Renal

Question 1

Urine Ca/Cr ratio that indicates hypercalciuria

Answer 1

> 0.25

Question 2

Hematuria, sensorineural hearing loss, ocular abnormalities. Inheritance?

Answer 2

Alport syndrome. X-linked dominant

Question 3

How to confirm an abnormal Ca/Cr ratio?

Answer 3

24 hour collection >4 mg/kg/day

Question 4

Protein/Creatinine ratio indicating renal disease

Answer 4

> 0.2

Question 5

Complications of nephrotic syndrome

Answer 5

Hypercoagulable, Immunodeficient, peritonitis, hypocalcemia, functional hypothyroidism (2/2 to decreased TBG)

Question 6

Most important prognostic factor of nephrotic syndrome

Answer 6

response to steroid treatment (if failed get renal bx)

Question 7

Kidney function and blood pressure in nephrotic syndrome?

Answer 7

Normal kidney function, BP is normal to low

Question 8

3 nephritides with LOW c3

Answer 8

PSGN, Membranoproliferative, and SLE

Question 9

Kidney function and blood pressure in nephritic syndrome?

Answer 9

Elevated Cr/BUN, Elevated BP

Question 10

How to differentiate PSGN from other low C3 disorders

Answer 10

C3 returns to normal in 2 months

Question 11

HUS with coombs +, pulmonary infiltrate/meningitis/bacteremia. Etiology?

Answer 11

Pneumococcus

Question 12

hematuria, several days after URI, with normal complement

Answer 12

Bergers disease (IgA nephropathy)

Question 13

Child with painful abdominal mass, hematuria

Answer 13

UPJ

Question 14

Penile hematoma, blood at meatus, inability to void. Best next step?

Answer 14

Retrograde urethrography (But in females- voiding cystoscopy)

Question 15

Newborn IDM with HTN. Etiology?

Answer 15

Renal artery or vein thrombosis

Question 16

HTN, sweating and flushing. Tx?

Answer 16

Phenoxybenzamine (alpha adrenergic blockade)

Question 17

Frequent UTIs causing renal scarring and HTN, how to treat HTN?

Answer 17

Treat Ace inhibitor for excessive renin

Question 18

Narrow urethra (spinning top deformity) in female. Tx?

Answer 18

None

Question 19

Cyst at head of epididymis that transilluminates

Answer 19

Spermatocele

Question 20

Treatment for persistent cryptorchidism? When should it be done?

Answer 20

Orchipexy if no descent by 1 year

Question 21

When should a patient be referred to urology for hydrocele?

Answer 21

When it persists beyond 18 mos of age

Question 22

School age child with testicular pain, bluish hue under the scrotal skin. Tx?

Answer 22

Testicular appendix torsion. Tx with supportive care, NSAIDs

Question 23

Tx of epididymitis

Answer 23

Ceftriaxone + PO doxycycline or azithromycin

Question 24

When is a renal biopsy indicated in a child with nephrotic syndrome?

Answer 24

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)

Question 25

Hepatitis D infection can result in liver failure in the setting of what?

Answer 25

CHRONIC Hepatitis B infection (If both are acute, the illness is no worse than acute hep B alone)