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89 Cards in this Set
- Front
- Back
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infants / adults kidneys are less effective in filtering
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infants' kidneys = less effective
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bilateral renal agenesis: seen in what syndrome?
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Potter's syndrome
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why do Potter's baby die shortly after birth?
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pulmonary hypoplasia
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most common renal dysplasia
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multicystic kidney
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T/F: multicystic kidneys do not function
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true
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2 most common causes of renal masses in newborns
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1.multicystic kidney
2.hydronephrosis |
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autosomal recessive polycystic kidney: pathophysiology?
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-palpable renal mass
-grossly nl -dilated CTs -> cysts -poor function |
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polycystic kidney: px?
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shortened life expectancy
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most common cause of hydronephrosis
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UPJ obstruction
(ureteropelvic junction) |
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UPJ obstruction: clinical sx
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1.palpable abd mass
2.abd/flank pain 3.hematuria |
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UPJ obstruction: tx
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surgery (pyeloplasty)
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UPJ obstruction: causes
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1.intrinsic fibrosis
2.kinked ureter 3.crossing renal vessel |
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vesicoureteral reflux (VUR): pathophysiology
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incompetent functional valve
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VUR: unilateral / bilateral?
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usually bilateral
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VUR: clinical sx
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1.recurrent UTIs (most common)
2.pyelonephritis 3.prenatal hydronephrosis |
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VUR: dx test
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VCUG (voiding cystourethrogram)
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T/F: UPJ obstruction can lead to renal parenchyma destruction
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true!!!
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VUR: tx
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1.abx prophylaxis (age < 5)
2.surgery (grade V) |
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VUR: classification based on...
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1.level of reflux
2.collecting system dilation |
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posterior urethral valves: what is it?
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posteriorly situated leaflets in prostatic urethra -> partial bladder outlet obstruction
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PUV: consequences
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1.urethral dilation
2.bladder neck hypertrophy 3.mucosal trabeculation 4.VUR 5.renal agenesis |
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most common cause of end-stage renal disease in childhood
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posterior urethral valves
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PUV: dx tests
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1.U/S
2.VCUG (clearly detects) |
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PUV: tx
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1.transurethral ablation (cystocopy)
2.temporary supravesical diversion (vesicostomy) for neonates |
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most common congenital anomaly of penis
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hyposapdias
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ventral placement of urethral meatus
dx? |
hypospadia
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hypospadia: associated anomalies
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1.hernia
2.undescended testes |
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cryptochidism
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testes that have not fully descended into scrotum
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cryptochidism: complications
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1.ultrastructural changes
2.impaired sperm production 3.CA risk |
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bilateral cryptochidism -> ?
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oligospermia
infertility |
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cryptochidism: higher rate in infants / premies?
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premies
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palpable mass along inguinal canal + inguinal hernia
dx? |
cryptochidism
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cryptochidism: spontaneous descent at 6-12 months?
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unlikely
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cryptochidism: tx
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surgery (orchiopexy) at 12-18 months
good success rate |
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testicular torsion = surgical emergency?
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yes! (prevent loss of testicle!)
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testicular torsion: pathophysiology
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no posterior attachment to tunica vaginalis to prevent testis from rotating around spermatic cord
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unilateral scrotal pain
n/v tender, swollen testis scrotal edema (-) cremasteric reflex ddx? |
1.testicular torsion
2.epididimytis |
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testicular torsion
vs. epididimytis? |
doppler U/S
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testicular torsion: tx
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surgery (best if < 6 hrs)
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"bag of worms"
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varicocele
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varicocele: more common on L / R?
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left side
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noncommunicating hernias: resolve on own by...?
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age 12 months
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hydrocele: dx at what age?
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newborn / early childhood
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varicocele: dx at what age?
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adolescence
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communicating hydroceles & scrotal hernias: must be repaired b/c...
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prevent incarcerated hernias
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varicocele: what is it?
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dilated testicular vein
enlarged pampiniform plexus |
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varicocele: clinical sx?
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1.usually on left
2.nontender 3.prominent when standing |
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varicocele: surgery indications
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1.pain
2.interfer w/hormone production 3.ipsilateral testicular atrophy |
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T/F: unrepaired varicocele can place pt at increased risk of infertility
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true
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febrile infant: most common site of infection?
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UTI
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UTI: common bugs
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1.e.coli
2.proteus 3.klebsiella |
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UTI: risk factors
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UT abnlity ->
-stasis -obstruction -reflux -dysfxnal voiding |
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UTI: ddx
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1.external irritation
2.sexual abuse 3.pinworm 4.adenovirus 5.LL PNA |
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febrile infants < 1-2 yrs: must check what?
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urine U/A
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UTI: gold standard dx test
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UCx
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T/F: absence of WBCs/RBCs r/o UTI
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false!
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UTI: all children < 24 mos need what dx test?
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renal U/S to r/o hydronephrosis, etc.
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UTI: source of infection in neonates vs. older children
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neonates: hematogenous seeding
older children: fecal flora |
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UTI: if (+) LE, then...
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treat presumptively until UCx results return
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nephrotic syndrome: components
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1.proteinuria
2.hpoalbuminemia 3.hyperlipidemia 4.edema |
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periorbital edema -> LE edema -> generalized edema -> ascites
also anorexia &/ diarrhea dx? |
nephrotic syndrome
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minimal change disease: presents at age...?
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age 2-6
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nephrotic syndrome: tx
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1.restrict salt intake
2.oral steroids 3.biopsy if resolution in 8-12 wks |
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most frequent complication of nephrotic syndrome
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spontaneous bacterial peritonitis (SBP)
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red cell casts + hematuria
dx? |
glomerulonephritis
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most common glomerulonephritis
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APGN
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strep throat / impetigo -> 1-3 wks later -> hematuria + red cell casts
dx? |
APGN
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T/F: treating strep throat will prevent APGN
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false!
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HSP: indisgtuinshable from what other glomerulonephritis?
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IgA nephropathy
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IgA nephropathy: benign / progressive renal failure?
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25% progress to renal failure
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IgA nephropathy: dx test
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renal biopsy
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alport's syndrome: defect in...?
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type IV collagen
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alport's syndrome: inheritane pattern
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x-linked
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sensorineural hearing loss
hereditary nephritis |
alport's syndrome
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thinning glomerular BM
asx microscopic/gross hematuria nl renal fxn AD hereditary pattern |
benign familial hematuria
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"tea colored" urine, oliguria
malaise abd pain, edema HTN |
glomerulonephritis
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T/F: most syndromes recur in transplanted kidney
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true!
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renal tubular acidosis: lyte abnlity found
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hyperchloremic metabolic acidosis
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most common type of RTA in children & adults
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distal RTA type 4
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excessive urinary loss of bicarb, aa, proteins, glucose, lytes, water
dx? |
fanconi's syndrome
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RTA: tx
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alkalinizing agent (bicarb, citrate)
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nephrogenic DI: inherited / acquired?
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both
presents in 1st few yrs of life |
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polyuria
compensatory polydipsia recurrent hyperNa+ dehydration developmental delay frequent hyperNa+ seizures dx? |
nephrogenic DI
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nephrogenic DI: tx
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1.low Na+ diet
2.thiazide diuretics 3.indomethacin |
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HTN: definition for children
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>95% for age, gender, ht on 3 separate occassions
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children more likely to have primary/secondary HTN
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secondary HTN (renal disease)
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HTN
vomiting ataxia AMS seizures dx? |
HTN encephalopathy
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HTN: best tx
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preventative health care
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hyperkalemia
azotemia metabolic acidosis dx? |
acute renal failure (ARF)
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