Pedia: Renal Flashcards
Acute PSGN follows infection which which Streptococcal serotypes
12 - throat
49 - skin
Sudden onset hematuria and flank mass in an infant of a diabetic mother. Labs reveal hemolytic anemia and thrombocytopenia
Renal vein thrombosis
Indications for renal biopsy in the evaluation of GN
Acute renal failure Nephrotic syndrome Absence of evidence of strep infection Normal complement Persistently low serum C3 (>3 months)
Most common chronic glomerular disease worldwide
IgA nephropathy
Treatment for IgA nephropathy
Primary treatment is proper BP control.
Fish oil reduces renal disease progression.
Steroids beneficial in some
Most common cause of acute renal failure in young children
Hemolytic uremic syndrome
Upper limit of normal protein excretion in healthy children
150 mg/day
Non pathologic causes of proteinuria
Postural (orthostatic)
Fever
Exercise
Causes of false positive proteinuria
Highly concentrated urine Gross hematuria pH > 8 Contamination with chlorhexidine or benzalkonium Phenazopyridine therapy
What is the major complication of nephrotic syndrome?
Infection
What are the usual causes of spontaneous bacterial peritonitis in nephrotic syndrome?
Streptococcus pneumoniae
Escherichia coli
Causes of false negative dipstick test for hematuria
Formalin
High urine vitamin C
Components of acute nephritic syndrome
Tea or cola-colored urine
Facial or body edema
Hypertension
Oliguria
Most common cause of gross hematuria
UTi
Pathognomonic feature of Alport syndrome
Anterior lenticonus
Isolated hematuria in multiple family members without renal dysfunction
Benign familial hematuria
Acute PSGN develops how many weeks after a skin infection? A throat infection?
3 - 6 W after pyoderma
1 - 2 W after pharyngitis
Best single antibody titer to document cutaneous strep infection
Anti-deoxyribonuclease B
Classic lesion of HIV-associated nephropathy
Focal segmental glomerulosclerosis
Most common cause of membranous nephropathy worldwide
Malaria
Prognosis of kids with membranous nephropathy
20% - chronic renal failure
40% - active disease
40% - complete remission
Both PSGN and MPGN present with hematuria and low C3. How does one differentiate between the two?
PSGN does not have nephrotic features. C3 levels remain low in MPGN, while it returns to normal within 2 months in PSGN.
What are renal conditions more likely to present as rapid progressive GN? What is the unifying characteristic in these conditions?
- Systemic vasculitis
- HSP
- ANCA-mediated GN
- SLE
- MPGN
Crescents in glomeruli is the hallmark finding
Triad of HUS
Microangiopathic hemolytic anemia
Renal insufficiency
Thrombocytopenia
Infectious causes of HUS
Verotoxin producing E. coli
Shiga toxin prodding Shigella dysenteriae type I
Neuraminidase-producing Streptococcus pneumoniae
HIV
Classic features of nephritic syndrome
Hypoalbuminemia
Edema
Hyperlipidemia
Hallmark of idiopathic nephrotic syndrome
Effacement of podocyte foot processes
Congenital nephrotic syndrome + bilateral microcoria (fixed narrowing of the pupil)
Pierson syndrome
Distal and proximal RTA both present with NAGMA and growth failure. How does one differentiate the two conditions?
Nephrocalcinosis and hypercalciuria in distal RTA.
Phosphate and massive HCO3 wasting in proximal RTA
Urine pH low in proximal,
High in distal
How does one differentiate Bartter from Gitelman’s syndromes?
- Hypocalciuria in Gitelman;
Hypercalciuria in Bartter - HypoMg more prominent in Gitelman
- Renin and aldosterone elevated in Bartter
An adolescent presenting with hypokalemic metabolic alkalosis, with hypomagnesemia and hypocacliuria. Diagnosis?
Gitelman’s syndrome
Gain of function mutation in the epithelial Na channel
Liddle syndrome
Excessive NCCT-mediated salt reabsorption
Gordon syndrome
Renal mass. Histo reveals granulomatous inflammation with giant cells and foamy histiocytes
Xanthogranulomatous pyelonephritis
Infectious causative agents of acute hemorrhagic cystitis
E. coli
Adenovirus type 11 and 21
Sterile Pyuria is seen in what conditions
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
Indications for voiding cystorethrogram
DMSA (+) scan showing acute pyelonephritis or scarring
Patient with second febrile UTI with previous negative upper tract evaluation
