Nephrology/Urology Flashcards by Ryan Good

Electrolyte requirements

Na - 1 mEq/kg
K - 2 mEq/kg
Cl - 3 mEq/kg

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Volume of distribution

0.6 x wt x 1L/kg

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Osmolarity calculation

2NA + BUN/2.6 + glucose/18

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Electrolyte disturbances in hypernatremic dehydration

Hyperglycemia, hypocalcemia

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FENa calculation

(Una x Pcr)/(Ucr x Pna)

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FENa in prerenal AKI

< 1%

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RAS stimulation

decreased renal perfusion

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Angiotensin II effects

vasoconstriction, renal effects (efferent vasoconstriction, Na reabsorption, aldosterone secretion), ADH secretion

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Aldosterone effects

Na reabsorption, K secretion

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ANP effects

vasodilation, renal effects (dilates afferent/constricts efferent, decrease Na reabsorption, decrease RAS)

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Diagnosis of nephrotic syndrome

Proteinuria (> 40 mg/mg2/hr)
Edema
Elevated cholesterol

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False positive for protein on UA

pH > 7.5

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FSGS diagnosis

Nephrotic syndrome NOT responsive to steroids

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FSGS prognosis

50-70% progress to CKD (30% relapse in transplant)

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Nephrotic syndrome causes

Primary (90%) - MCD&raquo_space;> FSGS > MPGN

Secondary (10%) - HSP, SLE, HUS

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Renal disease with decreased C3

PSGN, MPGN, SLE nephritis

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Congenital nephrotic syndrome genetics

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Congenital nephrotic syndrome findings

Oligohydramnios, large placenta, presentation < 1 yo, death by E. coli sepsis

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MCD age group

preschool

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Complications of MCD

peritonitis (s. pneumo, e. coli), thrombosis

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Treatment of refractory MCD

cyclophosphamide, cyclosporine

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Most common vasculitis in children

HSP

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HSP pathogenesis

IgA deposition

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HSP findings

Palpable purpura, abdominal pain (intussusception), arthralgia/arthritis, renal dz

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HSP diagnosis

clinical (biopsy reserved for atypical cases)

Indications for glucocorticoids in HSP

abdominal pain (NOT indicated for renal dz)

Recurrence rate of HSP

up to 1/3 (screen with UA every 6 mo)

HUS findings

microangiopathic hemolytic anemia, AKI, thrombocytopenia

HUS prognosis

5% mortality, 5% complictions

Risk factors for development of HUS

antimobility agents, vomiting (if < 5.5 yo), WBC > 13 K

ARPKD presentation

Infant - enlarged kidney, pulmonary hypoplasia, highest mortality Children - liver fibrosis, less renal dz

Most common cause of congenital hydronephrosis

UPJ obstruction

Prophylactic antibiotics in VUR

For patients 2-24 mo

Prune belly syndrome eponym

Eagle-Barrett syndrome

Prune belly syndrome findings

lack of abd. muscles, cryptorchidism, GU abnormalities

RTA type 1

Distal - inability to secrete H+ causes severe acidosis

RTA type 2

Proximal - inability to reabsorb HCO3

RTA type 4

Deficiency or resistance to aldosterone (decreased K+, mild acidosis

Alport genetics

X-linked

Alport defect

type IV collagen

Alport findings

Glomerulonephritis, hearing loss, ocular abnormalities

Cystinosis genetics

Cystinosis defect

defect in lysosomal transport

Liddle syndrome genetics

Liddle syndrome defect

"gain on function" of aldosterone sensitive Na channels --> HTN, hypokalemia, alkalosis

Membranous glomerulonephritis association

HBV

Diagnosis of metabolic syndrome

3/5 of obesity, HTN, insulin resistance, hyperlipidemia, hyperglycemia

Most common cause of severe HTN in childhood

renal artery stenosis

Lethal side effect of metformin

lactic acidosis

Causes of anion gap acidosis

Methanol, Uremia, DKA, Paraldehyde, Inborn EM, Lactic acidosis, Ethylene glycol, Salicylate

Ammonium chloride (acid load) test

Expect acidification (pH < 5.5) of urine (does NOT happen in RTA type 1)

Diagnosis of RTA type 2

24-hour urine collection (?Fanconi syndrome)

Unilateral cystic kidney

Multicystic dysplastic kidney

Multiscystic dysplastic kidney association

VUR (40%)

PSGN treatment

symptomatic - ie diuretic if HTN

Hypokalemia metabolic acidosis

Bartter syndrome, Gitelman syndrome

Bartter syndrome

Hypercalciuria, nephrocalcinosis, polyhydramnios

Gitelman syndrome

Hypocalcemia, hypomagnesemia, salt-wasting

Most common cause of abdominal mass in a newborn

multicystic dysplastic kidney

Management of UPJ obstruction

surgical intervention if decreased ipsilateral function on renal scan

2nd most common cause of prenatal hydronephrosis

megaureter

Management of hypospadias and unilateral undescended testicle

karyotype - possible mixed gonadal dysgenesis (45 XO, 46 XY)

Radiographic evaluation of undescended testicle

unnecessary

Age of orchidopexy

6-12 months

Rate of foreskin retraction

1 yr - 50%, 5 yr - 90%

Balanoposthitis

inflammation of prepuce and glans

Paraphimosis

foreskin stuck in retracted position

Most common complication of circumcision

meatitis leading to meatal stenosis

Hypospadias location

ventral side (underside)

Medical management of bladder instability

oxybutynin (SE: dry mouth, facial flushing, constipation)

Management of enuresis

bedwetting alarm, desmopressin, imipramine

Indication for management of varicocele

ipsilateral testicular hypotrophy

Management of torsion of appendix testis

NSAIDs

Age range for testicular torsion and torsion of appendix testis

appendix testis - pre-pubertal | testicular torsion - pubertal boys

Nephrology/Urology Flashcards

(74 cards)