Renal-Fahim Flashcards
You are asked by an obstetrician to evaluate the results of intrauterine ultrasonography of a 35-year-old healthy female who is in the 20th week of her fourth pregnancy. Her husband is 41 years old and healthy, as are her three children. Ultrasonography reveals a probable male fetus that has severe bilateral hydronephrosis and oligohydramnios. Of the following, the MOST likely cause of the intrauterine hydronephrosis is:
A. autosomal dominant polycystic kidney disease
B. autosomal recessive polycystic kidney disease
C. medullary cystic disease
D. posterior urethral valves
E. prune belly syndrome
D. posterior urethral valves
A 2 y/o boy is brought to ER w/ complaints of fever, chills, and flank pain. His immunizations are UTD, and his mother states that it is his second time to have these symptoms. His tempterature is 39.1 (102.2) and PE is unremarkable except for CVA tenderness on the right. A CBC shows leukocytosis and UA shows the presence of WBC and RBC in the urine. What is the most likely mechanism of this patient’s recurrent complaints? A. immunoglobulin deficiency B. Nephroblastoma C. Poststreptococcal glomerulonephritis D. Vesicoureteral reflux
D. Vesicoureteral reflux
A 2 month old infant is found to have a horseshoe kidney. Which structure prevents this abnormal kidney from occupying its appropriate position? A. Aorta B. Celiac Trunk C. Inferior Mesenteric artery D. Inferior vena cava E. Superior mesenteric artery
C. Inferior Mesenteric artery
What is the most common cause of UTI’s?
E. coli
What should be considered in any child
UTI
UA obtained via catheter
How should you treat patients 2 months to 2 years old that have a UTI and are toxic appearing, dehydrated or unable to retain oral intake?
hospitalize and IV antibiotics
Who should be imaged for a UTI/
- All children younger than 5 years of age who have a febrile UTI
- GIRLS younger than 3 years of age and boys younger than 1 year of age experiencing a first UTI
- Children who have recurrent UTIs,
- Patients who do not respond promptly to appropriate antimicrobial therapy.
What is the most common site of urinary tract obstruction in children?
Uretero-Pelvic Junction Obstruction (UPJ)
Which collecting system problem can present with not peeing straight or severe hydronephrosis at a young age?
Posterior urethral valve
Nephrotic syndrome is characterized by severe protineuria, decreased serum albumin, and edema. This results from damage to one or more components of the glomerular capillary wall. In particular, the glomerular basemement membrane is essential for maintaining serum oncotic pressure. In nonpathological states, which of the following properties of the GBM prevent albumin from being freely filtered into the urine?
A. a combination of small pore size and negatively charged pore-forming molecules prevents albumin filtration
B. a combination of small pore size and positively charged pore-forming molecules prevents albumin filtration.
C. Albumin is freely filtered across the basement membrane but is readily reabsorbed along the nephron.
D. The positive charge of proteoglycans in the basement membrane repels albumin
E. The small size of the glomerular basement membrane pores excludes albumin molecules.
A. a combination of small pore size and negatively charged pore-forming molecules prevents albumin filtration
What does >3.5 g/day of protein in the urine or > 50 mg/kg/24 hours indicate?
Nephrotic symdrome
Which nephrotic syndrome presents with a uniform thickening of the glomerular capillary wall without significant mesangial proliferation (spike and dome appearance)?
Membranous glomerulopathy
“Be a member in the spike and dome club”
What is the nephrotic syndrome associated with fused foot processes? What is the prognosis?
Minimal change disease
good prognosis (only protein in urine in 2-6 yo)
What is Burger’s Disease?
IgA deposits in the mesangium (“A Messy Burger)
What nephrotic disorder has sub epithelial immune complex deposits describes as lumpy bumpy?
Post-strep GN
