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70 Cards in this Set
- Front
- Back
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crystals in the urine point to what? |
kidney stone dz |
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whats a good marker for tubular proteinuria (tubules are broken and can't REABSORB low weight proteins?) |
B2-microglobulin |
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general what causes glomerulonephritis |
IMMUNE-mediated damage to glomerulus, with IC deposition |
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Hematuria with HTN** |
Nephritic |
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Hematuria with lOw** BP, high**lipids |
NephrOtic |
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kid has IMPETIGO or Strep Throat, 1-2 weeks later gets nephritic syndrome, what bug? |
GABH strep |
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PMS give low complements |
-post strep -membranoprolif -SLE |
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what titers should you get if you suspect post-strep nephritis? |
ASO & ADB(more reliable) |
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#1 cause CHRONIC glomerulonehpritis in the world |
IgA nephropathy (Bergers)-can't clear IgA and make ICs |
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RECURRENT* bouts of hematuria with* URI |
IgA |
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Dx IgA nepropathy |
Renal Bx: mesangial proliferation and IgA deposition |
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7yo boy has abdominal pain (from IgA vasculitis===> could become ileal-ileal intussesception), joints, microscopic hematuria, palpable purpura* evrywhere but the trunk! |
Henoch-Schoenlein Purpura |
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Tx for HSP |
steroids |
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thickened glomerula BASEMENT MEMBRANE |
membranoprolif nephritis |
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low albumin, high cholesterol, EDEMA, low BP, HEAVY proteinuria |
Nephrotic |
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loss of charge and size selectivity of glomerular barrier to filtration of plasma proteins |
Nephrotic synrome |
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proteins lost in urine==>lose oncotic pressure==>liver compensates===>makes more plasma proteins, including lipids |
can't clear lipids because of reduce activity of lipoprotein lipase in fat tissue |
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BAD EDEMA* following URI |
nephrotic |
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what are nephrotic patients predisposed to? |
THROMBOSIS* d/t HYPERCOAGULABILITY (Ex; renal vein, sagittal sinus, stroke!) |
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what are nephrotic patients at risk of? |
infxn by ENCAPSULATED bugs (strep pneumo) -could present with spontaneous bacterial peritonitis, PNA, or sepsis! |
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why are you hypercoagulable in Nephrotic? |
because losing AT3*** and vK factor** |
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casts in the urine? |
NOT minimal change dz!! |
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Tx minimal change dz |
steroids |
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Tx for steroid-resistant MCdz? |
cyclophosphamide or cyclosporine |
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LOW PLTS, hemolytic anemia, renal failure |
Hemolytic Uremic Synrome |
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two types of HUS |
1. shiga toxin 2. atypical (drugs, inherited) |
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what bacteria causes HUS? |
E. coli 0157:H7===>shiga toxin |
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how does Shiga toxin work? |
binds to vascular endothelial cells, causing injury and plat thrombosis and renal ischemia |
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NEVER give Abx for E. coli hemorrhagic colitis/HUS!!!* |
could worsen it! just do supportive Tx |
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drugs causing Atypical HUS |
OCPs, cyclosporine, tracrolimus, OKT3 |
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Atypical HUS is just like Shiga toxin HUS except for: |
no diarrhea |
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Hereditary Renal Disease: |
-alports -multicystic renal dysplasia -PCKD (AR, AD) |
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defects of type IV collagen in basement membrane |
Alport's syndrome: X dominant |
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what else besides kidney dz happens in Alports? |
-hearing loss -ocular |
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Tx alports |
-treat HTN with ACEinhib to slow progression of renal dz, then do transplant |
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#1 cause of renal mass in NEWBORN* |
multicystic renal dysplasia |
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PCKD (AR): infantile |
-Hx of oligohydramnios==>pulmonary hypoplasia -large cystic kidneys -severe HTN -liver cirrhosis with PHTN |
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PCKD (AD): |
adult onset |
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RTA |
-can't conserve BICARB or -can't excrete H+ |
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hyperCl ACIDOSIS, NAG |
RTA |
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infant, young child with RTA |
-FTT, vomiting |
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older kid with RTA |
-recurrent kidney stones, muscle weakness, bone pain, myalgias |
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Distal tubule can't excrete* H+ |
distal RTA: I |
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prox tubule can't reabsorb* HC03- |
proximal RA: II |
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RTA associate with nephrotic syndrome or Amphotrecin |
Type I |
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can cause nephrocalcinosis or nephrolithiasis if untreated |
RTA I |
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TRANSIENT acidosis in infants/kids and HYPERKALEMIA* |
RTA IV |
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Tx for RTA IV |
furosemide to lower serum potassium, and oral alkali |
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RTA associated with aldoterone deficiency |
RTA IV |
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caused by heavy metal intoxication, gentamicin, Fanconi syndrome |
Prox RTA:II |
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associated with muscle weakness |
RTA II |
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what is oliguria in kids? |
UO<1mL/kg/hr |
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BUN/Crt >20 |
prerenal |
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urine Na <20 |
prerenal |
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FENA <1% |
prerenal |
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ischemic injury caused by renal hypopefusion |
AKI: high urinary B2-microglobulin and FENA>1% |
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most common abdominal mass in a newborn |
multicystic dysplastic kidney |
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what can VUR lead to? |
pyelonephritis (because backflow of urine up to kidneys) |
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Dx of VUR |
voiding cystourethrogram |
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any kid with renal stones, think: |
metabolic disorder |
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conditions associated with renal stones: |
-hyperCa -Hyperoxaluria -distal RTA I -hyeprPTH -cystinuria -UTI |
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hyperoxaluria can be secondary to: |
malabsorption (inflammatory bowel disease) |
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hyperuricosuria can occur during tx of what? |
-luekemia or lymphoma |
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hyperuricosuria can occur with what condition? |
Lesch-Nyhan syndrome |
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radioopaque renal stones |
cystinuria |
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#1 cause of UTI |
E. coli |
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bug causing UTI associated with high urine pH |
Proteus |
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bug causing UTI most common in adolescent females |
staph saprophyticus |
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Tx for UTI |
oral TMP/SMX |
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neonate with UTI tx: |
-admit for initial IV amp/gent |
