Brandau Pediactric 1 Flashcards
(41 cards)
gross hematuria
bright red blood, clots in urine or tea colored urine
microscopic hematuria
> 5 RBCs per higher power field on MORE THAN two occasions
-so check on second occasion before working up further
DDx for gross hematuria
kidney stones trauma AV malformation renal vein thrombosis acute tubular necrosis IgA nephropathy Alport nephritis glomerular nephritis
renal vein thrombosis
primary in neonates
- hemoconcentration and reduced renal blood flow
- abdominal mass and tenderness, hematuria, oligria, thrombocytopenia (low platelets - used in clot)
-ULTRASOUND will show enlarged kidneys with hyperechogenicity
renal AV malformations
congenital or acquired
-complication of renal biopsy
-gross hematuria and decreasing renal function
complication of renal biopsy
renal AV malformation**
acute tubular necrosis
ischemia or toxins
critically ill child - nephrotoxic or ischemic insult
-tubular cell necrosis
meds cause acute tubular necrosis
aminoglycosides
cyclosporine
oncologic drugs
heavy metals
aminoglycosides
good against gram negative
-but damage kidney
IgA nephropathy
most common chronic glomerular disease worldwide
- IgA mesangial deposits
- absence of systemic disease
-gross hematuria following respiratory infection
mild proteinuria
C3 levels are normal**
alport nephritis
mutations in type IV collagen
- proteinuria - more in males
- hearing loss
- ocular abnormalities
- leiomyomatosis of esophagus and bronchial
acute post-strep GN
gross hematuria, edema, HTN, renal insufficiency
- follows group A beta hemolytic streptococci
- skin or throat
children age 5-12
C3 levels depressed**
approach to hematuria
urinanalysis
- no Hg or cell elements - look for causes of red urine
- Hg but no cell elements - causes of Hg-uria or Mg-uria (muscle breakdown)
- cellular elements - casts - suggest glomerular cause
RBC casts
suggests glomerular pathology
low C3
suggest SLE
normal C3
henoch schonlein HUS wegeners granulomatosis goodpastures syndrome polyarteritis nodosa
common organism with HUS
e. coli
atypical HUS
alternate complement overactivation
low C3
PSGN MPGN SBE HIV Hep B
normal C3
IgA nephropathy
alports
thin glomerular basement membrane
idiopathic progressive GN
non-glomerular hematuria
interstitial nephritis sickle cell trait polycystic kidney disease tumors renal vein thrombosis A/V malformation
most common renal tumor in kidneys
wilms
von willebrands disease
can cause hematuria
child with post-strep GN
-likely HTN and headache
normal systolic <94 in child
