Renal Flashcards
How does renal vein thrombosis present? dx?
infant who is dehydrated, birth depression, polycythemia, or DM mom
hx oliguria, hematuria, palpable enlarged kidneys
dx = renal US /w renal vein doppler studes
What are signs of lobar nephronia? How do you treat?
long fever curve w/ antibitoics
treat: prolonged IV and PO abx
What are signs of urolithiasis? diagnose?
obstructive sx w/ dysuria, urgency, frequency
dx: non contrast CT to dx # and location of stones and check for hydronephrosis
What are signs of fanconi syndrome?
anorexia, polydipsia, polyuria, vomit, unexplained fevers
have glucosuria w/ normal blood sugar, phosphaturia, aminoaciduria, high urine pH, mild albuminuria
What is next step if you see high protein in kid’s urine?
repeat urine dipstick on 2 separate occasions to differentiate transient vs persistent proteinuria
once its persistent –> do 24 hr urine collection for protein + renal US
What is likely to present w/ painless hematuria?
renal papillary necrosis
normal appearing RBCs in urine
What are findings in acute glomerulonephritis?
hematuria w/ htn, proteinuria, drysmorphic RBCs, RBC casts
What do you see in urine in acute interstitial nephritis?l
lots of WBCs w/ eos, not likely to have hematuria
What do you see in urine in acute tubular necrosis?
granular casts, hematuria, renal tubular epithelial cells
What are sx of goodpasture? how do you dx?
pulmonary hemorrhage, progressive renal impairment
dx: hemosiderin laden macrophages on sputum or pulm secretions, antibodies to glomerular basement membrane
What are sx/signs of HUS? treat?
bloody diarrhea + anemia (RBC hemolysis) + thrombocytopenia (activated coagulation cascade) + renal failure (high creatinine, hematuria, proteinuria, casts)
treat: supportive w/ controlling htn, fluid/electrolyte/nutrition
What is treatment for post strep glomerulonephitis?
treat underlying infection if still present, monitor BP nd fluid restrict
What is type 1 (distal) RTA?
poor k secretion into urine due to genetic, med, autoimmune
urine pH > 5.5, low-normal K
low serum HCO3, high Cl
chronic met acidosis
What is treatment for rental tubular acidosis?
oral bicarb replacement
What is type 2 (proximal) RTA?
due to poor bicarb resorption, seen in fanconi syndrome
urine pH
What is type 4 RA?
aldosterone resistance, due to obstructive uropathy or CAH
urine pH
What risk factor, histo finding in membranous nephropathy?
risks: Hep B
histo: thick BM, subepithelial spikes
What risk factor, histo finding in FSGS nephropathy?
risks: HIV
histo: crescent formation
What histo finding in minimal change nephropathy? dx? next step?
T cell mediated injruy to podocytes –> effacement of foot processes on EM
Dx: proteinuria, hypoalbuminuria, renal biopsy w/o microscopic change
Tx: steroids
What does it suggest if hum/bruit at CVA and hypertension? What test/finding to dx?
fibromuscular dysplasia
on angiography have string of beads in renal artery
What is next step for working up UTI in kid? who gets this?
US bladder/renal
-
Who gets CVUG?
if abnormal renal US or
- pts
What is most common cause of recurrent UTI?
vesicoureteral refleux –> can lead to hydroureter + hydronephrosis
What is complication of VUR?
recurrent pyelo –> blunting calices and focal parenchymal scarring
more prone to renal insufficiency, ESRD