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Peds > peds44 > Flashcards

peds44 Flashcards

1
Q

repletion phase for hyponatremic or isonatremic dehydration

A

replace fluids over 24 hours

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2
Q

repletion phase for hypernatremic dehydration

A

replace more slowly over 48 hours to minimize risk of cerebral edema

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3
Q

oral rehydration salt salotions

A

balanced mixtures of glucose and electrolytes (since glu co-transport still works in secretroy diarhhea, whereas other pways of Na absorption are impaired)

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4
Q

when is ORT inapprop

A

severe life-threatening dehydration, paralytic ileus, or GI obstruction, patients with extremely fast stool losses or repeated severe emesis losses

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5
Q

microscopic hematuria

A

greater than 6 RBCs per HPF, detected on 3 or more consec samples

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6
Q

urinary dipstick for hamturia

A

detects hemoglobin or myoglobin in the urine

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7
Q

false neg on urine dipstick for hematuria

A

vit C ingestion

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8
Q

RBC casts

A

glomerular bleeding (acute or active glomerulonephritis)

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9
Q

dymorphic RBCs

A

originating in the glomerulus, ofetn have blebs

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10
Q

RBCs that look normal

A

originate in the lower urinary tract

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11
Q

large numbers of RBCs (esp in the presence of dysuria)

A

may indicate acute hemorrhagic cystitis (due to bacterial or viral infection or chemotherapeutic agents like cyclophosphamide)

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12
Q

proteinuria

A

more than 100 mg/m2/day

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13
Q

how to screen for proteinuria

A

urine dipstick; it detects albumin

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14
Q

false pos on urine dipstick for protein

A

if urine is very concentrated (sg>1.025) or alkaline (pH > y) or If patient received certain meds (peniccilin, aspirin, oral hypoglycemic agents)

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15
Q

false neg on urine dipstcik for protein

A

if the urine is very dilute

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16
Q

most accurate way to detect proteinuria

A

24 hour protein collection ; normal Is less than 100 mg/m2

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17
Q

random spot urine

A

protein to creatinine ratio; early morning sample is ideal;

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18
Q

normal urine TP/CR for 6-24 months

A

<0.5

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19
Q

normal urine TP/CR for > 2 years is <0.2

A

right

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20
Q

benign transient proteinuria

A

may be associated with vigorous exercise, fever, dehydration, and CHF

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21
Q

wht if dipstick is pos for blood but no rbcs on microscopic U/A

A

hemoglobinuria or myoglobinura

22
Q

RBC casts

A

glomerulonephritis; if no casts, can be glomerular or lower urinary source

23
Q

examples of tubular proteinuria

A

interstitial nephritis, ischemic renal injury (ATN), and tubular damage due to nephrotoxic drugs

24
Q

marker for tubular proteinuria (as opposed to glomberular)

A

urinary B2 microglobulin

25
Q

glucosuria and aminoaciduria

A

accompany tubular proteinuria

26
Q

nephritic syndrome

A

gross hematuria, htn, fluid overload from renal insuff

27
Q

most common form of acute glomerulonephritis in school aged kids

A

psotstrep glomerulonephritis; but rare before age 2

28
Q

when does post strep glomerulonephritis develop relative to infection

A

8-14 days after infection of skin or pharynx with group A beta hemolytic strep

29
Q

low serum complement (C3)

A

transient in post-strep GN

30
Q

prognosis of post strep GN

A

usually normalizes in 6-8 weeks; severe renal failure is rare

31
Q

diagnosis of poststrep GN

A

ASO titer, ADB titer

32
Q

bx in post-strep gn?

A

not typically indicated but if you were to do it, youd see mesangial cell proliferation

33
Q

does antibiotic tx of strep reduce the risk of post strep GN?

A

no, but it does reduce the risk of rheumatic fever

34
Q

bergers diseaes

A

aka IgA nephopathy

35
Q

most common type of chronc glomerulonephritis world wide

A

bergers disease

36
Q

when does bergers disease usually present?

A

second or third decade of life

37
Q

bergers diseae more common in what races?

A

asia, australian, and in native americans; rare in african american

38
Q

clinical features of bergers

A

recurrent bouts of hematuria assoc with resp infections

39
Q

diagnosis of iga nephropathy (bergers)

A

renal biopsy shows mesangial prolif and incr mesangial matrix

40
Q

treatment for iga nephropathy

A

mainly supportive; meds only recommended for patients with associated pathologic proteinuria or renal insuff

41
Q

henoch-schonlein purpura nephritis

A

igA mediated vasculitis with palpable purpura on the butt and thigh, abdominal pain, arthritis and hematuria

42
Q

prognosis

A

in majority of patients, the renal featurs of HSP are self-limited with recovery in 3 months; 1 to 5% develop chronic renal failure

43
Q

membranoproliferative glomerulonephritis

A

mesangial hypercellularity and thickened glomerular basement membrane

44
Q

prognosis for membranoproliferative glomerulonephritis

A

variable, but most patients ultimately develop end stage renal disease

45
Q

managmeent of membranoproliferative glomerulonephritis

A

some patients repsond to steroids; ace inhib may slow progression

46
Q

membraneous nephropahty

A

more common in young kids; heavy proteinuria and often progresses to renal insuff

47
Q

most common cause of nephrotic syndrome in the US

A

membraneous nephopathy

48
Q

nephrotic syndrome characterisitics

A

heavy proteinuria (>50 mg/kg/day), hypoalbuminemia, hypercholesterolemia, and edema

49
Q

when does nephrotic syndrome present?

A

2/3 present before 5 years

50
Q

types of nephrotic syndrome

A

primary (most common), NS that results from other primary glomerular diseases; NS that results from systemic diseases

51
Q

most common cause of primary NS

A

minimal change disease

52
Q

systemic diseases that can cause NS

A

SLE and HSP

Peds (99 decks)

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