nephrology Flashcards
HUS TRIAD what is usualy the history
THROMBcytopenia
haemolytic anaemia- microangipathic
kidney failure
diarrhea for a bout a week and then when its dissolves child is pale
history of child with hUS
parents would say that child has been having diarrhoea (bloody or non bloody) before symptoms began or had contact with farm annals
normal urine output
1-3ml/kg
<1 year = 2 - so if mcc says infant !
toddler =1.5
older children =1
1.
treatment of upper uti in babies
no symptoatic bacyteriua
cephalosporins or co-amoxi for 7-10 days
postive mb in urine but no symptoms common in girls who bed wed
Abs for post strep grammarian arthritis
nephritic syndrome and neutrophils
protein too
low c3
cells seen in HUS
tx for lower uti
schistocytes
nitrofurointin, cephalosportins for 3 days
What can cause post strep a
skin infection or a throat infection
Difference between IGA and toe streptococcus
Both wIll present with a similar history but POST STREP it’s more chronic weeks where is IG A is more acute
and also the antibodies
IG A - will have iG a depostis
pst strep - IG G
WHAT I S TTUBULAR CASTSIN URINE INDICATIVE OF
TUBULAR NECROSIS
CLASSIC SIGN OF IG A
MACROSPCI HEMATURIA
TARGET AUDIENCE FOR IG A
YOUNG MEN -2-3 DAYS AFTER A RESPI INFECTION
TX HUS
DO NOT GIVE TRANSFUSION OF BLOOD OR PLATELTES will make it worse, we just treat symptomatically, either fluid restriction to not overwhelm or hydration, depends on the degree of damage
tea and coke sign of
nephritic
ARF IN KIDS
less than 0.5/kg/hour, we can commonly see this in gastroenteritis
SODIUM LEVELS
in pre-renal it tends to be low (because kindeys are trying to hold on to as much water as possible) and in renal it tends to be high as the kidneys lose their ability to conserve and re-absorb sodium
RENAL >20
PRE- RENAL <10 or some say 20?
which conditions are associated with low c3
post strep and lupus!1
Glomerular versus extra glomerular
glomerular : no clots, coke and tea, rbc casts, protein cast
posterior urthral valves
whats important to remember
associated with respiratory problems can lead to potters syndrome hypertrophic bladder bilateral hydronephrosis vesicle uretral reflux key hole sign on ultrasound dont use a baloon catheter, catheritiesaton can be difficult and lead to bladder spasm
potter syndrome
whcih condtions are only found in boys
oligohydromious
Potter phenotype refers to a typical facial appearance that occurs in a newborn when there is no amniotic fluid.
typcically can die from respiratory issues
fetal compression : dysmorphic features suquashed face/limbs
posterior uretheral valve
urtheral atresia
urtheral hypoplasiia
b2 microglobulin
use b2 microlgllbulin, its found on most nucleated cells and shed to be excreted. Small traces are found in blood and urine, because the tubules reabsorb the b2 was filtered so if there is a tubular problem then levels in urine increase and since the glomeruli are responsible for the filtering process, if they are not working then levels in blood increase. B2 is also a tumour marker for certain malignant silk eleukemia, mm,
AKI CONSTELLATION
hyperkalemia
hypnatremia
hypocalcemi
hyperphosphatrema
most serious complications of AKI
LUPUS labs
pulmonary edema
hyperkalemia
metabolic acidosis
low c3! ANA, (RF in 30%) anticardilipin antibodies
hemorrhagic cystitis
bed wetting
adenovirus
more common in boys, upper age limit is 5, a lot will have a history of bed wetting
primary
secondary: used to be dry now nt so have to test for all the diabtees and do an palpation to check for large bladder
tx - restroct fluids before bed
waking child up to pee after a few hours
TCA- imiprimine
frailly syndrome
dilated calyx
hydronephrosis
tumour
heamtauriai
