Renal Flashcards
Urine Ca/Cr ratio that indicates hypercalciuria
> 0.25
Hematuria, sensorineural hearing loss, ocular abnormalities. Inheritance?
Alport syndrome. X-linked dominant
How to confirm an abnormal Ca/Cr ratio?
24 hour collection >4 mg/kg/day
Protein/Creatinine ratio indicating renal disease
> 0.2
Complications of nephrotic syndrome
Hypercoagulable, Immunodeficient, peritonitis, hypocalcemia, functional hypothyroidism (2/2 to decreased TBG)
Most important prognostic factor of nephrotic syndrome
response to steroid treatment (if failed get renal bx)
Kidney function and blood pressure in nephrotic syndrome?
Normal kidney function, BP is normal to low
3 nephritides with LOW c3
PSGN, Membranoproliferative, and SLE
Kidney function and blood pressure in nephritic syndrome?
Elevated Cr/BUN, Elevated BP
How to differentiate PSGN from other low C3 disorders
C3 returns to normal in 2 months
HUS with coombs +, pulmonary infiltrate/meningitis/bacteremia. Etiology?
Pneumococcus
hematuria, several days after URI, with normal complement
Bergers disease (IgA nephropathy)
Child with painful abdominal mass, hematuria
UPJ
Penile hematoma, blood at meatus, inability to void. Best next step?
Retrograde urethrography (But in females- voiding cystoscopy)
Newborn IDM with HTN. Etiology?
Renal artery or vein thrombosis
HTN, sweating and flushing. Tx?
Phenoxybenzamine (alpha adrenergic blockade)
Frequent UTIs causing renal scarring and HTN, how to treat HTN?
Treat Ace inhibitor for excessive renin
Narrow urethra (spinning top deformity) in female. Tx?
None
Cyst at head of epididymis that transilluminates
Spermatocele
Treatment for persistent cryptorchidism? When should it be done?
Orchipexy if no descent by 1 year
When should a patient be referred to urology for hydrocele?
When it persists beyond 18 mos of age
School age child with testicular pain, bluish hue under the scrotal skin. Tx?
Testicular appendix torsion. Tx with supportive care, NSAIDs
Tx of epididymitis
Ceftriaxone + PO doxycycline or azithromycin
When is a renal biopsy indicated in a child with nephrotic syndrome?
When there is hematuria, hypertension, abnormal complement levels or abnormal renal function, or outside the age range of 1-6 years old (If they do not have these, may begin an empiric course of steroids, if don’t respond need renal biopsy)
