Nephrology and Urology – Set 1

What this deck covers

Nephrology and Urology – Set 1 in 50 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Daily volume after a laparotomy
2. Too weak to climb onto his bed
3. First maintenance bag after surgery
4. Thirsty, salt-craving 3-year-old
5. How fast may a high sodium fall
6. Headache on day 3 after surgery
7. Sorting causes by the anion gap
8. Sizing the fluid loss in an infant
9. Cramps and salt craving at 12
10. Working out plasma osmolality
11. The odd one out for potassium
12. Deep sighing breaths in a toddler
13. Sodium in a half-strength bag
14. Low potassium, low urine chloride
15. Strong pulses despite a big deficit
16. Hormone profile of a salt-losing boy
17. Seizure during hypotonic fluids
18. The strongest bag on the shelf
19. Silent abdomen and U waves
20. Urine result in a thin, thirsty boy
21. Next drip once the fit has stopped
22. What a faulty SLC12A3 gene imitates
23. Potassium for a child kept fasting
24. Two bags on the fluid shelf
25. Mottled infant, weak pulses
26. Timing of a urine chloride sample
27. Low bicarbonate, stools now formed
28. Fit continues despite first treatment
29. Why a sodium rise is capped
30. Constipated infant, poor weight gain
31. Cramps on the football pitch
32. Osmolality from mg/dL results
33. Polyuria after tubular injury
34. Dry child with a low sodium
35. Doughy skin, a tenth of weight lost
36. Urine calcium and a hidden tablet
37. Long-term plan for a salt craver
38. Wheezy after a week of diarrhoea
39. Forceful vomiting at 6 weeks
40. Site of the fault in the nephron
41. Potassium leaking into the urine
42. Reading a gas in a breathless baby
43. Low potassium with headaches
44. Before the kidney ultrasound
45. Dry but alert after vomiting
46. Seizure twelve hours into rehydration
47. Alkalosis in a heatwave
48. Treating a salt-wasting toddler
49. Potassium will not rise on tablets
50. A gymnast with low potassium

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Bartter syndrome, Acetazolamide, a large saline infusion and diarrhoea, 149 mOsm/kg, High renin, low aldosterone, low pressure, A diluted intravenous infusion with ECG monitoring, Thick ascending limb; a loop diuretic, Oral rehydration solution by nasogastric tube, Change to restricted isotonic fluid and observe, A high protein:creatinine ratio, Syndrome of inappropriate ADH secretion, A thiazide with a low-salt diet, Mineralocorticoid excess states, Osmotic demyelination from the high sodium itself, Her low magnesium.

Clinical pearls from this deck

• Maintenance by weight band: 100, then 50, then 20 mL/kg a day.
• In hypokalaemia, the urine potassium tells gut from kidney.
• Hypotonic bags are for named indications, never the default.
• Polyhydramnios, then polyuria and a low potassium: Bartter until proved otherwise.
• Measure often: the safe rate cannot be seen clinically.
• A falling sodium on a drip is water excess until proved otherwise.

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 and urology case decks · pediatric reference values.