Pediatrics 7/8

Question 1

2 nephrogenic forms of hypertention

Answer 1

1. Renin Mediated

2. Volume overload

Question 2

Normal GFR in preterm/term baby

Answer 2

Preterm: 15 ml/mon/1.73m2
Term: 20 ml/min/1.73 m2

Question 3

What defines normotensive in kids

Answer 3

> 90%ile for sex/age/length

Question 4

Ford’s Four

Answer 4

Kidney Function (filtration/tubular activity)
Blood pressure
Urine (blood/protein?)
Anatomy (i.e. ultrasound)

Question 5

Types of proteinuria in kids

Answer 5

• Transient
• Orthostatic: not persistent; leak protein when up on feet, etc
• Persistent: what we worry about; check a 1st morning void r/p transient

Question 6

Nephrotic Syndrome characteristics

Answer 6

1. Nephrotic range proteinuria (Upr:cr >2)—HAVE TO HAVE
2. Low serum albumin
3. Edema
4. High Serum cholesterol—should be high with MCD. If nl, have lymphoma, lupus

Question 7

Hematuria

Answer 7

5-10 RBCs /hpf on 3 separate checks

need to confirm with U/A with micro

Question 8

Nephritis

Answer 8

1. RBC casts on microscopic urine!!!
2. Edema
3. Hypertension
   4; Acute kidney injury
   - CHECK C3

Question 9

Basic physiology of nephrotic syndrome

Answer 9

Glomeruli are leaky; intravascular volume depleted

Diuretics contraindicated

Question 10

Basic physiology of nephritis

Answer 10

Gloms are inflammed, so volume overloaded/hypertensive

Diuretics indicated
Edema caused by increase in hydrostatic pressure

Question 11

Low C3 indicates…

Answer 11

Acute Post-infectious GN:
- C3 normalizes in 4-6 weeks
Lupus
- C3 corresponds with lupus flairs
Membranoproliferative
- C3 remains low (hypocomplementemic GN)
- treat with 2 years on steroids

Question 12

Most common nephritis?

Answer 12

IgA Nephropathy

Question 13

Renal Tubular Acidosis

Answer 13

Non-gap metabolic acidosis without diarrhea (

3 types
Type I: distal; can’t acidify urine; RARE
Type II: most common; proximal tubule; can’t reabsorb enough bicarb but grow out of it; compensate with more bicarb
Type III: mixed