3 December Flashcards
What are the NICE guidelines for imaging of the urinary tract in children?
Infants <6 months who present with a UTI which responds to treatment should have USS within 6 weeks
Children >6 months who had UTI that was treated does not require imaging unless atypical infection or recurrent infection
What are features of IgA nephropathy?
Commonest cause of glomerulonephritis worldwide
Presents as macroscopic haematuria following URTI
How can you differentiate between post strep glomerulonephritis and IgA nephropathy?
Post strep- develops 1-2 weeks post URTI, proteinuria and haematuria
IgA- onsets 1-2 days post URTI, young males, macroscopic haematuria
What antibodies are present in goodpasture disease?
Anti-glomerular basement membrane
What are features of goodpasture disease?
Haemoptysis
Dyspnoea
Fatigue
chest pain
Dysuria
Haematuria
Proteinuria
What are complications of nephrotic syndrome?
Renal vein thrombosis- due to hypercoagulable state
Peritonitis
Reduced resistance to infections
What are features of vesicoureteric reflux?
Hydronephrosis on US
Recurrent childhood UTI
refleux nephropathy
What are investigations of vesicoureteric refluex?
1)MSUG
2) DMSA to look for renal scarring
What is the grading of VUR?
1- reflux into the ureter only no dilatation
2- reflux into renal pelvis on urination- no dilatation
3- mild/moderate dilatation of the ureter, renal pelvis and calyces
4- dilatation of the renal pelvis, calyces with moderate ureteral tortuosity
5- gross dilatation of the ureter, pelvis and calyces with ureteral tortuosity
What is found on urine electrophoresis in MM?
Bence Jones proteins
What results are concerning when testing for diabetic nephropathy?
Raised albumin excretion >2.5 men and 3.5 women
If present should be commenced on ACEi
Microalbuminuria is early indicator of renal disease
What is the management of anaemia in chronic renal disease?
target Hb 100-120
Check Fe levels first and replace iron first
Then commence ESA such as erythropoietin to stimulate production or RBC (normally low in renal failure)
What is found n urine analysis of glomerulonephritis?
Red cell casts
Worsening disease- white cell casts
What is the tirad of HUS?
AKI
Thrombocytopenia
Haemolytic anaemia
What are causes of HUS?
E.coli- most common
Pneumococcal infection
HIV
SLE
Cancer
