Hematoria In Chuldren Flashcards
(31 cards)
What are the most imp lab signs of renal dz
Hematuria
Protienuria
Hematuria is the presence of >3-5 RBC/mm3 for > than 3times in fresh and concentrated urine
T or f
T
UTI is the most common etiology for hematuria
F
PIGN is the most common (50%)
UTI 2nd most common but (most common in urological problems)
Tests for hematuria :
Dipstick
Microscope
Dipstick become red colored when free Hb and myoglobin are present
f
Dipstick is orthotoluidine impregnated
Detect HB and Myoglobin by turning dipstick blue due to ortho oxidation
Free Hb and Myoglobin increase sensitivity of the test
State some cases where red urine dont represent hematuria
-beets
-blackberries
-rifampicin (Tb)
-deferroxamine (anti epilepsy)
In hemoglobinuria, RBCs are present in urine
F:
-absent RBCs in urine
-AKI
-brown/ red urine
-positive orth test
Hemoglobinuria with hematuria occurs:
Following hemolysis in urine when:
-highly alkaline urine
-very low specific gravity
Hemoglobinuria without hematuria:
Intravascular hemolysis:
-decrease in plasma haptoglobin levels
-pinkish color of plasma after centrifugation
-spun urine remains res
Intravascular hemolysis + low platlets+ high creatinine kinase
Hemolytic uremic syndrome due to E coli
Agents that cause hemoglobinuria:
-fava beans
-chloroform
-nephtaline
-quinine
Myoglobinuria is common in pediatric pop
F
It is uncommon
In myoglobinuria the AKI may follow increase in muscle exertion
T or f
T
After :
-Phy ex
-grand mal seizures
-status asthmaticus
-muscle dz
-toxins
-trauma
-burns
-heat stroke
Only CPK is increased in myoglobinuria
T or f
F
cpk and aldolase both increase
Serum is clear
Simple and practical way to localize source of hematuria
By RBC morphology thru examining 50-100 RBCs by:
-phase contrast microscopy
-conventional light microscopy
Fresh RBC indicate
Non glomerular origin
Glomerular origin for hematuria
- > 10-20% of crenated RBCs
- RBC casts (RBC + tubular matrix proteins)
- acantholysis
What can we find in fam Hx when searching for hematuria
-renal failure- nephrolithiasis- Pkd
-CAKUT (congenital anomalies of kidney and urinary tract)
- alport synd (hearing loss- occular abn- hematuria)
-sickle cell anemia and bleeding disorder
Hematuria with dysmorphic RBC cases:
1- PIGN
2- IgA nephropathy (BERGER dz)
3- familial benign hematuria
4- recurrent benign hematuria
5-henoch scholein purpura
6- SLE
7- shunt neohritis
8- memrano proliferative glomerulo nephritis
9- alport synd
10- bac endocarditis
11- interstitial nephritis
PIGN develops rapidly after infection
T or f
False
Develop after 7-21 d of infection
PIGN characteristics:
-hematuria, oliguria, HTN, and edema
- decrease in C3 ( alternative path is activated)
- good pronosis
After how many time is the C3 corrected in PIGN
After 4-8 w
IgA neohropathy have microscopic hematuria
T or f
F
It has macroscopic hematuria
Characteristic of IgA nephropathy
-recurrent macroscopic hematuria
- N C3
- ** during or shorlty** after URTI or excessive exercise
