Peds Exam 2 latest complete update A+
graded
How many different BP readings do you need to dx a kid w/ HTN? - answers At least 3
different ones
Definition of HTN in kids - answers BP >95th percentile for age, sex and measured on
at least 3 different occasions
Primary vs Secondary HTN
MCC - answers Primary
Primary vs Secondary HTN
RF: Obese children - answers Primary
Primary vs Secondary HTN
Young children - answers Secondary (<6 yo)
MCC of secondary HTN? - answers Kidney dz
1-13 yo child
Normal BP classification - answers SBP & DBP <90th percentile
1-13 yo child
Elevated BP classification - answers SBP & DBP 90th-95th percentile
(or)
120/80 to 95th percentile
1-13 yo child
Stage 1 HTN classification - answers SBP & DBP >=95th to <95th percentile + 12
mmHg
(or)
130/80 to 139/89 mmHg
1-13 yo child
Stage 2 HTN classification - answers SBP & DBP >=95th percentile + 12 mmHg
,(or)
>=140/90
<6 yo w/ HTN. What dx test should you get? - answers US of kidneys (more likely
secondary if young)
Indications for meds in primary HTN? - answers 1) Stage 2
2) Stage 1 if not responding to lifestyle changes
Stage 2 HTN tx? - answers AntiHTN meds
Stage 1 HTN tx? - answers Start w/ lifestyle changes and then consider meds
1st line meds for primary HTN in kids? - answers ACEi & ARB
Kid is on ACEi for HTN, needs a second med. What med is safe to add? - answers
Thiazide
What AntiHTN med is recommended in sexually active female? - answers CCB
(Cuz ACEi & ARB CI in pregnancy)
Med indicated in secondary HTN, that is caused by renovascular dz. - answers CCB
3 Nephritic syndromes - answers 1) IgA Nephropathy
2) Poststreptococcal GN
3) Henoch-Schonlein Purpura
Nephritic vs Nephrotic
Proteinuria >3.5 g per day - answers Nephrotic
Nephritic vs Nephrotic
Proteinuria 1-3.5 g per day - answers Nephritic
Nephritic vs Nephrotic
Protein & RBC loss - answers Nephritic
Nephritic vs Nephrotic
"Coca cola colored urine" - answers Nephritic
Systemic sxs of Nephritic dz - answers 1) Preceding rash
2) Fever
3) Arthralgia
High or low levels in nephritic dz?
Serum Cre:
Albumin: - answers Serum Cre: High
,Albumin: Low
High or low levels in nephritic dz?
Cholesterol:
C3/C4 Complement: - answers Cholesterol: High
C3/C4 Complement: Low
Nephritic vs Nephrotic
RBC casts - answers Nephritic
12 yo M pt presents w/ gross hematuria, flank pain and coca colored urine. They had an
URI 48 hours ago. Dx?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers a) IgA Nephropathy
M or F for IgA Nephropathy? - answers M
IgA Nephropathy AKA - answers Berger dz
Pathophys in Berger dz? - answers IgA immune complexes 1st line defense against
URI/GI infx overproduce & damage kidneys
Definitive dx of Berger dz? - answers Renal biopsy (+ IgA deposits in the mesangium)
Mgmt of IgA Nephropathy? - answers ACEi/ARB for proteinuria
BP control
7 yo boy peeing blood, had pharyngitis 3 weeks ago?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers c) Poststreptococcal GN
7 yo boy peeing blood, has impetigo 5 weeks ago?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers c) Poststreptococcal GN
M or F for Poststreptococcal GN? - answers M
Poststreptococcal GN
, Group A strep pharyngitis. How long ago? - answers 1-3 weeks
Poststreptococcal GN
Group A strep impetigo. How long ago? - answers 3-6 weeks
Best lab to get to check for recent group A strep when pt presents w/
glomerulonephritis? - answers Ab titers
(Cultures might not be positive anymore)
MC Ab titer to get for Poststreptococcal GN? - answers Anti-streptolysin (ASO)
Which 2 Ab titers are seen w/ impetigo?
a) AHase
b) Anti-NAD
c) ASO
d) Anti-DNase B Ab
e) ASKase - answers a) AHase
d) Anti-DNase B Ab
Nephritic vs Nephrotic
Immune mediated - answers Nephritic
Supportive mgmt for Poststreptococcal GN? - answers 1) Dietary Na+/water restriction
2) Diuretics
3) AntiHTN agents
4) Steroids
5) Immunosuppressants
6) Loop diuretics (IV Furosemide)
Pt presents w/ hematuria, arthralgia, abd pain and rash. Dx?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura (HSP) - answers e) HSP
MC systemic vasculitis of childhood - answers Henoch-Schonlein Purpura (HSP)
M or F for HSP? - answers M
Tetrad of HSP? - answers 1) Rash (palpable purpura)
2) Arthralgia/arthritis
3) Abd pain
4) Renal dz
Is palpable purpura blanchable from HSP? - answers No
graded
How many different BP readings do you need to dx a kid w/ HTN? - answers At least 3
different ones
Definition of HTN in kids - answers BP >95th percentile for age, sex and measured on
at least 3 different occasions
Primary vs Secondary HTN
MCC - answers Primary
Primary vs Secondary HTN
RF: Obese children - answers Primary
Primary vs Secondary HTN
Young children - answers Secondary (<6 yo)
MCC of secondary HTN? - answers Kidney dz
1-13 yo child
Normal BP classification - answers SBP & DBP <90th percentile
1-13 yo child
Elevated BP classification - answers SBP & DBP 90th-95th percentile
(or)
120/80 to 95th percentile
1-13 yo child
Stage 1 HTN classification - answers SBP & DBP >=95th to <95th percentile + 12
mmHg
(or)
130/80 to 139/89 mmHg
1-13 yo child
Stage 2 HTN classification - answers SBP & DBP >=95th percentile + 12 mmHg
,(or)
>=140/90
<6 yo w/ HTN. What dx test should you get? - answers US of kidneys (more likely
secondary if young)
Indications for meds in primary HTN? - answers 1) Stage 2
2) Stage 1 if not responding to lifestyle changes
Stage 2 HTN tx? - answers AntiHTN meds
Stage 1 HTN tx? - answers Start w/ lifestyle changes and then consider meds
1st line meds for primary HTN in kids? - answers ACEi & ARB
Kid is on ACEi for HTN, needs a second med. What med is safe to add? - answers
Thiazide
What AntiHTN med is recommended in sexually active female? - answers CCB
(Cuz ACEi & ARB CI in pregnancy)
Med indicated in secondary HTN, that is caused by renovascular dz. - answers CCB
3 Nephritic syndromes - answers 1) IgA Nephropathy
2) Poststreptococcal GN
3) Henoch-Schonlein Purpura
Nephritic vs Nephrotic
Proteinuria >3.5 g per day - answers Nephrotic
Nephritic vs Nephrotic
Proteinuria 1-3.5 g per day - answers Nephritic
Nephritic vs Nephrotic
Protein & RBC loss - answers Nephritic
Nephritic vs Nephrotic
"Coca cola colored urine" - answers Nephritic
Systemic sxs of Nephritic dz - answers 1) Preceding rash
2) Fever
3) Arthralgia
High or low levels in nephritic dz?
Serum Cre:
Albumin: - answers Serum Cre: High
,Albumin: Low
High or low levels in nephritic dz?
Cholesterol:
C3/C4 Complement: - answers Cholesterol: High
C3/C4 Complement: Low
Nephritic vs Nephrotic
RBC casts - answers Nephritic
12 yo M pt presents w/ gross hematuria, flank pain and coca colored urine. They had an
URI 48 hours ago. Dx?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers a) IgA Nephropathy
M or F for IgA Nephropathy? - answers M
IgA Nephropathy AKA - answers Berger dz
Pathophys in Berger dz? - answers IgA immune complexes 1st line defense against
URI/GI infx overproduce & damage kidneys
Definitive dx of Berger dz? - answers Renal biopsy (+ IgA deposits in the mesangium)
Mgmt of IgA Nephropathy? - answers ACEi/ARB for proteinuria
BP control
7 yo boy peeing blood, had pharyngitis 3 weeks ago?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers c) Poststreptococcal GN
7 yo boy peeing blood, has impetigo 5 weeks ago?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura - answers c) Poststreptococcal GN
M or F for Poststreptococcal GN? - answers M
Poststreptococcal GN
, Group A strep pharyngitis. How long ago? - answers 1-3 weeks
Poststreptococcal GN
Group A strep impetigo. How long ago? - answers 3-6 weeks
Best lab to get to check for recent group A strep when pt presents w/
glomerulonephritis? - answers Ab titers
(Cultures might not be positive anymore)
MC Ab titer to get for Poststreptococcal GN? - answers Anti-streptolysin (ASO)
Which 2 Ab titers are seen w/ impetigo?
a) AHase
b) Anti-NAD
c) ASO
d) Anti-DNase B Ab
e) ASKase - answers a) AHase
d) Anti-DNase B Ab
Nephritic vs Nephrotic
Immune mediated - answers Nephritic
Supportive mgmt for Poststreptococcal GN? - answers 1) Dietary Na+/water restriction
2) Diuretics
3) AntiHTN agents
4) Steroids
5) Immunosuppressants
6) Loop diuretics (IV Furosemide)
Pt presents w/ hematuria, arthralgia, abd pain and rash. Dx?
a) IgA Nephropathy
b) Alport syndrome
c) Poststreptococcal GN
d) Minimal change dz
e) Henoch-Schonlein Purpura (HSP) - answers e) HSP
MC systemic vasculitis of childhood - answers Henoch-Schonlein Purpura (HSP)
M or F for HSP? - answers M
Tetrad of HSP? - answers 1) Rash (palpable purpura)
2) Arthralgia/arthritis
3) Abd pain
4) Renal dz
Is palpable purpura blanchable from HSP? - answers No
