Kids and Kidneys Flashcards Preview

Hugh's MD3 Paediatrics > Kids and Kidneys > Flashcards

Flashcards in Kids and Kidneys Deck (29):
1

How does kidney disease present in children?

Late

2

How do you tell if the blood pressure cuff is the right size?

Largest cuff that fits between the shoulder and elbow

3

What is normal BP in children?

Less than 90th percentile

4

What are the cut offs for hypertension?

90-95th or more than 120/80 - pre-HTN
More than 95th - stage 1
More than 99th - stage 2

5

What are the causes of HTN?

White coat HT
Organic
- Renal, cardiac, endocrine
Lifestyle/familial

6

What are the most common causes of organic HTN?

Renal - cyst, reflux

7

Who do you measure BP in?

Children with chronic disease

8

What are the symptoms of malignant HT?

Headache
Blurred vision
Nausea
Vomiting
- Medical emergency due to raised ICP and risk of encephalopathy

9

How do you treat malignant HT?

Bring it down slowly

10

How do you treat malignant HT?

Bring it down slowly

11

What are the main causes of haematuria?

Artefact
Transient
UTI
Medical Renal disease
- Hypercalciuria
- Thin basement membrane disease
- Alport syndrome
- Glomerulonephritis
- Coagulopathy

Urological disease
- Calculi - 1-2% of children
- Tumour
- Stricture
- Trauma

12

What is thin membrane disease?

Recessive collagen type 4 disorder
Generally benign, causes haematuria during illness

13

How do you investigate proteinuria?

Spot collection
- Early morning, albumin creatinine ratio

14

What are the causes of proteinuria?

Artefact
Transient
Benign orthostatic proteinuria
UTI
Renal disease
- Acute or chronic kidney disease

15

What are the features of nephrotic syndrome?

Oedema
Hypoalbuminaemia
Proteinuria
Hypercholesterolaemia
Prothrombic

16

Why do you get prothrombic in nephrotic syndrome?

Concentrated blood
Loss of anticoagulant factors

17

What is minimal change disease?

GN
In 2-10 yo, atopic, triggered by infection and immune mediated, 90% response to steroids, relapse occur in 2/3

18

How is minimal change disease managed?

Steroids - take 1 week to work
Penicillin to prevent spontaneous bacterial peritonitis
Aspirin - prothrombic state

19

What are the features of nephritic syndrome?

HT
Haematuria - heavy and macroscopic
Proteinuria
Renal impairment
Oliguria

20

What are some acute complications of nephritic syndrome?

K derangement

21

What are the causes of nephritic syndrome?

GN of any sort - SLE, IgA
Post-strep GN important

22

What is the most important test in post-strep GN?

Complement levels - C3 and C4 will be low in Post-strep GN

23

How is nephritic syndrome treated?

Diuretics - Frusemide

24

What is HUS? How does it present?

Haemolytic uraemic syndrome

Bloody diarrhoea illness one week previous
Reduced urine output
Also
- CNS
- Pancreatitis

25

What is the pathophysiology of HUS?

Thrombotic microangiopathy
Mechanical not immune mediated

26

What is the classic Ix finding in HUS?

RBC fragments on blood film

27

How does HSP present?

Not unwell
Lower limb purpura
GI - abdo pain
Joint - arthralgia

28

What is the long term risk in HSP?

IgA nephropathy

29

How do you Mx HSP?

Steroids for GI and joint symptoms
Monitor for six months for kidney involvement