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Flashcards in Nephrology Deck (12):
1

What  is  the  daily  fluid  requirement  for  15kg  baby?

A.  1000

B.  1200 

C.  1400

D. 1600

 

Answer:  b

For  the  first  10  kg  we  give  100  ml  per  each  kilo

For  the  second  10  kg  (from  10  to  20  kg)  we  give  50  ml  per  each  kilo

For  every  kilo  after  20  kg  we  give  20  ml  per  each  kilo

So  this  baby  is  15  kg  which  will  be  (1000  ml  from  the  first  10  kg)  and  (5  kg  multiplied  by  50  =  250  ml)  so  the  baby’s  daily requirement will be 1250 ml per day.

 Answer:  15Kg  =  1250 . 1Kg = 2.2lbs. 

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2

What  is  the  most  common  intra-abdominal  tumor  in  children?

A.  Hepatoma (scc)

B.  Rhabdomyosarcoma

C.  Ewing tumor

D. Wilms tumor 

Answer:  d Explanation:  although  other  tumors  may  occur  at  such  age,  wilm’s  tumor  of  the  kidney  is  the  most  common  intra  abdominal malignancy of childhood. 

But the most common pediatric tumor in general is leukemia 

3

Baby  came  to  the emergency with  abnormal  movement  and  teeth  delay.   

Glucose is 5 (normal  range  from  (5-10) ,  Calcium is low   Magnesium is low ,  Phosphate is high What  is  the  best  management ?

 A.  Ca

B.  Mg

C.  Ringer

D.  Glucose  

   

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Answer  :  a

4

Child  with  fever,  general  swelling  and  dark  colored  of  urine  which  best  evaluate  for  this  pt:

A.  Us

B.  Rft

C.  Urine culture

D. Urine specimen

 

Answer: d 

this  Q  there  is  hematuria  we  will  do  Urine  analysis  to  confirm  hematuria  and  to  look  for  microscopic examination  and  also  will  give  us  a  hint  about  the  origin  of  hematuria  (  is  it  glomerular  or  non  glomerular )  then  if  it  is  glomerular  hematuria  requires  more  extensive  evaluation  (renal  ultrasound;  CBC;  complement  levels;  antinuclear  antibody  (ANA),  antineutrophilic  cytoplasmic  antibody  (ANCA),  and  ASO  titers; hepatitis B ) 

urinalysis  and  sediment  examination  are  crucial  in  the  evaluation  of  patients  with  acute  nephritic  syndrome.  Look  for the  following: •  Protein •  Blood •  Red blood  cells  (rbcs) •  White blood  cells  (wbcs) •  Dysmorphic  rbcs •  Acanthocytes •  Cellular  (ie,  rbc,  wbc)  casts •  Granular  casts •  Oval fat  bodies

5

Child  with  aspirin  intake  overdose  …  what  kind  of  acid-base  balance:

A.  Metabolic  alkalosis

B.  Metabolic  acidosis

C.  Respiratory  alkalosis

D. Respiratory acidosis

 

Answer  :  b

The  net  effect  of  these  changes  in  most  adults  is  respiratory  alkalosis  or  a  mixed  respiratory  alkalosis-metabolic  acidosis.  Pure metabolic  acidosis  is  unusual  in  adults,  but  is  more  common  in  children  .  

Children  with  mild  to  moderate  acute  salicylate poisoning  lose  the  respiratory  drive  and  are  more  likely  to  present  with  mixed  metabolic  and  respiratory  acidosis  . Respiratory alkalosis first in oncent then metabolic acidosis. 

6

Baby thirsty with tachycardia, sunken eye. Volume loss

A. 1%

B. <3%

C. 5-9%

D. 9% 

Answer: d ?

7

Typical  case  of  Poststreptococcal  glomerulonephritis  (PSGN).  What  will  you  do  to  confirm  diagnosis?

 

Answer:?

Occurs  1-3  wk  following  initial  primary  GAS  infection  of  pharynx  or  skin.  

 If the Glomerular involvement occurred in less than a week after URTI it’s due to IgA Nephropathy ( normal complement )

Post-Streptococcal  Glomerulonephritis  (PSGN) :

results in dark urine, described as “tea colored” or “cola colored.” Periorbital  edema  and  hypertension  also occur.

both throat and skin infections can lead to PSGN.

Diagnostic Testing

· Best  initial  test:  Antistreptolysin O (ASLO),  anti-DNase,  antihyaluronidase in blood. Complement levels c3 are low.

· Most accurate test:  Although  biopsy  is the most accurate test, it should  not be done routinely, because the blood tests are most often sufficient. Biopsy shows subepithelial deposits ( humps ) of IgG and C3.

Treatment

· Penicillin  and  other  antibiotics  for the infection should be given, although they do not clearly reverse the disease.

· Control the hypertension and fluid overload with  diuretics.

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8

7   y   child   and   an   U   & L   respiratory   tract   infection   since   birth   with    generalized   joint   pain  aches   his   uncle   and   brother   have   the   same   condition   labs     show   high   creatinine   and   BUN   and  +ve   urine   protein.  repeated

A.  idiopathic  fibrosis    

B.  Autoimmune  

 

Answer:  B.  Autoimmune  (**  With  broad  DDx  like  HSP  ,  WG  ,  SLE  and also   glomerulonephritis) 

Wegener’s  Granulomatosis ( GPA )  Upper respiratory problems  such as  sinusitis  and  otitis  are the key to diagnosis.  Lung  problems  (cough, hemoptysis, abnormal chest x-ray) are present as  well. Wegener’s is a  systemic  vasculitis,  so joint, skin, eye, brain, and GI problems are also present, but the  key is both  upper and  lower respiratory  involvement  in  addition  to renal involvement.

Diagnostic Testing

·Best initial test: c-ANCA (antineutrophil cytoplasmic antibodies) ·

Most accurate test:  Biopsy of  kidney

Treatment : The best initial therapy is cyclophosphamide and steroids.

9

baby  with  bilateral  renal  agenesis:

 

 Answer:  with  bilateral  renal  agenesis:  (oligohydramnios  which  is  a  sign  for  the  disease  during  prenatal diagnosis) 

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10

child  alert,  anterior  fontanelle  depressed,  how  much  dehydration:

   A. 5 - 9

B. >9

 

Answer:  A

Mild  5%  :  normal  fontanelle  

moderate  6-10%  :  Sunken  slightly

severe >10 % : Sunken significantly 

11

boy  with  glomerulonephritis  after  week  he  developed  hemoptysis  :

A. HSP 

B. goodpasture  syndrome

C. rapid  deterotion

Answer : B 

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12

3  year  old  child  with  UTI  admitted  what  investigation  to  be  done  ?

  -US

  -Cystoscope  

 

Answer:  

First you should do analysis and culture if not in the choices go for US 

guideline recommend routine ultrasonography of the urinary tract after first febrile UTI in children aged from 2 -24 years