Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paedriatrics > Nephrology > Flashcards

Nephrology Flashcards

(94 cards)

Start Studying
1
Q

What is the average GFR in a neonate?

A

20-30ml/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

By what age does the GFR equal an adult?

A

2yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 5 basic kidney functions?

A
  1. Waste handling
  2. Water handling
  3. Salt balance
  4. Acid base control
  5. Endocrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are parts of the glomerular filtration barrier?

A

Endothelial cell
Glomerular basement membrane (GBM)
Podocyte
Mesangial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What suggests glomerular injury?

A

Proteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the underlying cause of: increasing haematuria and intravascular overload?

A

Nephritic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the underlying cause of: increasing proteinuria and intravascular depletion?

A

Nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If the epithelial cell (podocyte) is affected in acquired glomerulopathy what is the likely pathology?

A

Minimal Change Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If the basement membrane is affected in acquired glomerulopathy what is the likely pathology?

A

Post Infectious Glomerulonephritis (PIGN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If the endothelial cell is affected in acquired glomerulopathy what is the likely pathology?

A

PIGN, Haemolytic uraemic syndrome (HUS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If the mesangial cell is affected in acquired glomerulopathy what is the likely pathology?

A

HSP/IgA nephropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which is common and which is rare out of acquired and congenital glomerulopathy?

A

Acquired - common

Congenital - rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

If the podocyte cytoskeleton integrity is affected in congenital glomerulopathy what is the likely pathology?

A

Congenital nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mutations in which proteins can lead to congenital nephrotic syndrome?

A

Podocine

Nephrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If the basement membrane proteins are affected in congenital glomerulopathy what is the likely pathology?

A

Alport syndrome

Thin basement membrane disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If the endothelial/microvascular integrity is affected in congenital glomerulopathy where is the likely pathology?

A

Complement regulatory proteins (MPGN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can you check for proteinuria?

A

Dipstix
Protein Creatinine Ratio
24hr urine collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the gold standard for checking proteinuria?

A

24hr urine collection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is a dipstix usually abnormal?

A

> 3+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does a dipstix do?

A

Measures concentration of protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is it best to measure protein creatinine ratio?

A

Early morning urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is the Protein Creatinine ratio in the nephrotic range?

A

> 250mg/mmol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the normal protein creatinine ratio?

A

Pr:CR ratio <20mg/mmol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are common symptoms of nephrotic syndrome?

A

Nephrotic range proteinuria
Hypoalbuminaemia
Oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is a typical presentation of nephrotic syndrome?
``` Swollen face (worse in mornings) Exam: pale, looked well, inflated weight, periorbital oedema, pitting oedema legs, ascites, small pleural effusions, frothy urine ```
26
What three things diagnose nephrotic syndrome?
Oedema Proteinuria Low albumin (bloods)
27
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
28
What are typical features of nephrotic syndrome?
Normal BP No frank haematuria Normal renal function Typically age 1-10
29
What are atypical features of nephrotic syndrome?
Suggestions of autoimmune disease Abnormal renal function Steroid resistance
30
What is the treatment for nephrotic syndrome if typical features?
Prednisolone 8wks
31
What are the typical side effects from high dose glucocorticoids that parents notice?
Behaviour Mood lability Sleep disturbance
32
What do doctors need to consider in terms of side effects from high dose glucocorticoids in children?
Infection risk | Hypertension
33
What percentage of children with nephrotic syndrome should react to steroids?
90%
34
What percentage of nephrotic syndrome in children relapse?
80%
35
What is an acquired nephrotic syndrome that can be steroid resistant?
Focal Segmental Glomerulosclerosis (FSGS)
36
What are congenital nephrotic syndromes that can be steroid resistant?
NPHS1 - nephrin | NPHS2 - podocin
37
If there is haematuria and associated proteinuria what would you assume?
Glomerular disease
38
What are some causes of haematuria?
``` Systemic: clotting disorder Renal: glomerulonephritis Tumour/malignancies Cysts UTI Stones Trauma Urethritis ```
39
If there is frank haematuria, is it more likely nephrotic or nephritic?
Nephritic
40
What is the usual cause of acute post-infectious glomerulonephritis?
Group A strep
41
How would you diagnose acute post-infectious glomerulonephritis?
Bacterial culture Positive ASOT Low C3 complement level normalises
42
What is the treatment for post-infectious glomerulonephritis?
Antibiotic Support renal function Diuretics for overload/hypertension
43
What is the outcome for post-infective glomerulonephritis usually?
Self-limiting
44
How would you make clinical diagnosis of Henoch Schonlein Purpura (IgA related vasculitis)?
``` Mandatory palpable purpura One of 4: - Abdo pain - Renal involvement - Arthritis or arthralgia - Biopsy: IgA deposition ```
45
What is the most common childhood vasculitis?
IgA vasculitis
46
When does IgA vasculitis usually occur?
1-3 post-trigger e.g. virus
47
How long does IgA vasculitis usually last?
4-6wks
48
What is the treatment for IgA vasculitis?
Symptomatic Glucocorticoid therapy Immunosuppression
49
What is the most common glomerulonephritis?
IgA nephropathy
50
How does IgA nephropathy present clinically?
Recurrent macroscopic haematuria +/- chronic microscopic haematuria Varying degrees of proteinuria
51
How is IgA nephropathy diagnosed?
Clinically | Confirmation renal biopsy
52
What biopsy is done in IgA nephropathy for confirmation?
Renal biopsy
53
What is the treatment for mild IgA nephropathy?
Proteinuria with ACEi
54
What is the treatment for moderate to severe IgA nephropathy?
Immunosuppression
55
What is the outcome for those with IgA nephropathy?
25% ESRF by 10yrs
56
What diseases are likely if it is nephritic syndrome?
Post-infectious GN | HSP/IgA
57
What diseases are likely if it is nephrotic syndrome?
FSGS | Minimal change disease
58
What is FSGS?
Focal segmental glomerulosclerosis
59
What signs happen in acute renal failure?
Anuria/oliguria Hypertension with fluid overload Rapid rise plasma creatinine
60
What is AKI?
Abrupt loss kidney function, retention of urea and other nitrogenous waste products and dysregulation of extracellular volume and electrolytes
61
What is the serum creatinine in AKI?
>1.5x age specific reference creatinine
62
What is the urine output in AKI?
<0.5ml/kg for >8hrs
63
What are the 3 AKI warning scores?
AKI 1: creatinine >1.5-2x ref AKI 2: creatinine 2-3x ref AKI 3: serum creatinine >3x ref
64
What are the 3 M's of AKI management?
Monitor: PEWS, urine output, weight Maintain: good hydration Minimise: drugs
65
What are the main causes of AKI?
Pre-renal Perfusion problem Post-renal
66
What are intrinsic renal problems that can cause AKI?
Glomerular disease: HUS (haemolytic uremic syndrome) , glomerulonephritis Tubular injury: acute tubular necrosis (ATN) Interstitial nephritis
67
What are causes of acute tubular necrosis (ATN)?
Hypoperfusion | Drugs
68
What are causes of interstitial nephritis?
NSAID Autoimmune Drugs
69
What are post-renal causes of AKI?
Obstructive uropathies
70
When does HUS typically occur?
Post-diarrhoea
71
What typically causes HUS?
Entero-haemorrhagic e.coli
72
When is the period of risk of HUS?
Up to 14days after onset of diarrhoea
73
What is HUS a triad of?
Microangiopathic haemolytic anaemia Thrombocytopenia AKI/ARF
74
What are the 3 M's of HUS?
Monitor: 5 kidney functions Maintain: IV, renal replacement therapy Minimise: no antibiotics/NSAIDs
75
What are the long term consequences of AKI?
BP Proteinuria monitoring Evolution to CKD
76
What are examples of congenital anomalies of the kidney and urinary tract (CAKUT)?
Reflux nephropathy Dysplasia Obstructive uropathy
77
What are causes of CKD in paediatrics?
CAKUT Hereditary conditions GN
78
What may CAKUT be associated with?
Turner Trisomy 21 Branchio-oto-renal Prune Belly syndrome
79
At what GFR would you start to see signs and symptoms in CKD?
<60
80
How would you diagnose UTI?
Clinical signs + - bacteria culture from MSSU - grow on suprapubic aspiration/catheter
81
What are the clinical findings in younger paediatric patients for a UTI?
More systemic symptoms: fever, vomiting, lethargy, irritability
82
What are the clinical findings in older paediatric patients for a UTI?
More lower tract symptoms: frequency, dysuria
83
What can you use to diagnose UTI?
Dipstix Microscopy Culture
84
What is a concerning diagnosis with recurrent UTI?
Vescico-ureteric reflux | Renal scarring
85
What are the different grades of vescico-ureteric reflux?
Grade 1-5
86
What investigations can be done for UTI?
US DMSA (isotope scan) Micturating cysto-urethrogram (MCUG) MAG 3 scan
87
What is the treatment for lower tract UTI?
3 days oral antibiotic
88
What is the treatment for upper tract UTI/pyelonephritis?
Antibiotics 7-10 days Prevention Fluids, hygiene
89
What are factors affecting progression of CKD?
``` Late referral Hypertension Proteinuria High intake protein, phosphate, salt Bone health Acidosis Recurrent UTIs ```
90
What is the gold standard for BP?
Spigmanometer
91
What happens to phosphate in kidney disease?
High phosphate as kidneys normally excrete phosphate | High phosphate -> increase PTH
92
What does a high PTH cause?
Metabolic bone disease
93
What is the treatment to prevent metabolic bone disease in kidney failure?
Low phosphate diet Oral phosphate binders Vitamin D
94
What is CVS in renal failure?
Accelerated atherosclerosis

Paedriatrics (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions