Acute Kidney Injury in Children – 18 Board-Style Cases with Answers

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What this deck covers

Acute Kidney Injury in Children in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

  1. Three days of diarrhoea and no urine
  2. Cold, shut down and not passing urine
  3. Baseline thirty, now ninety six
  4. Peaked T waves at seven point four
  5. A month old who only dribbles urine
  6. Pale and oliguric after bloody stools
  7. What not to give in this illness
  8. Third episode, and no diarrhoea
  9. Full tank, and still no urine
  10. Two nephrotoxins at once
  11. Rash and sterile pyuria on day ten
  12. Twelve hours into chemotherapy
  13. Tea-coloured urine after a match
  14. Overloaded, acidotic and unresponsive
  15. How much fluid for a child passing none
  16. Which drug stays and which goes
  17. Kidneys failing fast, and haemoptysis
  18. What happens after the kidneys recover

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Prerenal failure from volume depletion, Intravenous furosemide to start the urine flowing, Stage 1, Calcium gluconate, Give an intravenous fluid bolus, Immune thrombocytopenia, A red cell transfusion, Plasma exchange, continued indefinitely, Established tubular injury, Stop the ibuprofen and continue the gentamicin, Acute pyelonephritis, Calcium gluconate to correct the low calcium, Generous intravenous fluid, A further dose of insulin and glucose.

Clinical pearls from this deck

  • A urine sodium under 20 mmol/L in a dry child means the kidney is under-perfused, not injured.
  • Fill the child before you judge the kidney; urine made by a diuretic is not restored filtration.
  • Stage on the worse of creatinine or urine output, and never stage without a baseline creatinine.
  • Calcium first when the ECG has changed; it buys the minutes the shifting agents need.
  • Obstruction is the only cause of acute kidney injury you can relieve with a catheter, so look for it early.
  • Fragments plus a low platelet count plus a rising creatinine after bloody diarrhoea is one diagnosis, not three.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all nephrology case decks · pediatric reference values.

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