Peds Renal

Question 1

What is the percentile for normal BP in a kid?

Answer 1

Less than 90 percentile

Question 2

At what age do we start checking BP in kids?

Answer 2

3

Question 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?

Answer 3

3 separate visits above 95th percentile

Question 4

At what BP are we telling a kid to go to ER?

Answer 4

180/120

Question 5

What is the predominant cause of HTN in kids? Diastolic HTN and Systolic HTN is indicative of what cause of HTN?

Answer 5

Primary HTN is predominant cause. Diastolic is indicative of secondary and systolic is indicative of primary

Question 6

Most common cause of secondary HTN in kids?

Answer 6

Renovascular HTN

Question 7

Quick calculation for determining systolic BP in kids age 1-10?

Answer 7

70 + 2 * age

Question 8

What is white coat HTN and masked HTN?

Answer 8

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

Question 9

When do we hear the systolic BP and diastolic BP and what can happen in kids?

Answer 9

1st sound. 5th sound. You can continue hearing the sounds in a kid so just listen for when it goes down in volume.

Question 10

For primary HTN, it has increased hand in hand with what condition?

Answer 10

Obesity

Question 11

What health condition is best evidence that the patient has target-organ damage from high BP and what image modality to determine it?

Answer 11

LVH. Echocardiogram. Long standing or new HTN.

Question 12

What happens to the BP when we use too small or too big of a cuff?

Answer 12

Too small BP is high. Too big BP is low.

Question 13

Dr. Newmans definition of hematuria?

Answer 13

5 RBCs per high power field.

Question 14

What condition did he mention that can provide a false positive for blood in the urine?

Answer 14

Dehydrated patient has uric crystals in urine.

Question 15

Because of false positives, what do you need to order with UA?

Answer 15

UA with Microscopy

Question 16

RBC Casts in glomerular or extra?
RBC morphology in glomerular or extra?
Proteinuria?
Clots?
Color?

Answer 16

Glomerular.
Dysmoprhic vs. uniform
Glomerular
Extra

Question 17

What is the danger combo with hematuria?

Answer 17

Hematuria and proteinuria is way worse than just hematuria

Question 18

Two clinical signs of APGN from strep that I don’t usually think of?

Answer 18

Elevated ASO titer and low serum complement

Question 19

What to think of with Lupus affecting the kidney?

Answer 19

Glomerulonephritis

Question 20

With HSP, what are the two things that indicate long term renal damage?

Answer 20

Hematuria and proteinuria

Question 21

What urine ca/creatinine ratio is indicative of excessive calcium excretion?

Answer 21

Greater than .2

Question 22

Two obstructions he wants us to know for kids?

Answer 22

UPJ and PUV

Question 23

Best 2 ways to get a clean catch urine for a kid if they cant go on their own?

Answer 23

Catheter or Supra pubic aspiration

Question 24

Most common drug family to treat UTIs in kids?

Answer 24

Cephalosporin

Question 25

When do you image a boys urinary tract, what is required? What about girls?

Answer 25

After first UTI, ultrasound the bladder and renal and VCUG for boys. Same for girls if they also have signs of chronic.