Nephrology

Question 1

What is the approximate GFR for a neonate?

Answer 1

20-30ml/min/1.73 m^2

Question 2

What is the approximate GFR for a 2yr old?

Answer 2

Equal to an adult: ie around 90-120ml/min/1.73 m^2

Question 3

What are the 5 main functions of the kidneys?

Answer 3

• Waste handling
• Water handling
• Salt balance
• Acid base control
• Endocrine (RBCs/BP/Bone health)

Question 4

What are the three main components of the glomerular filtration barrier?

Answer 4

• Fenestrasted endothelial cells
• Glomerular basement membrane
• Podocytes

Question 5

What may frothy urine suggest?

Answer 5

Proteinuria

Question 6

What does proteinuria signify?

Answer 6

Glomerular injury

Question 7

What syndrome is increasing proteinuria associated with?

Answer 7

Nephrotic syndrome

Question 8

What syndrome is increasing haematuria associated with?

Answer 8

Nephritic syndrome

Question 9

Which conditions affect the podocytes of the glomerulus?

Answer 9

Minimal Change Disease (MCD)
FSGS
Lupus

Question 10

Which conditions affect the basement membrane of the glomerulus?

Answer 10

Post Infectious Glomerulonephritis (PIGN)

Membranous glomerulopathy, Membranoproliferative glomerulonephritis - MPGN

Question 11

Which conditions affect the endothelial cells of the glomerulus?

Answer 11

Post Infectious Glomerulonephritis (PIGN)
Haemolytic Uraemis Syndrome (HUS)
(MPGN
Lupus)

Question 12

Which conditions affect the mesangial cells of the glomerulus?

Answer 12

HSP (Henoch-Schönlein purpura)
IgA nephropahty
Lupus

Question 13

List some congenital glomerulopathies

Answer 13

Congenital nephrotic syndrome
Alport syndrome
Thin basement membrane disease
MPGN

Question 14

In a urine dipstix, what would abnormal protein be?

Answer 14

> = 3

Question 15

What Protein Creatinine Ratio would indicate nephrotic syndrome?

Answer 15

> 250 mg/mmol

Normal = <20

Question 16

How much proteinuria would be considered nephrotic in a 24 hour urine collection for children?

Answer 16

> 1g/m²/24hrs

Normal = <60mg

Question 17

What are some side effects from high dose glucocorticoids in children?

Answer 17

• Behaviour change
• Mood lability
• Sleep disturbance
• Infection risk (Antibiotic prophylaxis)
• Hypertension

Question 18

List some causes of haematuria

Answer 18

Systemic clotting disorders
Renal glomerulonephritis
Tumour (Wilm's nephroblastoma)
Cysts
Malignancies - sarcomas
Stone
UTI
Trauma
Urethritis

Question 19

What conditions are associated with nephrotic syndrome?

Answer 19

Minimal change disease
FSGS
MPGN

Question 20

What conditions are associated with nephritic syndrome?

Answer 20

Post infectious GN
HSP/IgA
Lupus

Question 21

What factors may affect progression of CKD?

Answer 21

Late referral
Hypertension
Proteinuria
High intake  of protein, phosphate and salt 
Bone health
-PTH
-Phosphate
Acidosis
Recurrent UTIs

Question 22

What can be use for BP monitoring?

Answer 22

• Sphigmanometer
• Oscilliometry
• 24 hr ABPM

Question 23

What are some systemic presentations of paediatric urological problems?

Answer 23

• Fever, vomiting
• Failure to thrive
• Anaemia
• Hypertension
• Renal failure

Question 24

What are some suggested advantages to circumcision?

Answer 24

• UTI risk reduction?
• Malignancy reduction?
• Sexual enhancement?
• STDs?

But no evidence of medical benefit!

Question 25

What are some disadvantages to circumcision?

Answer 25

• Painful

- Complications (Bleeding, Meatal stenosis, fistula, cosmetic)

Question 26

What are some differentials for the acute scrotum?

Answer 26

• Torsion testis
• Torsion appendix testis
• Epididymitis
• Trauma,
• Hematocele,
• Incarcerated inguinal hernia

Question 27

What investigation can be used for the assessment of drainage, function, and reflux in UTI?

Answer 27

MAG3

Question 28

What investigation can be used for the assessment of function and scarring in UTI?

Answer 28

DMSA