7 - Pediatric Nephrology

Question 1

Clinical manifestations in nephritic syndrome

Answer 1

Hematuria
Oliguria
Hypertension
Azotemia

Question 2

Clinical manifestations in nephrotic syndrome

Answer 2

Proteinuria
Hypoalbuminemia
Hyperlipidemia
Edema

Question 3

Hematuria

Answer 3

> 5 RBCs/HPF (centrifuged)

Question 4

Origin of grossly red urine with or without blood clots

Answer 4

Lower urinary tract

Question 5

Origin of tea-colored urine

Answer 5

Glomerulus

Question 6

Most common cause of gross hematuria in children

Answer 6

UTI

Question 7

Children with prior THROAT infection develops APSGN after how many weeks

Answer 7

1-2 weeks

Question 8

Children with prior SKIN infection develops APSGN after how many weeks

Answer 8

3-6 weeks

Question 9

Children with APSGN C3 levels normalize after

Answer 9

6-8 weeks

Question 10

Urinary protein excretion and hypertension in children with APSGN normalize after

Answer 10

4-6 weeks

Question 11

Microscopic hematuria in children with APSGN normalizes after

Answer 11

1-2 years

Question 12

Evidence of prior strep infection required in APSGN diagnosis confirmation

Answer 12

ASO titer (throat)
Anti-DNAse B (skin)

Question 13

Only causes of renal insufficiency that can cause decreased C3

Answer 13

PSGN
MPGN
Lupus nephritis

Question 14

Indication for renal biopsy in APSGN

Answer 14

• Acute renal failure
• Nephrotic syndrome
• Absence of evidence of strep infection
• Normal complement level
• Hematuria and proteinuria
• Low C3 that persists more than 2 months

Question 15

Presents similarly like PSGN but the throat infection coincides with the appearance of renal symptoms

Answer 15

IgA nephropathy

Question 16

Triad of Hemolytic Uremic Syndrome

Answer 16

Thrombocytopenia
Microangiopathic hemolytic anemia
Acute Kidney Injury

Question 17

HSP tetrad

Answer 17

Palpable purpura
Arthritis
Abdominal pain
Glomerulonephritis

Question 18

Pathognomonic for Alport Syndrome

Answer 18

Anterior lenticonus

Question 19

Nephrotic range proteinuria (24hr urine protein determination)

Answer 19

> 40mg/m2/hr

Question 20

Nephrotic range proteinuria (urine protein:creatinine)

Answer 20

> 2

Question 21

T or F: Renal biopsy is the required for diagnosis of Minimal Change Disease

Answer 21

F

Question 22

Most frequent type of infection in nephrotic syndrome

Answer 22

Spontaneous bacterial peritonitis

Question 23

EM: Sub-epithelial deposits of electron-dense material “Spike and Dome” appearance

Answer 23

Membranous glomerulonephritis

Question 24

EM: Diffuse effacement of epithelial foot process

Answer 24

Minimal Change Disease

Question 25

LM: Double contour or tram-track appearance

Answer 25

Membranoproliferative GN

Question 26

EM: Loss of foot process, epithelial denudation

Answer 26

Focal Segmental Glomerulosclerosis

Question 27

May be the only manifestation of pyelonephritis in children

Answer 27

Fever

Question 28

Most common serious bacterial infection in younger than 24 months

Answer 28

Acute pyelonephritis

Question 29

Irritative voiding symptoms relieved by voiding with negative urine culture

Answer 29

Interstitial cystitis

Question 30

Collection of urine

Answer 30

<2 years old: clean catch >2 years old: mid-stream

Question 31

Pyuria

Answer 31

Centrifuged: WBC >5/HPF Uncentrifuged: WBC >10/uL

Question 32

Gold standard for UTI diagnosis

Answer 32

Urine culture

Question 33

KUB ultrasound with post void study indications

Answer 33

Culture-proven pyelonephritis Febrile presumptive UTI Recurrent UTI

Question 34

Clinical manifestations that differentiate TTP from HUS

Answer 34

CNS involvement Fever

Question 35

Hypertension for children 1-13 years old

Answer 35

• Elevated BP: ≥90th to <95th OR 120/80mmHg to <95th percentile (whichever is lower) • Stage 1: ≥95th to <95th + 12mmHg OR 130/80- 139/89mmHg (whichever is lower) • Stage 2: ≥95th +12mmHg or ≥140/90mmHg (whichever is lower)