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37 Cards in this Set
- Front
- Back
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What is the significance of an elevated serum creatinine?
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*Decreased renal clearance of creatinine
*Decline in GFR |
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Why is urea nitrogen a less reliable indicator of glomerular filtration?
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B/c urea is freely filtered but also reabsorbed in the renal tubules
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How is the renal concentration capacity commonly assessed? Which is more accurate?
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Measurement of urine specific gravity & urine osmolality; urine osmolality more accurate
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What is the appropriate renal response to metabolic acidosis?
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excretion of an acidic urine
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What endocrine fxns of the kidney are affected by renal failure?
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*EPO production
*Vit D3 production |
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What is usually the first imaging study in the evaluation of the child w/suspected kidney dz?
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Urinary tract US
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What information is provided in the urinary tract US?
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*size
*parenchymal texture *size of collecting system *anatomy of bladder |
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What advantage does radionuclide scanning for VUR have over voiding cystourethrogram?
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less radiation
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What are the manifestations of nephrotic syndrome?
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*massive proteinuria
*hypoalbuminemia *edema *hyperlipidemia |
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What is the most common presenting symptom of nephrotic syndrome?
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edema
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What is the proteinuria of nephrotic syndrome mainly composed of?
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albumin
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At what level of serum albumin is edema likely to appear?
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Serum albumin <2.5 g/dL
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What is the mechanism for the development of edema?
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*transudation of fluid
*increased renal tubular reabsorption of Na+ & H2O |
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What is the most accurate method for quantifying urinary protein excretion? What is most commonly used?
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*24 hour urine collection
*spot urine for protein & creatinine |
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With which conditions is transient proteinuria associated?
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*fever
*dehydration *stress *exercise |
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What is the most common form of nephrotic syndrome in childhood?
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Minimal Change Disease
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What is the drug of choice in childhood nephrotic syndrome?
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corticosteroids
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What is the definition of microscopic hematuria?
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>5 RBCs per high power field in three fresh urine specimens
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What conditions are associated with hematuria?
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*immunologic abnormalities
*coagulation disturbances *biochemical defects *direct toxic insults |
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What is the typical presentation associated with acute glomerulonephritis?
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*hematuria "cola-colored"
*edema *HTN *with or without oliguria |
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In the absence of bacteriologic evidence of infection, what lab studies are useful for diagnosing postinfectious glomerulonephritis? Which is more superior?
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*ASO
*Anti-DNAse-B titers *Anti-zymogen titer --superior |
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What is the most common variety of primary glomerulonephritis in children?
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IgA nephropathy
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What are the indications for hospitalization of the child with glomerulonephritis?
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*decreased urine output
*high blood pressure *any sign of fluid overload |
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What are the most typical findings in HSP?
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*purpuric rash
*arthritis *abd pain *nephritis |
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What is an important risk factor for UTI in boys? Girls?
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Boys- not being circumcised
Girls- previous ABX tx |
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What anatomic abnormality is associated w/urinary tract infection?
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VUR
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How should urine specimens be obtained from infants & children?
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*mid-stream clean catch
*catheterization *suprapubic aspiration |
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What are the most useful components of the urinalysis in the evaluation of UTI?
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*leukocyte-esterase test
*nitrite test *urine microscopy |
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Does the child with VUR need ABX prophylaxis?
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Yes
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Pediatric HTN is an average systolic or diastolic bp reading, taken on at least 3 separate occasions, > or equal to ____ %tile.
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95
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Why should bp & pulse be measured in all four extremities?
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to evaluate for the presence of coarctation of the aorta
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What finding, if present, is an indication of coarctation of the aorta?
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*weak femoral pulses or
*radial/femoral delay |
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The ______ the pt, the greater the likelihood that the HTN is secondary.
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younger
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How is acute renal failure (ARF) classified?
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*oliguric ARF
*nonoliguric ARF |
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When is end-stage renal disease present?
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When the GFR is 10 ml or less and renal replacement therapy is needed to maintain life.
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What three events may account for decreased GFR in AFR.
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*constriction of the afferent arteriole
*dilation of the efferent arteriole *decrease in permeability of the glomerular capillaries |
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What findings on UA may suggest ARF?
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*renal tubular casts
*tubular cells *cellular debris |
