SM_217a: Pediatric Nephrology Flashcards
Prenatal ultrasound reveals that the fetus has 2 kidneys that are both measured large for gestational age and are echogenic. Most likely diagnosis is _____
Prenatal ultrasound reveals that the fetus has 2 kidneys that are both measured large for gestational age and are echogenic. Most likely diagnosis is ARPKD
A 16 year old boy with no past medical history presents with clearly chronic ESRD of unknown etiology. Most likely underlying diagnosis is ______
A 16 year old boy with no past medical history presents with clearly chronic ESRD of unknown etiology. Most likely underlying diagnosis is renal dysplasia
Complication of CKD unique to pediatric population is ______
Complication of CKD unique to pediatric population is growth impairment
A 7 year old boy presents with brown urine, hematuria, and proteinuria and urinalysis, and hypertension. Complement level C3 is low. Most likely diagnosis is _____
A 7 year old boy presents with brown urine, hematuria, and proteinuria and urinalysis, and hypertension. Complement level C3 is low. Most likely diagnosis is Post-infectious Glomerulonephritis
Cutoff for normal protein:creatinine spot ratio in urine is ____
Cutoff for normal protein:creatinine spot ratio in urine is 0.2
Protein:creatine is considered to be in nephrotic range above _____
Protein:creatine is considered to be in nephrotic range above 2-3
Micoscopic hematuria is defined as microscopic urinalysis with ____ RBC/hpf
Micoscopic hematuria is defined as microscopic urinalysis with > 5 RBCs/hpf
Most common cause of CKD/ESKD in kids is _____ group of abnormalities followed by _____
Most common cause of CKD/ESKD in kids is CAKUT group of abnormalities (aplasia/hypoplasia/dysplasia, obstructive uropathy/reflux nephropathy) followed by FSGS
(NOT hypertension or diabetes)
Describe the CAKUT abnormalities in order of decreasing frequency
CAKUT abnormalities
- Most common: hydronephrosis ± obstructive, vesicoureteral reflux
- Renal cysts
- Renal dysplasia ± hydronephrosis and/or cysts
- Renal agenesis
Describe complications of CKD in kids and associated treatments
Complications of CKD in kids and associated treatments
- Growth failure: treat with rHGH
- Mineral and bone disorder: dietary phosphorus restriction, phosphorus binders, treatment of secondary hyperparathyroidism with activated Vitamin D
- Anemia: higher doses of rHuEPO than adults
- Hypertension: intensified BP control
- CVD: address CVD and CKD risk factors
- Cognitive and psychosocial development
_____ is leading cause of death in pediatric CKD population
Cardiovascular disease is leading cause of death in pediatric CKD population
Describe causes of UTI in kids
UTI in kids
- Urinary obstruction
- Vesicoureteral reflux: retrograde flow of urine flrom bladder into ureters (Grade I-V)
- Voiding dysfunction
Painful hematuria is _____
Painful hematuria is urologic
Imaging is used when patient has hematuria to rule out _____ and _____
Imaging is used when patient has hematuria to rule out mass (Wilm’s tumor) and nephrolithiasis
Describe the differential diagnosis for nephrotic syndrome in kids
Differential diagnosis for nephrotic syndrome in kids
- Minimal change disease (most kids)
- FSGS: idiopathic, familial, HIV, hepatitis, heroim, NSAIDs, obesity, drugs
- Membranous nephropathy
- Congenital nephrotic syndrome: nephrin, Denys-Drash syndrome, others
- Familial nephrotic syndrome: podocin, alpha actinin, others
Glomerulonephritis with low complement is most often _____
Glomerulonephritis with low complement is most often PIGN (low C3, C4 usually normal)
_____, _____, and _____ are causes of glomerulonephritis with normal complement levels
IgA nephropathy, Henoch Schonlein purpura, and pauci-immune GN (ANCA-associated GN) are causes of glomerulonephritis with normal complement levels
PIGN has ____ C3 level and ____ C4 level
PIGN has low C3 level and normal C4 level
IgA nephropathy has _____ complement levels
IgA nephropathy has normal complement levels
Henoch Schonlein Purpura has ____ complement levels, while lupus nephritis has ____ complement levels
Henoch Schonlein Purpura has normal complement levels, while lupus nephritis has low complement levels
ARPKD involves _____ and _____
ARPKD involves congenital hepatic fibrosis and portal hypertension
ADPKD is associated with ____
ADPKD is associated with intracranial aneurysms
