Renal Flashcards
1
Q
- patient with recent exercise
- grossly bloody urine
- UA with 0-2 RBCs
A
Myloglobinuria
2
Q
- repeat microscopic hematuria
- calcium/Cr ratio > 0.25
- may be on Lasix
- may present with abdominal pain and dysuria
- check RUS
A
Hypercalciuria
3
Q
- microscopic hematuria after an MVA or sports injury
- one day old with palpable flank mass
- unilateral flank mass onUS
- hydronephrosis on CT
A
UPJ obstruction
4
Q
- proteinuria present during the daytime but disappears when the pt has been laying down
- negative fresh urine sample upon waking and a subsequent positive one
A
Orthostatic hematuria
5
Q
- x-linked dominant
- BL sensorineural hearing loss, ocular defects, ultimate renal failure
- MC in males
A
Alport Syndrome
6
Q
- enlarged kidney with non communicating cysts and thin parenchyma
- unilateral flank mass
- oligohydramnios and minimal fluid in the bladder
- associated with UPJ obstruction, VUR, PUV, megaureter and duplications
- VCUG to r/o comorbid abnl
- RUS best initial study to order
- associated with congenital hepatic fibrosis and portal HTN (hematemesis, palpable liver, thrombocytopenia, splenomegaly)
A
Multicystic Dysplastic Kidney Disease
7
Q
-associated with intracranial aneurysms
A
ADPKD
8
Q
- autosomal recessive
- polyuria, enuresis, polydipsia, hyposthenuria
- short stature, retinitis pigmentosa, anemia
A
Juvenile-onset Medullary Cystic Kidney Disease
9
Q
- MC cause of urinary retention in females
- mass protruding from the urethral meatus
- dysuria, hematuria, abd pain
A
Ureterocele
10
Q
- Grade 1 or 2: no Tx, periodic cultures
- Grade 3: PPx Abx with f/u VCUG
- Grade 4 or 5: surgery
- females need PPx cultures
A
VUR
11
Q
- palpable bladder, weak urinary system
- prenatal US with hydronephrosis and reduced renal parenchyma
- pass a catheter
- immediate urological correction
- risk for renal failure within 5 years
- occurs exclusively in males
A
PUV
12
Q
- Dx: > 100K colonies
- MC E.coli, also klebsiella, enterococcus, adenovirus
- RUS indicated if pyelo, newborn, male
A
UTI
13
Q
- no abdominal musculature
- prone to chronic UTIs, dilated ureters, and large bladders
- newborn with decreased UOP, soft abd musculature, undescended testicles, and distended bladder
A
Eagle Barrett
14
Q
- hypoproteinemia, proteinuria, edema
- -MC: minimal change disease
- MC ages 2-8 in males
- decreased UOP, abd pain, and weight gain
- nl renal function
- hypercoagulable
- lose Ig, albumin, and thyroxine binding globulin resulting in immunodeficiency, hypocalcemia, and hypothyroidism
A
Nephrotic syndrome
15
Q
-presence of RBC casts
A
glomerular disease
16
Q
Red Urine
Oliguria
Proteinuria
Elevated BPP and BUN
A
Glomerulonephritis
17
Q
Post-strep GN
Membranoproliferative GN
SLE
A
low complement levels
18
Q
- loss of foot processes
- responds to Prednisone
- many go onto remission in adolescence
A
Minimal Change Disease
19
Q
- MC in teenagers
- leads to progressive renal failure
- unpresponsive to steroids
A
FSGS
20
Q
- low C3
- requires aggressive treatment to prevent renal failure
A
Membranoproliferative GN
21
Q
- result of throat or skin infx
- HTN, edema, and hematuria
- low albumin due to hemodilution
- C3 low for up to 2 months
- Tx: supportive, fluid restriction
A
Post-strep GN
22
Q
- hematuria > 8wk
- low serum complement persisting
- HTN
- proteinuria
- abnl renal fxn
A
Reasons to biopsy
23
Q
- elevated serum IgA
- IgA deposits on renal Bx
- children younger than 10
- gross painless hematuria several days after an URI
- mild abd pain
- persistent proteinuria indicates worsening disease
A
IgA nephropathy
24
Q
- FTT
- anemia (decr erythropoietin)
- metabolic acidosis (bicarb loss, decreased acid excretion)
- secondary hyperparathyroidism (elevated Phos, low Ca)
- uremia (high BUN)
- HTN (salt and water retention, incr renin)
- neuro abnl (mental status changes, seizures, peripheral neuropathies)
- hypocalcemia (decreased calcitriol)
- Derm issures (dry skin, pruritis, bruising)
A
Chronic renal failure
25
- hemolytic anemia
- renal failure
- thrombocytopenia
- present with anemia and pallor, abd pain, decr UOP, purpura and ecchymoses, seizures, lethargy, HTN
- caused by E. coli (meat and milk)
- Tx: replacement of insensible losses
HUS
26
- BP >95%ile fro age and sex, taken on 3 separate occasions
- use appropriate size cuff
- check BUN and Cr
HTN
27
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Polycystic Kidney Disease
O (zero) Enzyme (11 hydroxylase deficiency)
Urinary Reflux Nephropathy
Neonatal problem (BPD)
Deficiency (17 hydroxylase)
```
Heart (Coarc, Renal artery stenosis)
Adrenal (pheo)
Reflux nephropathy (again)
Difficult to fit in (Cushingoid)
Risk factors for HTN
28
- family history of HTN
| - short obese patient
Renal or Endocrine problem
29
-h/o prematurity with HTN
Renal injury 2/2 umbilical catheterization
30
-HTN with joint pain, swelling
Connective Tissue Disorder like Lupus
31
-HTN with flushing, palpitations, fever, and weight loss
Pheochromocytoma
32
--HTN with muscle cramps, wekaness
Hypokalemia 2/2 hyperaldosteronism
33
-HTN onset with sexual development
One of the enzyme deficiencies
34
-HTN with pale color and edema
Renal disease
35
- HTN with pale color, increased sweating at rest, flushing, abdominal mass
- Tx: alpha blockade
- B blockers are contraindicated (unopposed alpha effect) cause worsening HTN
Pheochromocytoma
36
-HTN with wide spaced nipples and webbing of the neck
Turner Syndrome (Coarc)
37
-HTN with Elfin facies
Williams Syndrome (AS)
38
-HTN with decreased femoral pulses or low BP in legs v arms
Coarc
39
-causes of dysuria in a preadolescent female
Pinworms
Poor hygeine
Trauma
Vaginitis
40
-dysuria in an adolescent female who is not sexually active
UTI
41
-dysuria in an adolescent female who is sexually active
UTI
| GC/CT
42
-dysuria in an adolescent male
GC/CT
43
-child's age +2
Bladder capacity
44
-UOP 1-2mL/kg/day
Infant UOP
45
-population with increased FeNa
Neonates
