Pediatric Session

Question 1

renal v. thrombosis

Answer 1

Primary occurs in neonates

Predisposing factors are hemoconcentration and reduced renal blood flow

Presents with abdominal mass and tenderness, hematuria, oliguria and thrombocytopenia

Sonography will show enlarged kidneys with hyperechogenicity

Question 2

Renal AV malformation

Answer 2

when arteries and veins are connected resulting in bypassing the capillary system

• congenital or acqd.
• complication of renal biopsy
• presents w/ gross hematuria and decreasing renal fn.

Question 3

meds that cause ATN?

Answer 3

Aminoglycosides
Cyclosporine
Oncologic drugs
Heavy metals

Question 4

IgA nephropathy

Answer 4

• IgA most common chronic glomerular disease worldwide
• Characterized by a predominance of IgA within mesangial deposits of the glomerulus in the absence of systemic disease such as lupus or Henoch-Schonlein purpura
• Gross hematuria occurs most often with upper respiratory infection
• Proteinuria is usually less than 1,000 mg/24 hours
• C3 levels are normal

Question 5

Alport nephritis

Answer 5

Genetically heterogeneous disease caused by mutations in the genes coding for type IV collagen

Proteinuria more prevalent in males

Other findings

• Hearing loss
• Ocular abnormalities
• Rarely leiomyomatosis of the esophagus and tracheobronchial tree and female genitals

Question 6

Acute Poststreptococcal GN

Answer 6

Characterized by sudden onset of gross hematuria, edema, hypertension and renal insufficiency
Second only to IgA nephropathy as a glomerular cause of gross hematuria

Follows infections with “nephritogenic” strains of Group A β hemolytic streptococci infections of the skin or throat

Occurs primarily in children ages 5-12 and uncommon before the age of 3

C3 levels are markedly depressed

Question 7

C3 changes in multisystemic diseases?

Answer 7

low C3 = SLE

normal C3 = HSP, HUS, Wegener’s granulomatosis, Goodpastures, polyarteritis nodosa

Question 8

low C3 and glomerular disease?

Answer 8

PSGN, membranoproliferative GN, SBE, HIV, Hep B

Question 9

normal C3 glomerular problems?

Answer 9

IgA nephropathy
alport’s syndrome
thin glomerular basement membrane
idiopathic, progressive GN

Question 10

macroscopic hematuria, RBC casts present, normal complement levels, esophageal mass, proteinuria

Answer 10

alport syndrome

Question 11

micro vs. macro hematuria

Answer 11

Gross hematuria-bright red blood, clots in urine or tea colored urine

Microscopic hematuria- > 5 RBCs/HPF on more than 2 occasions