Nephrology Flashcards Preview

Pediatrics PLE > Nephrology > Flashcards

Flashcards in Nephrology Deck (44):
1

Most common chronic glomerular disease worldwide

More common in males

Predominance of IgA within mesangial deposits of the glomerulus

Normal C3 level

Gross/microscopic hematuria associated with URTI or GI infection 1-2days prior to its onset

IgA Nephropathy/Berger Disease

2

Treatment for IgA Nephropathy

ACE inhibitors and ARBs - proteinuria, proper BP control

3

X-linked disease due to mutation in the COL4A5 gene

All patients have asymptomatic microscopic hematuria
Bilateral sensorineural hearing loss
Anterior lenticonus

Alport Syndrome / Hereditary Nephritis

4

Presence of persistent microscopic hematuria and isolated thinning of the GBM on electron microscopy

Thin Basement Membrane Disease

5

Immune complex mediated reaction

It follows infection of the throat (1-2wks) or skin (3-6wks) by GABHS

Decrease in C3/hypocomplementemia

Gross hematuria, periorbital edema, hypertension and oliguria

Lumpy-bumpy pattern
Subepithelial humps

Acute Poststreptococcal Glomerulonephritis

6

Best single Ab titer to document skin infection

DNAse B antigen

7

DOC for acute PSGN

Penicillin (10 days)

8

(+) anti-GBM antibody

IF: linear IgG, C3
EM: no deposits
LM: focal to diffuse proliferation with crescents

Associated with pulmonary hemorrhage, iron deficiency anemia

Treatment: cyclophosphamide, plasma exchange, steroids

Goodpasture Syndrome

9

Hallmark: Crescents in the majority of glomeruli

Rapid and relentless progression to ESRD

Acute nephritis with concomitant proteinuria, often with nephrotic syndrome

Crescentic glomerulonephritis / Rapidly Progressive Glomerulonephritis

10

Microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency

Onset is preceded by gastroenteritis

Eating of undercooked meat and unpasteurized milk

Helmet cells, Burr cells, schistocytes on PBS

Hemolytic uremic syndrome

11

Most common form of Hemolytic uremic syndrome

Toxin-producing E. Coli

12

Microangiopathic hemolytic anemia, thrombocytopenia, renal insufficiency, CNS involvement, fever

Thrombotic Thrombocytopenic Purpura

13

Sudden onset of gross/microscopic hematuria and unilateral flank mass, flank pain, oliguria, hemolytic anemia, thrombocytopenia

Renal Vein Thrombosis

14

Bilateral palpable flank masses in an infant with pulmonary hypoplasia, oligohydramnios/Potter fascies, hypertension

Polycystic Kidney Disease

15

Most common cause of Urinary tract infection

E. Coli

16

Fever, flack pain, nausea and vomiting, malaise

Pyelonephritis

17

Gross hematuria and dysuria, urgency, frequency, incontinence, malodorous urine, suprapubic pain

Associated with Adenovirus

Cystitis

18

(+) urine culture without any manifestations of infection

Most common in girls

Asymptomatic bacteriuria

19

DOC for Acute Cystitis

Trimethoprim-Sulfamethoxazole (3-5 days)

20

Treatment for pyelonephritis

Oral: Cefixime
IV: Ceftriaxone 50-75mg/kg/day OR Cefotaxime 100mg/kg/day OR Ampicillin 100mg/kg/day plus Gentamicin 3-5mg/kg/day

21

Heavy proteinuria (40mg/m2/hr)
Hypoalbuminemia (<2.5mg/g/dl)
Hyperlipidemia
Edema

Nephrotic Syndrome

22

Most common idiopathic form of nephrotic syndrome

E/M: flattening of effacement of epithelial cell foot processes

Normal C3 level

Minimal Change Disease

23

Most common cause spontaneous bacterial peritonitis?

Streptococcus pneumoniae

24

Increased T3 and T4; low TSH; (+) TRSAb

Anxiety attacks with palpitations, feeling of restlessness

Marked proptosis and fine tremors with increasing frequency

Graves' Disease

25

Low T4 & T3; elevated TSH

Prolonged physiologic jaundice

Birthweight and length are normal

Feeding difficulties, sluggishness, lack of interest, somnolence

Hypothyroidism

26

Most common cause of thyroid disease in children and adolescents

Thyroiditis

27

Stimulates osteoclasts to reabsorb calcium in the DCT

PTH

28

Inhibits osteoclast activity thus decreasing calcium reabsorption

Calcitonin

29

Most commonly due to a PTH-producing parathyroid adenoma that is not responsive to normal feedback regulation via an increased Ca concentration

Primary hyperparathyroidism

30

High PTH production due to decreased Ca and resulting in compensatory parathyroid gland hyperplasia

Secondary Hyperparathyroidism

31

Persistent parathyroid hyperfuction in spite of hypocalcemia correction and preexisting secondary hyperparathyroidism

Tertiary Hyperparathyroidism

32

Most consistent x-ray finding in hyperparathyroidism

Resorption of subperiosteal bone along the margins of the phalanges of the hands

33

Deficiency of 21-hydroxylase: increase serum 17-Hydroxyprogesterone

Congenita Adrenal Hyperplasia

34

Deficient production of cortisol or aldosterone due to congenital or acquired lesion of the hypothalamus, pituitary gland or adrenal cortex

Addison's Disease

35

Gradual muscle weakness, general wasting, hypotension

increased skin pigmentation on face and hands, most intense around the genitals

Addison's Disease

36

Obesity with associated hypertension which is the result of abnormally high blood levels of cortisol resulting from hyperfunction of the adrenal cortex

Cushing syndrome

37

Cathecholamine secreting tumor arising from the chromaffin cells

Pheochromocytoma

38

Most common sex chromosomal aneuploidy in males

Tall, slim, underweight, long legs, small testes and penis

Associated with leukemia and lymphoma

47, XXY / Klinefelter Syndrome

39

Cardinal finding in all girls with Turner Syndrome

Short stature

40

Most common skeletal abnormalities in Turner Syndrome

Shortening of the 4th metatarsal and metacapal bones
epiphyseal dysgenesis in the joints of the knees and elbows

41

Most common endocrine-metabolic disorder of childhood and adolescence

Diabetes Mellitus

42

Diagnostic criteria Diabetes Mellitus

Random plasma glucose >200 mg/dl
Fasting plasma glucose >126 mg/dl
PLUS polyuria, polydipsia, unexplained weight loss with glucosuria and ketonuria

43

Secondary nephrotic syndrome should be suspected in patients with

Proteinuria
Hypertension

44

The antihypertensive medication of choice in ALL children with proteinuric renal disease at chronic kidney disease

Enalapril