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Diagnosis and primary care management of focal segmental glomerulosclerosis in children

doi: 10.1097/01.NPR.0000545041.30947.6c
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INSTRUCTIONS Diagnosis and primary care management of focal segmental glomerulosclerosis in children

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PROVIDER ACCREDITATION

Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity.

Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

This activity has been assigned 1.5 pharmacology credits.

Diagnosis and primary care management of focal segmental glomerulosclerosis in children

Purpose: To provide information on FSGS in children. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Examine the pathophysiology and epidemiology of FSGS and the clinical presentation of children who have this disease. 2. Select diagnostic testing strategies and treatment options for children with FSGS.

  1. There is a higher annual incidence of FSGS in persons with which ethnicity?
    1. Asian Americans
    2. Black Americans
    3. White Americans
  2. The most common type of FSGS is
    1. primary (idiopathic).
    2. adaptive.
    3. high-penetrance genetic.
  3. Drug-associated FSGS may be caused by taking
    1. rituximab.
    2. corticosteroids.
    3. heroin.
  4. Which histologic subtype of FSGS has the worst prognosis with rapid progression to kidney failure?
    1. perihilar
    2. collapsing
    3. cellular
  5. The most common presenting symptom of FSGS in children is asymptomatic
    1. hyperlipidemia.
    2. hypertension.
    3. proteinuria.
  6. Nephrotic syndrome in children is described as
    1. serum albumin more than 2.5 g/dL.
    2. more than 200 mg/dL total cholesterol.
    3. less than 1 g/m2 urine protein per day.
  7. At the time of FSGS onset, what symptom is present in almost half of patients?
    1. edema
    2. petechiae
    3. gross hematuria
  8. The ultimate diagnosis of FSGS depends on
    1. response to corticosteroid therapy.
    2. kidney biopsy findings.
    3. clinical presentation.
  9. Testing for the genes that may be responsible for FSGS can aid in
    1. anticipating symptoms specific to certain gene mutations.
    2. determining additional diagnostic testing that may be needed.
    3. recognizing patients at greater risk for FSGS reoccurrence after transplant.
  10. The standard of care for the treatment of patients with FSGS is
    1. renin-angiotensin-aldosterone blockers.
    2. mycophenolate mofetil.
    3. adalimumab.
  11. Lifestyle modifications for patients with FSGS include
    1. weight maintenance.
    2. potassium-rich diet.
    3. limiting physical activity.
  12. As noted in the article, persistent proteinuria can lead to a higher risk of
    1. diabetes mellitus.
    2. skeletal muscle wasting.
    3. cardiovascular disease.
  13. Because FSGS often presents as nephrotic syndrome, patients are treated empirically with oral corticosteroids for
    1. 9 days.
    2. 14 days.
    3. 4 to 6 weeks.
  14. Adverse reactions to treatment with mycophenolate mofetil include
    1. hypothyroidism.
    2. leukopenia.
    3. growth impairment.
  15. What drug is recommended as the first-line therapy for steroid-resistant nephrotic syndrome?
    1. monoclonal antibodies
    2. HMG-CoA reductase inhibitors
    3. CNIs
  16. The authors report that there is a risk of developing malignancies with the use of
    1. rituximab.
    2. tacrolimus.
    3. adalimumab.
  17. In general, progression to ESRD occurs within
    1. 2 to 4 years.
    2. 5 to 10 years.
    3. 15 to 20 years.
  18. The first-line treatment for reoccurring FSGS is
    1. plasmapheresis.
    2. dialysis.
    3. another kidney transplant.
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