27. Childhood continence, proteinuria and haematuria & Renal Failure Flashcards
1
Q
Continence:
A
- Dry in day by 3 yrs – but accidents are common
* Dry at night by 5-6 yrs but much more variable
2
Q
Incontinence:
A
- Primary: never have been dry
* Secondary: incontinence after >6 months dry
3
Q
Enuresis:
A
Disorder of inability to control frequent urination especially at night
4
Q
Enuresis diagnosis:
A
- Urine dip stick, urine - test culture and glucose
- Early morning urine osmolality (To exclude diabetes insipidus, If >300 able to concentrate urine therefore not DI)
- Renal USS (Anatomy and bladder emptying)
5
Q
Enuresis – underlying pathology:
A
- UTI
- Diabetes
- Pelvic mass
- Renal failure
- Psychological abuse
6
Q
Management of enuresis:
A
- Regular toilet, avoid fizzy drinks, avoid bedtime drinks
- Desmopressin for short term use
7
Q
Causes of proteinuria:
A
- Nephrotic syndrome
- Nephritis
- Renal failure
8
Q
Test for proteinuria:
A
Dipstick test or 24h urine collection
9
Q
Nephrotic syndrome:
A
Heavy proteinuria with hypoalbuminaemia and oedema (ascites, pulmonary, peripheral)
10
Q
Acute complications of nephrotic syndrome:
A
- Hypovolaemia
- Infection
- Thrombosis
11
Q
Management of nephrotic syndrome:
A
- High dose steroid 6 week course
- Steroid sensitive might relapse but long term prognosis
- If not steroid sensitive -> ESRF
12
Q
Nephrotic syndrome OR Nephritic syndrome - discern
A
Haematuria
13
Q
Nephritis – intrinsic kidney disease:
A
- Post streptococcal
- Henoch Schoenlein Purpura
- SLE
- IgA nephropathy
14
Q
Nephritis symptoms:
A
- Haematuria
- Oedema
- Hypertension
- Renal failure
15
Q
Acute renal failure (3 types)
A
- Pre-renal: hypovolaemia
- Renal: haemolytic uraemic syndrome (anaemia, thrombocytopenia, uraemia)
- Post-renal: obstruction
