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Med Finals - Paediatrics > Urology > Flashcards

Urology Flashcards

(46 cards)

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1
Q

Define urinary tract infection

A

An infection aywhere in the urethra, bladder, ureters or kidney

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2
Q

Presentation of UTI in babies

A

Fever
Lethargy
Irritabilty
Vomiting
Poor feeding
Urinary frequency

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3
Q

Presentation of UTI in children

A

Fever
Abdo pain - suprapubic
Vomiting
Dysuria
Urinary frequency
Incontinence

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4
Q

Define acute pyelonephritis

A

Systemic signs of infection
Renal angle tenderness

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5
Q

Management of UTI

A

<3 months - IV abx
Trimethoprim
Nitro
Cefalexin
Amoxicillin

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6
Q

Investigations in recurrent UTI

A

US
DMSA scan
Micturating cystourethrogram - Vesico-Ureteric reflux 0

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7
Q

Define vululovaginitis

A

Inflammation and irritation of the vulva and vagina

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8
Q

Causes of vululovagnitis

A

Wet nappies
Chemicals or soaps
Tight clothing - traps moisture
Poor toilet hygiene
Constipation
Threadworms
Pressure on area - horse riding
Heavily chlorinated pools

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9
Q

Presentation of vulvulovaginitis

A

Soreness
Itching
Erythema around labia
Vaginal discharge
Dysuria
Constipation
Leukocytes but no nitirtes

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10
Q

Management of vulvulovaginitis

A

Supportive symptomatic management
Avoid washing
Avoid perfume
Good toilet hygiene
Keep dry
Emollients
Loose cotton clothing
Treat constipation
Avoid activities that exacerbate

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11
Q

Define nephrotic syndrome

A

Nephrotic syndrome occurs when the basement membrane of the glomerulus becomes highly permeable to protein allowing protein to leak from the blood into the urine.

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12
Q

Classic triad in nephrotic syndrome

A

Low serum albumin
High urine protein
Oedema

(deranged lipid profile with high cholesterol, high blood pressure, hyper coagulabilty)

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13
Q

Causes of nephrotic syndrome

A

Minimal change disease!!
Focal segmental glomerulosclerosis
Membranoproliferative glomerulonephritis

2ndry - henoch schonlein purpura, diabetes, infection

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14
Q

Management of nephrotic syndrome

A

High dose steroids
Low salt diet
Diuretics
Albumin infusions
Antibiotic prophylaxis

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15
Q

Complications of nephrotic syndrome

A

Hypovolaemia
Thrombosis
Infection
Acute or chronic renal failure
Relapse

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16
Q

Define nephritis

A

Inflammation within the nephrons of the kidney

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17
Q

Causes of nephritits

A

Post streptococcal glomerulonephritis
IgA nephropathy - Berger’s disease

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18
Q

Define post-streptococcal glomerulonephritis

A

Streptococcal antigens, antibodies and proteins get stuck in the glomeruli of the kidney and cause inflammation leading to acute kidney injury
Often 1-3 weeks post tonsillitis

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19
Q

Define IgA nephropathy

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A

Related to henoch-schonlein purpura - IgA vasculitis.
IgA deposits in the nephrons cause inflammation leading to AKI

20
Q

Define haemolytic uraemic syndrome

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A

Occurs when there is a thromboss within small blood vessels - usually triggered by the shiga toxin

21
Q

Classic triad in haemolytic uraemic syndrome

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A

Haemolytic anaemia
Acute kidney injury
Thrombocytopenia

22
Q

Presentation of haemolytic uraemic syndrome

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A

Post gastroenteritis - usually bloody, 5 days ago
Reduced urine output
Haematuria
Abdominal pain
Lethargy
Confusion
Oedema
Hypertension
Bruising

23
Q

Management of haemolytic uraemic syndrome

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A

Medical emergency
Supportive management
Renal dialysis
Antihypertensives
Careful management
Blood transfusion

24
Q

Define enuresis

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A

Involuntary urination often nocturnal
Primary nocturnal - has never been dry at night
Secondary nocturnal - begins wetting bed when previously been dry for 6 months

25
Causes of primary nocturnal enuresis
FH! Overactive bladder Fluid intake Failure to wake Psychological distress Secondary causes - constipation, UTI, learning disability
26
Causes of secondary nocturnal enuresis
UTI Constipation TIDM Maltreatment New psychosocial problems - school, home.
27
Pharmalogical management of enuresis
Desmopressin - reduces urine volume Oxybutinin - anticholinergic Imipramine - relaxes bladder?
28
Define polycystic kidney disease
Genetic condition leading to formation of fluid filled cysts in the kidney Commonly autosomal dominant but recessive is found in neonates Very poor prognosis - 1/3 die in neonatal period
29
Presentation of ARPKD
In utero Cystic enlargement of the renal collecting duct Oligohydramnios - pulmonary hypoplasia Congenital liver fibdrosis In life Liver failure Portal hypertension Progressive renal failure Hypertension Chronic lung disease
30
Define Wilm's tumour
A specific type of tumour affecting the kidney in children - typically under 5
31
Presentation of Wilm's tumours
Abdominal pain Mass in abomen Haematuria Lethargy Fever Hypertension Weight loss
32
Investigations of Wilm's tumour
Ultrasound CT or MRI for staging Biopsy for definitive diagnosis
33
Management of Wilm's tumour
Surgical removal! Adjuvant therapy to reduce size
34
Define posterior urethral valve
A pathology where there is tissue at the proximal end of the urethra that causes obstruction to the outflow of urine. Found in newborn boys. Creates back pressure causing hydronephrosis
35
Presentation of posterior urethral valve
Difficulty urinating Weak stream Chronic retention Palpable bladder Recurrent infections Impaired kidney function Bilateral hydronephrosis Oligohydramnios - pulmonary hypoplasia
36
Presentation of posterior urethral valve
Difficulty urinating Weak stream Chronic retention Palpable bladder Recurrent infections Impaired kidney function Bilateral hydronephrosis Oligohydramnios - pulmonary hypoplasiaI
37
Investigations in posterior urethral valve
Abdo ultrasound Micturating cystourethrogram Cystoscopy
38
Management of posterior urethral valve
Catheter for acute management Ablation of extra tissue
39
Define undescended testes
Also known as cryptorchidism Where testes do not escend from their point of development in the abdomen throgh the inguinal canal
40
Risk factors for undescended testes
FH Low birth weight Small for gestational age Prematurity Maternal smoking history
41
Management of undescended testes
Normally resolves in 3-6 months Orchidopexy
42
Define hypospadias
Condition affecting males where the urethral meatus (opening) is abnormally displaced to the ventral side of the penis towards the scrotum.
43
Management of hypospadias
Do not circumcise Surgery at 3-4 months
44
Define hydrocele
A collection of fluid within the tunica vaginalis
45
Clinical signs of hydrocele
Soft Non-tender Unilateral Infront and below teste Transilluminate with light
46
Management of hydroceles
US Usually resolve Surgical repair?

Med Finals - Paediatrics (17 decks)

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