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Paediatrics > Renal/ Urinary > Flashcards

Renal/ Urinary Flashcards

1
Q

Causes of primary enuresis

A

Lack of attention to bladder Detrusor instability Bladder neck weakness Neuropathic bladder UTI Constipation Ectopic ureter

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2
Q

Management of enuresis

A

Star charts, bladder training, pelvic floor exercises Enuresis alarm Anticholinergic drugs (Oxybutinin) Desmopressin for short term (synthetic analogue of ADH)

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3
Q

Causes of secondary enuresis

A

Emotional upset UTI Diabetes Renal concentrating disorder = sickle cell anaemia, renal failure

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4
Q

Common causes of UTI

A

E coli Klebsiella Proteus - common in boys + predisposes to phosphate stone formation Pseudomonas Strep faecalis

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5
Q

S+S UTI

A

Non-specific in infants = fever, vomiting, lethargy, jaundice, sepsis

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6
Q

Management of UTI by age

A

<3 months = admit, IV abx (cefotaxime) Infants >3 months or children with upper UTI = co-amoxiclav for 7-10 dyas Older children with lower UTI = oral trimethoprim 3 days

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7
Q

What are the signs of glomerular haematuria?

A

Brown urine Presence of deformed red cells + casts Accompanied by proteinuria

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8
Q

Glomerular causes of haematuria

A

Glomerulonephritis (usually with proteinuria) IgA nephropathy Familial nephiritis (e.g. Alport syndrome) Thin basement membrane disease)

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9
Q

Non-glomerular causes of haematuria

A

Infection Trauma to genitalia, urinary tract or kidneys. Stones Tumours Sickle cell disease Bleeding disorders Renal vein thrombosis Hypercalciuria

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10
Q

What is recurrent haematuria syndrome?

A

Occurs at time of systemic infection Due to nephritis

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11
Q

What are the features of haemolytic uraemic syndrome?

A

Acute renal failure Microangiopathic haemolytic anaemia Thrombocytopenia

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12
Q

Pathology + causes of HUS

A

Typically secondary to GI infection with E coli producing verocytotoxin Coagulation cascade activated but normal clotting

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13
Q

S+S HUS

A

Prodrome of bloody diarrhoea Abdo pain Fever Vomiting

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14
Q

Management of HUS

A

Peritoneal dialysis Plasma exchange if needed

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15
Q

Pathology of nephrotic syndrome

A

Heavy proteinuria = low albumin + oedema Peak onset 2-5 y/o

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16
Q

S+S of nephrotic syndrome

A

Periorbital oedema Scrotal/ leg/ ankle oedema Ascites SOB

17
Q

Blood results for nephrotic syndrome

A

Low albumin Raised cholesterol

18
Q

Management of nephrotic syndrome

A

Prenisolone

19
Q

What features suggest nephrotic syndrome is steroid sensitive?

A

1-10 y/o No macroscopic haematuria Normal BP Normal complement levels Normal renal function Precipitated by resp infection

20
Q

Causes of steroid resistant nephrotic syndrome?

A

Glomerulonephritis Membranous nephropathy

21
Q

Pathology of glomerulonephritis

A

Renal inflammation causing: Haematuria Oliguria HTN Raised creatinine

22
Q

Causes of glomerulonephritis

A

2-3 weeks after B haemolytic strep throat

23
Q

S+S of glomerulonephritis

A

Sudden onset illness 2-3 weeks after pharyngitis Coco-cola coloured urine (excess RBC, WBC + proteinuria) Facial oedema Abdo pain Raised BP

24
Q

Causes of acute nephritis

A

post infection Vasculitis (HSP, SLE etc) IgA nephropathy

25
Q

Pathology of acute nephritis

A

Increased glomerular cellularity restricts blood flow so there is reduced filtration Leads to reduced urine output + fluid overload HTN Oedema Haematuria + proteinuria

26
Q

HSP pathology

A

Skin rash Arthralgia Periarticular oedema Abdo pain Glomerulonephritis Due to raised IgA

27
Q

S+S HSP

A

Symmetrical rash (buttocks, arms, legs and ankles) = urticarial, rapidly becoming maculopapular and pupuric. Joint pain (esp knees and ankles) Periarticular oedema Abdominal pain Haematemesis Malaena Intussusception

28
Q

What is IgA nephropathy?

A

Episodes of macroscopic haematuria Commonly associated with URTIs

29
Q

What is familial nephritis?

A

Commonest: Alport syndrome X linked recessive disorder = progresses to renal failure Associated with nerve deafness + ocular defects

30
Q

What are the characteristics of SLE?

A

Presence of multiple autoantibodies C3 + C4 complements are low Haematuria + proteinuria

31
Q

What is hypospadias?

A

Urethral opening proximal to normal meatus on ventral surface Correctional surgery needed before 2 y/o

32
Q

What is a hydrocele and how is it managed?

A

Managed conservatively

Illuminates with transillumination

Disappears by 1

Paediatrics (19 decks)

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