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89 Cards in this Set

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infants / adults kidneys are less effective in filtering
infants' kidneys = less effective
bilateral renal agenesis: seen in what syndrome?
Potter's syndrome
why do Potter's baby die shortly after birth?
pulmonary hypoplasia
most common renal dysplasia
multicystic kidney
T/F: multicystic kidneys do not function
true
2 most common causes of renal masses in newborns
1.multicystic kidney
2.hydronephrosis
autosomal recessive polycystic kidney: pathophysiology?
-palpable renal mass
-grossly nl
-dilated CTs -> cysts
-poor function
polycystic kidney: px?
shortened life expectancy
most common cause of hydronephrosis
UPJ obstruction
(ureteropelvic junction)
UPJ obstruction: clinical sx
1.palpable abd mass
2.abd/flank pain
3.hematuria
UPJ obstruction: tx
surgery (pyeloplasty)
UPJ obstruction: causes
1.intrinsic fibrosis
2.kinked ureter
3.crossing renal vessel
vesicoureteral reflux (VUR): pathophysiology
incompetent functional valve
VUR: unilateral / bilateral?
usually bilateral
VUR: clinical sx
1.recurrent UTIs (most common)
2.pyelonephritis
3.prenatal hydronephrosis
VUR: dx test
VCUG (voiding cystourethrogram)
T/F: UPJ obstruction can lead to renal parenchyma destruction
true!!!
VUR: tx
1.abx prophylaxis (age < 5)
2.surgery (grade V)
VUR: classification based on...
1.level of reflux
2.collecting system dilation
posterior urethral valves: what is it?
posteriorly situated leaflets in prostatic urethra -> partial bladder outlet obstruction
PUV: consequences
1.urethral dilation
2.bladder neck hypertrophy
3.mucosal trabeculation
4.VUR
5.renal agenesis
most common cause of end-stage renal disease in childhood
posterior urethral valves
PUV: dx tests
1.U/S
2.VCUG (clearly detects)
PUV: tx
1.transurethral ablation (cystocopy)
2.temporary supravesical diversion (vesicostomy) for neonates
most common congenital anomaly of penis
hyposapdias
ventral placement of urethral meatus

dx?
hypospadia
hypospadia: associated anomalies
1.hernia
2.undescended testes
cryptochidism
testes that have not fully descended into scrotum
cryptochidism: complications
1.ultrastructural changes
2.impaired sperm production
3.CA risk
bilateral cryptochidism -> ?
oligospermia
infertility
cryptochidism: higher rate in infants / premies?
premies
palpable mass along inguinal canal + inguinal hernia

dx?
cryptochidism
cryptochidism: spontaneous descent at 6-12 months?
unlikely
cryptochidism: tx
surgery (orchiopexy) at 12-18 months

good success rate
testicular torsion = surgical emergency?
yes! (prevent loss of testicle!)
testicular torsion: pathophysiology
no posterior attachment to tunica vaginalis to prevent testis from rotating around spermatic cord
unilateral scrotal pain
n/v
tender, swollen testis
scrotal edema
(-) cremasteric reflex

ddx?
1.testicular torsion

2.epididimytis
testicular torsion
vs.
epididimytis?
doppler U/S
testicular torsion: tx
surgery (best if < 6 hrs)
"bag of worms"
varicocele
varicocele: more common on L / R?
left side
noncommunicating hernias: resolve on own by...?
age 12 months
hydrocele: dx at what age?
newborn / early childhood
varicocele: dx at what age?
adolescence
communicating hydroceles & scrotal hernias: must be repaired b/c...
prevent incarcerated hernias
varicocele: what is it?
dilated testicular vein

enlarged pampiniform plexus
varicocele: clinical sx?
1.usually on left
2.nontender
3.prominent when standing
varicocele: surgery indications
1.pain
2.interfer w/hormone production
3.ipsilateral testicular atrophy
T/F: unrepaired varicocele can place pt at increased risk of infertility
true
febrile infant: most common site of infection?
UTI
UTI: common bugs
1.e.coli
2.proteus
3.klebsiella
UTI: risk factors
UT abnlity ->
-stasis
-obstruction
-reflux
-dysfxnal voiding
UTI: ddx
1.external irritation
2.sexual abuse
3.pinworm
4.adenovirus
5.LL PNA
febrile infants < 1-2 yrs: must check what?
urine U/A
UTI: gold standard dx test
UCx
T/F: absence of WBCs/RBCs r/o UTI
false!
UTI: all children < 24 mos need what dx test?
renal U/S to r/o hydronephrosis, etc.
UTI: source of infection in neonates vs. older children
neonates: hematogenous seeding
older children: fecal flora
UTI: if (+) LE, then...
treat presumptively until UCx results return
nephrotic syndrome: components
1.proteinuria
2.hpoalbuminemia
3.hyperlipidemia
4.edema
periorbital edema -> LE edema -> generalized edema -> ascites

also anorexia &/ diarrhea

dx?
nephrotic syndrome
minimal change disease: presents at age...?
age 2-6
nephrotic syndrome: tx
1.restrict salt intake
2.oral steroids

3.biopsy if resolution in 8-12 wks
most frequent complication of nephrotic syndrome
spontaneous bacterial peritonitis (SBP)
red cell casts + hematuria

dx?
glomerulonephritis
most common glomerulonephritis
APGN
strep throat / impetigo -> 1-3 wks later -> hematuria + red cell casts

dx?
APGN
T/F: treating strep throat will prevent APGN
false!
HSP: indisgtuinshable from what other glomerulonephritis?
IgA nephropathy
IgA nephropathy: benign / progressive renal failure?
25% progress to renal failure
IgA nephropathy: dx test
renal biopsy
alport's syndrome: defect in...?
type IV collagen
alport's syndrome: inheritane pattern
x-linked
sensorineural hearing loss
hereditary nephritis
alport's syndrome
thinning glomerular BM
asx microscopic/gross hematuria
nl renal fxn
AD hereditary pattern
benign familial hematuria
"tea colored" urine, oliguria
malaise
abd pain, edema
HTN
glomerulonephritis
T/F: most syndromes recur in transplanted kidney
true!
renal tubular acidosis: lyte abnlity found
hyperchloremic metabolic acidosis
most common type of RTA in children & adults
distal RTA type 4
excessive urinary loss of bicarb, aa, proteins, glucose, lytes, water

dx?
fanconi's syndrome
RTA: tx
alkalinizing agent (bicarb, citrate)
nephrogenic DI: inherited / acquired?
both

presents in 1st few yrs of life
polyuria
compensatory polydipsia
recurrent hyperNa+ dehydration
developmental delay
frequent hyperNa+ seizures

dx?
nephrogenic DI
nephrogenic DI: tx
1.low Na+ diet
2.thiazide diuretics
3.indomethacin
HTN: definition for children
>95% for age, gender, ht on 3 separate occassions
children more likely to have primary/secondary HTN
secondary HTN (renal disease)
HTN
vomiting
ataxia
AMS
seizures

dx?
HTN encephalopathy
HTN: best tx
preventative health care
hyperkalemia
azotemia
metabolic acidosis

dx?
acute renal failure (ARF)