Pedia: Renal

Question 1

Acute PSGN follows infection which which Streptococcal serotypes

Answer 1

12 - throat

49 - skin

Question 2

Indications for renal biopsy in the evaluation of GN

Answer 2

Acute renal failure
Nephrotic syndrome
Absence of evidence of strep infection
Normal complement
Persistently low serum C3 (>3 months)

Question 3

Most common chronic glomerular disease worldwide

Answer 3

IgA nephropathy

Question 4

Treatment for IgA nephropathy

Answer 4

Primary treatment is proper BP control.
Fish oil reduces renal disease progression.
Steroids beneficial in some

Question 5

Most common cause of acute renal failure in young children

Answer 5

Hemolytic uremic syndrome

Question 6

Upper limit of normal protein excretion in healthy children

Answer 6

150 mg/day

Question 7

Non pathologic causes of proteinuria

Answer 7

Postural (orthostatic)
Fever
Exercise

Question 8

Causes of false positive proteinuria

Answer 8

Highly concentrated urine
Gross hematuria
pH > 8
Contamination with chlorhexidine or benzalkonium
Phenazopyridine therapy

Question 9

What is the major complication of nephrotic syndrome?

Answer 9

Infection

Question 10

What are the usual causes of spontaneous bacterial peritonitis in nephrotic syndrome?

Answer 10

Streptococcus pneumoniae

Escherichia coli

Question 11

Causes of false negative dipstick test for hematuria

Answer 11

Formalin

High urine vitamin C

Question 12

Components of acute nephritic syndrome

Answer 12

Tea or cola-colored urine
Facial or body edema
Hypertension
Oliguria

Question 13

Most common cause of gross hematuria

Answer 13

UTi

Question 14

Pathognomonic feature of Alport syndrome

Answer 14

Anterior lenticonus

Question 15

Isolated hematuria in multiple family members without renal dysfunction

Answer 15

Benign familial hematuria

Question 16

Acute PSGN develops how many weeks after a skin infection? A throat infection?

Answer 16

3 - 6 W after pyoderma

1 - 2 W after pharyngitis

Question 17

Best single antibody titer to document cutaneous strep infection

Answer 17

Anti-deoxyribonuclease B

Question 18

Classic lesion of HIV-associated nephropathy

Answer 18

Focal segmental glomerulosclerosis

Question 19

Most common cause of membranous nephropathy worldwide

Answer 19

Malaria

Question 20

Prognosis of kids with membranous nephropathy

Answer 20

20% - chronic renal failure
40% - active disease
40% - complete remission

Question 21

Both PSGN and MPGN present with hematuria and low C3. How does one differentiate between the two?

Answer 21

PSGN does not have nephrotic features. C3 levels remain low in MPGN, while it returns to normal within 2 months in PSGN.

Question 22

What are renal conditions more likely to present as rapid progressive GN? What is the unifying characteristic in these conditions?

Answer 22

1. Systemic vasculitis
2. HSP
3. ANCA-mediated GN
4. SLE
5. MPGN

Crescents in glomeruli is the hallmark finding

Question 23

Triad of HUS

Answer 23

Microangiopathic hemolytic anemia
Renal insufficiency
Thrombocytopenia

Question 24

Infectious causes of HUS

Answer 24

Verotoxin producing E. coli
Shiga toxin prodding Shigella dysenteriae type I
Neuraminidase-producing Streptococcus pneumoniae
HIV

Question 25

Classic features of nephritic syndrome

Answer 25

Hypoalbuminemia
Edema
Hyperlipidemia

Question 26

Hallmark of idiopathic nephrotic syndrome

Answer 26

Effacement of podocyte foot processes

Question 27

Congenital nephrotic syndrome + bilateral microcoria (fixed narrowing of the pupil)

Answer 27

Pierson syndrome

Question 28

Distal and proximal RTA both present with NAGMA and growth failure. How does one differentiate the two conditions?

Answer 28

Nephrocalcinosis and hypercalciuria in distal RTA.
Phosphate and massive HCO3 wasting in proximal RTA

Urine pH low in proximal,
High in distal

Question 29

How does one differentiate Bartter from Gitelman’s syndromes?

Answer 29

1. Hypocalciuria in Gitelman;
   Hypercalciuria in Bartter
2. HypoMg more prominent in Gitelman
3. Renin and aldosterone elevated in Bartter

Question 30

An adolescent presenting with hypokalemic metabolic alkalosis, with hypomagnesemia and hypocacliuria. Diagnosis?

Answer 30

Gitelman’s syndrome

Question 31

Gain of function mutation in the epithelial Na channel

Answer 31

Liddle syndrome

Question 32

Excessive NCCT-mediated salt reabsorption

Answer 32

Gordon syndrome

Question 33

Renal mass. Histo reveals granulomatous inflammation with giant cells and foamy histiocytes

Answer 33

Xanthogranulomatous pyelonephritis

Question 34

Infectious causative agents of acute hemorrhagic cystitis

Answer 34

E. coli

Adenovirus type 11 and 21

Question 35

Sterile Pyuria is seen in what conditions

Answer 35

Viral infection
Renal TB
Renal abscess
Partially treated bacterial UTI
UTI in the presence of urinary obstruction
Interstitial nephritis
Inflammation near the ureter or bladder

Question 36

Indications for voiding cystorethrogram

Answer 36

DMSA (+) scan showing acute pyelonephritis or scarring

Patient with second febrile UTI with previous negative upper tract evaluation

Question 37

Sudden onset hematuria and flank mass in an infant of a diabetic mother. Labs reveal hemolytic anemia and thrombocytopenia

Answer 37

Renal vein thrombosis