitor kidney functions
  • IV normal saline and fluids
  • Renal replacement therapy
  • No antibiotics and NSAIDs
33
Q

What are the long term consequences of an AKI?

A
  • Blood pressure increase
  • Proteinuria monitoring
  • Evolution to CKD
34
Q

Give examples of chronic kidney diseases that can occur in children

A
  • Reflux nephropathy
  • Dysplasia
  • Obstructive uropathy
  • Cystic kidney disease
  • Cystinosis
  • GN
35
Q

Which syndromes can be associated with chronic kidney disease?

A
  • Turners
  • Trisomy 21
  • Branchio-oto-renal
  • Prune belly syndrome
36
Q

How does chronic kidney disease present?

A
  • Loss of appetite
  • Weight loss
  • Polyuria
  • Lethargy
  • Reduced effort tolerance
  • UTIs
37
Q

What is the definition of a UTI in children?

A
  • Clinical signs
  • Bacteria culture from midstream urine
  • Any growth on suprapubic aspiration or catheter
38
Q

What are the principles of clinical findings of a UTI in children?

A
  • The youngger the age the more systemic symptoms

- The older the age the more lower tract symptoms

39
Q

How can UTIs be diagnosed in children?

A
  • Dipstix (leukocytes)
  • Microscopy: pyuria and bacturia
  • Urine culture: E coli
  • USS
  • DMSA (isotope scan)
  • Micturating cysto-urethrogram
40
Q

What are the potential consequences of UTIs in children?

A
  • Vescico-ureteric reflux

- Scarring

41
Q

What is the management of UTIs in children?

A
  • Lower tract: 3 days oral antibiotics
  • Upper tracts: 7-10 antibiotics, prevention, fluids, hygiene and constipation
  • Manage voiding dysfunction
42
Q

Which factors affect the progression of CKD?

A
  • Late referral
  • Hypertension
  • Proteinuria
  • High intake of protein, phosphate and salt
  • Bone health: PTH and phosphate
  • Acidosis
  • Recurrent UTIs
43
Q

How can CKD be managed?

A
  • Nutrition/protein intake/ minimise weight loss
  • Low potassium diet
  • Bicarbonate replacement
  • Erythropoetin if anaemic
44
Q

What are the treatment principles for metabolic bone disease?

A
  • Low phosphate diet
  • Oral phosphate binders
  • Active vitamin D
  • If ongoing poor growth: growth hormone

Paediatrics (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions