Flashcards in Urology Deck (14):
nepthritic syndrome mneumonic
PHAROAH = Proteinuria, Hematuria, Azotemia, RBC casts, Oliguria, Anti-strep titres (if post-strep), and Hypertension
1. Massive proteinuria (>3.5g/24hr)
Vesicoureteral reflux Grades
I/II not urgent. Observation, abx prophylaxis, cultures q3months. IV/V: suspect kidney damage, surgery.
Metabolic consequences of the nephrotic syndrome include the following:
Hyperlipidemia and atherosclerosis
Hypocalcemia and bone abnormalities
Selective vs nonselective proteinuria criteria
>85% albumin = selective (probably only affects glomerular charge).
Tx categories of nephrotic syndrome
steroid sensitive, steroid resistant, steroid dependent, frequently relapsing.
Causes of nephrotic syndrome
primary: MCD, focal glomerulosclerosis, membranous, hereditary.
Secondary: diabetes, SLE, amyloidosis, infection like HCV, HBV, HIV, drugs.
Posterior urethral valve
Congenital in males. Causes bilateral hydronephrosis. Dx: ultrasound is ok, best is voiding cystourethrogram or cystoscopy.
Clinical diagnosis. Adolescents and neonates mosty. Severe unilateral scrotal pain and swelling, abdominal cramps, nausea and vomiting. Absent cremasteric reflex. Surgical detorsion/exploration immediately. 90% are saved if within 6 hours.
A 7-year-old boy has crampy abdominal pain and a rash mainly on the back of his legs and buttocks as well as on the extensor surfaces of his forearms. Laboratory analysis reveals proteinuria and microhematuria. He is most likely to be affected by:
HSP. IgA small vessel vasculitis. Extensor surface of extremities rash (rarely trunk and face); colicky abdo pain, hematuria, arthritis, edema, GI bleed, renal failure. Supportive care. Recovery in several weeks.
A 2-year-old patient has microscopic and occasionally gross hematuria. His father has hearing loss and end-stage renal disease. The most
likely cause of this child’s hematuria is:
Alport Syndrome: xlinked. Hereditary nephritis/hearing loss. Leads eventually to ESRD.
aka juxtaglomerular hyperplasia - salt waste disorder. Autosomal recessive.
Maternal polyhydraminos. Polyuria, polydipsia. Hypokalemia, hypocalcemia, hyperaldosteronism, hyperreninism, alkalosis.
Encopresis stats and therapy
Common: 20% at age 5 with 15% spontaneously resolving per year. ddAVP can help but not a cure usually. Fm Hx common.