Pediatrics Renal

banannie's version from 2016-02-27 17:31

Nephrotic syndrome

Question Answer
proteinuria >3.5 with hypoalbuminemianephrotic [think minimal change, membranous, membranoproliferative]
podocyte effacementminimal change disease
associated with Hodgkin lymphomaminimal change disease
how do you treat minimal change disease?corticosteroids
subendothelial depositsmembranoproliferative glomerulonephritis
mesangial cell proliferationmembranoproliferative glomerulonephritis
tram-tracking membranoproliferative glomerulonephritis
complement activation with low C3 membranoproliferative glomerulonephritis
MC cause of chronic glomerulonephritis in older children/young adults membranoproliferative glomerulonephritis

Nephritic syndrome

Question Answer
proteinuria <3.5 with hematuria, edema and HTNnephritic [think PSGN, Alport, Goodpasture's, IgA]
subepithelial humpsPSGN
C3 deficiencyPSGN
how long after strep are patients at risk for PSGN2+ weeks after pharyngitis and 3-6 weeks after impetigo
classic triad of PSGNcola colored urine, HTN, edema
treatment of strepdoes not prevent PSGN
MC cause of nephritic syndrome in kidsPSGN
best test for acute PSGNanti-DNase antigen
what is the cause of PSGNtype III hypersensitivity aka immune complex deposits
thin-thick capillary loopsalport syndrome
what is the cause of alport syndromex-linked type IV collagen mutation
presentation of alportcan't see, can't pee can't hear a buzzing bee
1-2 day after URIAlport
hematuria + hemoptysisGoodpasture's
linear IgG depositsGoodpasture's
treatment of goodpasture'splasmapharesis
normal C3IgA nephropathy
1 week after URIIgA nephropathy
causes of IgA nephropathyhsp, cirrhosis, celiac, IBD
treatment of IgA nephropathyACEI, ARBs, statins, steroids
MC chronic glomerular disease worldwideIgA nephropathy


Question Answer
hematuria + unilateral flank masswilms tumor (nephroblastoma)
hematuria + hemoptysisGoodpasture's
hematuria + infection 2-4 weeks agoPSGN
hematuria + infection 1 week agoIgA nephropathy
hematuria + URI 1-2 days agoAlport's syndrome
hematuria + dilated pelvis and calycesureteropelvic junction obstruction
MC renal malignancy of early childhood (age 2-4)wilms tumor (nephroblastoma)
wilms tumor is a part of what syndromebeckwith-wiedemann or WAGR [Wilms tumor, Aniridia, GU malformation, Retardation]
ddx for unilateral flank masswilms tumor vs. neuroblastoma

Kidney Stones

Question Answer
mc typecalcium oxalate
envelope crystalscalcium oxalate
hexagonal crystalscystine
radiolucent on x-raycystine and uric acid
radiopaque on x-raycalcium oxalate, ammonium magnesium
kids w/family Hx of stonescysteine. can't resorb certain AA
staghorn calculicystine or ammonium magnesium phosphate


Question Answer
mc cause of hydronephrosis in childrenureteropelvic junction obstruction
presentation of ureteropelvic junction obstructiondilated kidney, urinary stasis, infection, hematuria
treatment of ureteropelvic junction obstructionpyeloplasty
what is vesicoureteral reflux?retrograde urine flow from bladder to ureters
recurrent UTIvesicoureteral reflux
complications of vesicoureteral refluxpyelonephritis, scarring, ESRD
treatment of vesicoureteral refluxresolves over time, but monitor and ppx UTI's
UTI in malesposterior urethral valves
presentation of posterior urethral valvesmild hydronephrosis in a boy with a palpable distended bladder
complications of posterior urethral valvesobstruction, UTI, ESRD
MC cause of potter'sposterior urethral valves
diagnose renal malformationsvoiding cystourethrogram (VCUG)
dx UTI in infants/toddlersurethral catheterization, urinalysis and urine culture
indications for renal and bladder u/s<24 mos with febrile UTI, recurrent UTI, FHx, no response to abx
MC cause of UTIE.coli, Klebsiella, Proteus, S.sapro
flank painpyelonephritis
Indications for a renal/bladder ultrasoundkids<2 years with febrile UTI, recurrent UTI, family history, not responding to ABX


Question Answer
complication of untreated or delay in treatment of undescended testesincreased risk for malignancy (seminoma mc)
mc cause of testicular pain over 12 years oldtesticular torsion
mc cause of testicular pain 2-11 yearstorsion of appendix testes
how do you treat testicular torsion?emergency surgery! within 6 hours, no more than 12 hours!
cause of varicoceleno venous valves results in dilated vein
bag of wormsVaricocele
what side do varicoceles usually present on?left, because of venous drainage
complication of unrepaired varicoceleinfertility
cause of hydrocelefluid fills scrotum due to patent processus vaginalis
treatment of hydrocelemost involute by 12 months
hypospadias is associated withhernias and undescended testes
risk factor for cryptorchismpremature
complications of cryptorchismoligospermia, infertility, increase risk of testicular cancer
medical treatment of enuresisdesmopressin
diagnose testicular torsion?ultrasound
diagnose appendix testes?blue dot in the skin


Question Answer
Defect of H+ secretionRTA 1 [Distal]
Causes of RTA IAmphotericin B, autoimmune (Sjogren, SLE, RA), Sickle cell
high urine pH >5.3RTA type 1 [Distal]
Treatment of RTA I and RTA IIPotassium Citrate
Complications of RTA INephrolithiasis
Defect of HCO3- rebsorptionRTA II [Proximal]
Causes of RTA IIFanconi syndrome (glucosuria, phosphaturia, aminoaciduria)
urine pH = 5.3 (eventually <5.3)RTA II
low K+RTA II
Complications of RTA IIRickets/Osteomalacia
Aldosterone resistanceRTA IV [Distal]
low urine pH <5.3RTA IV
high K+RTA IV
Causes of RTA IVCAH, obstructive uropathy
Treatment of RTA IFurosemide, Fludrocortisone
Complication of RTA IVHyperkalemia


Question Answer Column 3
labs of HUSlow hemoglobin, helmet cells, fragmented cells, reticulocytosis, low platelets, hematuria and proteinurainephropathy associated with Hepatitis Bmembranous nephropathy
HUS clinical presentationmost common less than 4 years old. blood diarrhea, mild renal insufficiency