Peds Renal Flashcards
What is the percentile for normal BP in a kid?
Less than 90 percentile
At what age do we start checking BP in kids?
3
How many high BP readings do we need to say a kid has HTN and what percentile does it need to be greater than?
3 separate visits above 95th percentile
At what BP are we telling a kid to go to ER?
180/120
What is the predominant cause of HTN in kids? Diastolic HTN and Systolic HTN is indicative of what cause of HTN?
Primary HTN is predominant cause. Diastolic is indicative of secondary and systolic is indicative of primary
Most common cause of secondary HTN in kids?
Renovascular HTN
Quick calculation for determining systolic BP in kids age 1-10?
70 + 2 * age
What is white coat HTN and masked HTN?
White coat is when someone gets high BP because they are nervous to be at the doc. Masked if when they have high BP away from the doc and they are normal in the office
When do we hear the systolic BP and diastolic BP and what can happen in kids?
1st sound. 5th sound. You can continue hearing the sounds in a kid so just listen for when it goes down in volume.
For primary HTN, it has increased hand in hand with what condition?
Obesity
What health condition is best evidence that the patient has target-organ damage from high BP and what image modality to determine it?
LVH. Echocardiogram. Long standing or new HTN.
What happens to the BP when we use too small or too big of a cuff?
Too small BP is high. Too big BP is low.
Dr. Newmans definition of hematuria?
5 RBCs per high power field.
What condition did he mention that can provide a false positive for blood in the urine?
Dehydrated patient has uric crystals in urine.
Because of false positives, what do you need to order with UA?
UA with Microscopy
RBC Casts in glomerular or extra? RBC morphology in glomerular or extra? Proteinuria? Clots? Color?
Glomerular.
Dysmoprhic vs. uniform
Glomerular
Extra
What is the danger combo with hematuria?
Hematuria and proteinuria is way worse than just hematuria
Two clinical signs of APGN from strep that I don’t usually think of?
Elevated ASO titer and low serum complement
What to think of with Lupus affecting the kidney?
Glomerulonephritis
With HSP, what are the two things that indicate long term renal damage?
Hematuria and proteinuria
What urine ca/creatinine ratio is indicative of excessive calcium excretion?
Greater than .2
Two obstructions he wants us to know for kids?
UPJ and PUV
Best 2 ways to get a clean catch urine for a kid if they cant go on their own?
Catheter or Supra pubic aspiration
Most common drug family to treat UTIs in kids?
Cephalosporin
When do you image a boys urinary tract, what is required? What about girls?
After first UTI, ultrasound the bladder and renal and VCUG for boys. Same for girls if they also have signs of chronic.
