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NURP 533 Renal Exam Study Guide
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NURP 533 Renal ExamStudy Guide
What is the most common cause of acute glomerulonephritis in children? - Answer 1.
Post-streptococcal glomerulonephritis
2. Focal segmental glomerulosclerosis
3. Membranoproliferative glomerulonephritis
4. Immunoglobulin A (IgA) nephropathy
Which of the following lab value patterns is most likely to be found 4 weeks after
Streptococcus pharyngitis in a child that has developed post-streptococcal
glomerulonephritis? - Answer 1. Elevated C3 level, elevated antistreptolysin (ASO) titer
2. Normal C3 level, normal ASO titer
3. Low C3 level, elevated ASO titer
4. Elevated C3 level, decreased ASO titer
What is the most common type of chronic glomerulonephritis in adults? - Answer 1.
Post-streptococcal glomerulonephritis
2. Lupus nephritis
3. Membranoproliferative glomerulonephritis
4. IgA nephropathy
S/S of acute postinfectious glomerulonephritis (GN) - Answer facial edema, abdominal
swelling, HTN, proteinuria, lymphadenopathy, swollen joints, hematuria, RBC casts in
urine, oliguria, strep rash or HSP, lethargy, anorexia, nausea, vomiting, abdominal pain,
weight gain with abrupt onset
what tests to order for postinfectious GN? - Answer CBC, ESR, UA, BMP, complement
levels (C3 will be decreased), ASO titer (may be increased w/ recent GAS
inf=poststreptococcal GN).
What are the complications of chronic renal failure? - Answer HTN, pulmonary edema,
HF, hyperlipidemia, electrolyte abnormalities, anemia, erythropoeiten def (page 752)
What labs will you check in a patient with CKD? - Answer Electrolytes, calcium, vit D,
, lipids, CBC, glucose, GFR, uric acid, creatinine, phosphorus
What is the definition of chronic kidney disease (CKD)? - Answer kidney damage or
glomerular filtration rate less than 60 mL/min for 3 months or more, regardless of the
cause.
What are the stages of CKD? - Answer Stage 1=Normal eGFR (>90)
With other evidence of kidney damage*
Stage 2=eGFR 60 - 89
With other evidence of kidney damage* (persistent microalbuminuria or proteinuria,
hematuria, structural abnormalities, biopsy-proven glomerulonephritis)
Stage 3a=eGFR 45-59
Stage 3b=eGFR 30-44
Stage 4=eGFR 15-29
Stage 5=eGFR less than 15
When do you refer to a nephrologist? - Answer Patients under the age of 18 should
immediately be referred to a pediatric nephrologist for consultation. Late referral is
commonly defined as referral to specialist services less than one year before start of
renal replacement therapy (RRT).
For adult patients, refer if=
● Acute kidney injury (AKI) or abrupt sustained fall in GFR;
● GFR less than 30 mL/min/1.73 m2 (GFR categories G4-G5)∗
● A consistent finding of significant albuminuria
● Progression of CKD
● Urinary red cell casts, RBC greater than 20 per high-power field (HPF) sustained and
not readily explained
● CKD and hypertension refractory to treatment with 4 or more antihypertensive agents
● Persistent abnormalities of serum potassium
● Recurrent or extensive nephrolithiasis
● Hereditary kidney disease
Which of the following patients would be characterized as having stage 2 chronic kidney
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