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Paediatrics > Lecture 14 Paediatric Nephrology > Flashcards

Lecture 14 Paediatric Nephrology Flashcards

1
Q

Proteinuria is a sign of what syndrome

A

Nephrotic Syndrome

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2
Q

Haematuria is a sign of what syndrome

A

Nephritic Syndrome

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3
Q

Haemolytic Uraemic Syndrome causes what type of kidney injury

A

Acute Kidney Injury

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4
Q

What percentage of the cardiac output do the nephrons receive

A

25%

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5
Q

Name 5 functions of the kidney

A 
Waste
Water
Salt
Acid base
Endocrine
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6
Q

What are the 2 types of proteins that make up the Glomerular Filtration Barrier

A

Type Iv collagen

Laminin

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7
Q

Where are Type IV collagen and Laminin synthesised from

A

Podocytes

Endothelial cells

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8
Q

Where are Mesangial cells found

A

Embedded in GBM

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9
Q

What is the function of Mesangial cells

A

Structural support

Regulates blood flow of the glomerular capillaries

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10
Q

Which component of the nephron is affected in minimal change disease

A

Epithelial (podocyte)

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11
Q

Which component of the nephron is affected in Post Infectious Glomerulonephritis

A

Basement Membrane

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12
Q

Which component of the nephron is affected in PIGN and Haemolytic Uraemic Syndrome

A

Endothelial cell

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13
Q

Which component of the nephron is affected in IgA Nephropathy

A

Mesangial cells

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14
Q

Which component of the nephron is affected in congenital nephrotic syndrome

A

Podocyte cytoskeletal integrity

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15
Q

Which component of the nephron is affected in Alport Syndrome

A

Basement membrane proteins

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16
Q

How is Proteinuria diagnosed

A

Dipstix
Protein Creatinine Raio >250mg
24 hour urine collection

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17
Q

What are the typical features of Nephrotic Syndrome

A

Age 1-10
Normal blood pressure
No frank haematuria
Normal renal function

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18
Q

What are the atypical features of Nephrotic syndrome

A

Suggestions of autommune disease
Abnormal renal function
Steroid resistance

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19
Q

What is the treatment for Nephrotic Syndrome

A

Predinsolone

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20
Q

Give an example of acquired steroid resistant nephrotic syndrome

A

Focal Segmental Glomerulosclerosis

21
Q

How is Haematuria diagnosied

A

Macroscopic- colour change

Microscopic- Dipstix

22
Q

Name causes of Haemturia

A 
Clotting disorders
Glomerulonephritis
Wolm's 
Cysts
Sarcomas
Stone
UTI
Trauma
Urethritis
23
Q

What organism commonly causes Acute post-infectious Glomerulonephritis

A

Group A strep Haemolytic

24
Q

What are the site of infections for PIGN

A

Throat

Skin

25
Q

How is PIGN diagnosed

A

Bacterial culture
Positive ASOT
Low C3 normalises

26
Q

How is PIGN treated

A

Antibiotics
Support renal functions
Diuretics

27
Q

What is the cause of IgA Nephropathy

A

1-2 days after URTI

28
Q

How is IgA nephropathy diagnosed

A

Clinical picture

Biopsy- IgA deposits

29
Q

What is the treatment of IgA Nephropathy

A

ACEI

Immunosuppression

30
Q

What are the symptoms of Henoch Schonlein Purpura IgA related Vasculitis

A

Abdominal pain
Renal involvement
Arthritis or arthralgia
Purpuric rash (thigh and buttock)

31
Q

Name 3 causes of IgA vasculitis

A

Viral URTI
Streptococcus
Drugs

32
Q

How is IgA vasculitis treated

A

Glucocorticoid therapy

Immunosuppression

33
Q

What Acute Kidney Injury 1

A

Measured creatinine >1.5-2x reference

34
Q

What Acute Kidney Injury 2

A

Measured creatinine 2-3x reference

35
Q

What is Acute Kidney Injury 3

A

Serum creatinine >3x reference

36
Q

Name pre-renal causes of AKI (4)

A

Glomerular disease
Tubular injury
NSAID
Autoimmune

37
Q

Name post renal causes of AKI

A

Obstructive Uropathies

38
Q

What are the clinical features Haemolytic Uraemic Syndrome

A

Haemolysis
Thrombocytopenia
AKI

39
Q

Name the causes of typical HUS

A

E.coli- Entero-haemorrhagic
E.coli- Verotoxic producing
Pneumococcal infections
Drugs

40
Q

Name a common feature of atypical HUS

A

Blood diarrhoea

41
Q

What is the management of Haemolytic Uraemic Syndrome

A

Monitor: fluid, waste, electrolytes, acid base, hormones
Maintain: IV normal saline and fluid
Minimise: NSAIDs, antibiotics

42
Q

What are the congenital factors linked to CKI

A

Turner, Trisomy 21

43
Q

What is the presentation of CKD

A 
Fever
Vomiting
Loin tenderness
Loss of appetite
Weight loss
Itch
Polyuria
Lethargy
UTIs
44
Q

How is CKD diagnosed

A

Dipstix- leucocyte esterase activity, nitrites
Microscopy: Pyuria and bacturia
Culture >10^5

45
Q

What are the further investigations used to confirm CKD

A

US
DMSA
MAG3 scan

46
Q

What is a DMSA isotope scan used to assess

A

Scarring and function

47
Q

How is CKD managed

A

Oral antibiotics
Fluids
Hygiene
Manage voiding dysfunction

48
Q

How does CKD cause metabolic bone disease

A

Causes phosphate retention
Increased PTH
Leads to Hypocalcaemia

49
Q

What are the treatment principles for Metabolic Bone Disease

A

Low phosphate diet
Phosphate binders
Active Vitamin D

Paediatrics (30 decks)

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