Gen Peds Nephrology
Proteinuria/Nephrotic Syndrome
Hematuria/GN
Renal Emergencies
Urinalysis Pearls
100
Creatinine increased from 0.3 → 0.5 mg/dL in a toddler. Is this AKI?
Yes
100
What are the three features of nephrotic syndrome?
-proteinuria
-hypoalbuminenia
-edema
100
What are the three classic features of GN?
-hematuria
-hypertension
-renal insufficiency
100
First step in treating hyperkalemia with ECG changes.
IV calcium
100
What should you consider in a patient with gross hematuria, negative dip UA, and negative for RBCs?
pigmenturia
200
A hospitalized child has decreased urine output. What urine output defines oliguria?
200
what defines proteinuria?
spot urine protein : creatinine
>0.2gm-gm
>2gm/gm = "nephrotic range"
200
Which labs should be obtained for initial work up of GN?
-UA with microscopy
-urine protein to creatinine ratio
-RFP
-CBC
-complements (C3, C4)
-ASO
-anti-DNAse B
200
Medications used to shift potassium intracellularly
insulin + glucose
bicarb
albuterol
200
What should you consider in a patient with gross hematuria, dip UA positive for blood, and UA negative for RBCs?
-hemoglobinuria
-myoglobinuria
300
Most common cause of AKI in hospitalized children.
Pre-renal injury from dehydration or hypoperfusion.
300
Which labs should be obtained for initial work up of nephrotic syndrome?
-UA with microscopy
-urine protein to creatine ratio
-RFP
-CBC
-complements (C3 and C4)
300
Name two sources of post-strep GN?
-throat infection (~2 weeks later)
-skin infection (4-6 weeks later)
300
A patient has low calcium and low bicarbonate. Which should you correct first?
calcium
300
What is the most common cause of recurrent UTIs in toilet-trained children?
bowel/bladder dysfunction
400
What do you need to know to assess if a child's BP is normal?
-height
-age
400
Name two complications of nephrotic syndrome
-thrombosis
-infection
400
Which diagnosis should you consider in a patient with gross hematuria with concurrent URI?
IgA
400
What BP reading in clinic should prompt referral to the ED?
Stage II hypertension with symptoms
OR
>30mmHg above 95th percentile
(or >180/120 in an adolescent)
400
How should you manage a pH of 9 on an otherwise normal UA?
Don't worry about it
500
How do you determine appropriate BP cuff size for a child?
-bladder should cover 80% of circumference of arm
-2/3 the length of the upper arm
500
What is the treatment for nephrotic syndrome?
-steorids!
-+/- albumin infusion
-sodium restriction
500
Which diagnosis should you consider with low C3 and low C4?
SLE
500
what are the indications for dialysis?
AEIOU (Acidosis, Electrolytes, Intoxications, Overload, Uremia)
500
What test/study should you obtain after a young child's first febrile UTI?
renal ultrasound