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Block 19 Module 3 > Glomerulonephritides in Kids > Flashcards

Glomerulonephritides in Kids Flashcards

(86 cards)

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1
Q

Edema of nephritic syndrome is typically most prominent on which part of the day?

A

Early in the morning (esp. on px dependent side)

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2
Q

T/F. Pregnancy is not an exacerbating factor for lupus nephritis

A

False (an exacerbating factor)

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3
Q

T/F. Acute nephrotic syndrome commonly affects adults

A

False (young children)

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4
Q

T/F. Typical prodrome of acute nephrotic syndrome in children

A

Gastroenteritis

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5
Q

Clinical criteria of acute nephritic syndrome

A

Edema, hypertension, hematuria, oliguria

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6
Q

Differentiate hpn of nephritic and nephrotic syndrome

A

Nephritic: HPN due to fluid retention VS Nephrotic: hypoalbuminuria → 3rd spacing → IV volume depletion

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7
Q

Most benign criteria in nephritic syndrome and also most common cause of consult

A

Hematuria

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8
Q

Hereditary nephritis

A

Alport syndrome

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9
Q

Most common cause of glomerulonephritis 2⁰ to isolated renal disease in our locality

A

Post infectious/strep GN

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10
Q

Most common cause of glomerulonephritis 2⁰ to isolated renal disease globally

A

IgA nephropathy

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11
Q

T/F. Membranous nephropathy is typically a disease of children

A

False (adults)

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12
Q

Commonly misdiagnosed as post strep GN

A

Membranoproliferative GN

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13
Q

Cause of GN with worst prognosis

A

Focal segmental glomerulosclerosis (FSGS)

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14
Q

T/F. Sickle cell glomerulopathy is common in Ph

A

False (seldom seen)

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15
Q

Typical picture of hemolytic uremic syndrome

A

GI symptoms prodrome then hematuria and abdominal pain

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16
Q

Difference of HUS from SLE

A

Type of rash and elevated BUN and creatinine

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17
Q

Most common glomerular cause of gross hematuria in children

A

Acute post streptococcal GN

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18
Q

Organisms associated with APSGN

A

Group A β-hemolytic streptococci

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19
Q

Immunofluorescent microscopy of APSGN

A

Lumpy bumpy deposits of Ig and complement in glomerular basement membrane

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20
Q

Reward given by doc to px after 6-12 weeks of management

A

McDonald’s

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21
Q

T/F. In a suspected APSGN px, confirm ddx if manifestations are triggered after 6-12 weeks of management

A

False (consider other ddx)

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22
Q

APSGN common in this age group

A

5-12 y.o.

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23
Q

Acute nephritic syndrome develops when post strep pharyngitis

A

1-2 weeks

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24
Q

Acute nephritic syndrome develops when after strep pyodermata

A

3-6 weeks

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25
T/F. Px referred late for APSGN should not be dialyzed
False (undergo dialysis)
26
Management of rapidly progressing glomerulonephritis
Immediate prednisolone tx and a course peritoneal dialysis
27
Phases of APSGN
Oliguric, Diuretic, Convalescence
28
Why is there edema in APSGN?
Salt and water retention
29
Adequate urine output
≥1 cc/kg/hour
30
What to monitor in diuretic phase of APSGN
Dehydration and electrolytes (e.g. Na, K)
31
C3 levels in APSGN
Reduced because they get deposited in the glomerular basement membrane
32
C3 levels in rapidly progressing glomerulonephritis
Elevated
33
T/F. ASO titers are always elevated after strep skin infection
False (rarely only compared to throat infection; anti-DNase B level used to document cutaneous strep)
34
Which is more specific: Streptozyme test or ASO titers?
Streptozyme test but ASO is enough for ddx
35
C4 levels in APSGN
Often normal or only mildly depressed
36
Neurologic involvement in APSGN
Posterior leukoencephalopathy in the parieto-occipital areas
37
Most common complication of APSGN
HPN
38
Drug of choice for APSGN
Penicillin for 10 days
39
1st line drugs for HPN
Diuretics
40
Safest anti-HPN in children
Calcium channel blockers
41
T/F. ACE inhibitors and ARBs may worsen renal hypoperfusion
True, use w/ caution
42
T/F. Skin infections are not risk for PSGN
False (risk)
43
Clinical criteria for acute nephrotic syndrome
Edema, Normal BP, Proteinuria, Hypercholesterolemia
44
Edema of nephrotic syndrome
Anasarca and 2⁰ to protein loss and drop in oncotic pressure
45
Proteinuria in pedia
≥40 mg/m2
46
Most common cause of nephrotic syndrome
Primary (idiopathic) nephrotic syndrome (INS)
47
Nephrotic common in
Males; 2-6 y.o.
48
Common cause of INS
Minimal change disease
49
Pathology of minimal change disease
T cell dysfunction → alteration of cytokines → loss of negative charged glycoprotein in glomerular capillary
50
Mutated podocyte proteins in FSGS
Podocin and alpha actinin
51
Mutated podocyte proteins in steroid resistant nephrotic syndrome
NPHS2 (podocin) and WT1 genes
52
Reason why FSGS still recur in transplanted kidneys
Plasma factor by lymphocutes causing permeability
53
WT1 gene also expressed in what tumor?
Wilm’s tumor
54
What to give in px with genital edema since it’s very painful
Albumin
55
Proteinuria in INS
+3 or +4 proteinuria
56
Serum creatinine, C3 and C4 in INS
Normal
57
T/F. Children with uncomplicated nephrotic syndrome, 1-8 y.o. likely to be unresponsive to steroid
False (responsive)
58
Gold standard drug for steroid resistant nephrotic syndrome
Prednisone, 60 mg/m2 for 6 weeks
59
Alternative tx aside from steroid
Cyclophosphamide
60
Steroid sparing agent
Cyclosporine
61
Adjunct tx to reduce proteinuria
ACE inhibitors and angiotensin II blockers
62
Most frequent type of infection in nephrotic syndrome
Spontaneous bacterial peritonitis by strep pneumonia
63
Also known as Berger Nephropathy and may cross between nephritic and nephrotic and the most common chronic glomerular disease worldwide
IgA Nephropathy
64
Part where IgA is deposited in IgA nephropathy
Mesangium of glomerulus
65
C3 in IgAN
Normal vs post strep nga reduced
66
T/F. Ddx of IgAN also does not require renal biopsy
False (requires)
67
Closely related disease of IgAN
Henoch-Schonlein purpura
68
What to suspect if px has gross hematuria 2-3 days after URTI
IgA Nephropathy
69
Mainstay of tx in IgAN
ACEIs or ARBS (primary tx is proper bp control and reduce proteinuria)
70
PSAGN vs IgAN
PSAGN: hematuria 2-3 weeks after infection IgAN: within days of iinfection
71
Form of hereditary nephritis with mutation in the COL4A5 gene encoding for the alpha chain of type IV collagen
Alport syndrome
72
Extrarenal manifestations of alport syndrome
Hearing deficits and ocular abnormalities
73
Presence of persistent microscopic hematuria and isolated thinning of the basement membrane on electron microscopy
Thin glomerular basement membrane disease
74
Most common cause of nephrotic syndrome in adults, but an uncommon cause of hematuria in children
Membranous nephropathy
75
Most common cause of Membranous nephropathy worldwide
Malaria
76
Most common small vessel vasculitis in pedia
Henoch schonlein purpura
77
Features of HSP
Purpuric rash and commonly accompanied by arthritis and abdominal pain
78
T/F. The glomerular findings can be indistinguishable from those of IgA nephropathy
True
79
T/F. Mild HSP nephritis requires treatment because it usually does not resolve spontaneously.
False (no tx because it resolves spontaneously)
80
One of the most common causes of community acquired acute kidney failure in pedia (<1 y.o. with acute gastroenteritis)
Hemolytic uremic syndrome
81
Triad of HUS
Acute renal failure, anemia, hx of AGE
82
Typical agents in HUS
E. coli and STX producing shigella dysenteriae; Non STX assoc (atypical)
83
Pathologic hallmark of HUS
Fibrin-platelet thrombi deposition in affected organs
84
T/F. Biopsy needed in ddx of HUS
False
85
Symptoms in HUS appear when post exposure
1-8 days ave 3 days
86
T/F. The prognosis for HUS not associated with diarrhea is more severe
True

Block 19 Module 3 (9 decks)

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