Clinic - Renal Flashcards
What are the catagories of CKD?
What is the most common cause of bladder outlet obstruction in newborn males?
What test do you do for it?
Posterior urethral valve
Test - Voiding Cystourethrogram
What is the investigation of choice for ?renal/urethralstones ?hydronephrosis
KUB US
Why may an xray be used for flank pain?
?stone
Why are UTIs important to pick up in children?
- Half have structural abnormalites
- Pyelonephritis (inflammed kidney commonly from UTI) may damage growing kidney
What are the clinical features of UTI?
Varied and non specific but often get the triad of:
- Loin pain
- Dysuria
- Increased frequency
Infants often get:
- irritability
- Poor feeding
- Lethagy
- Vomiting and nausea
Why is it wise to always do a urine sample in kids?
Due to the varied presentation of UTI and they are easy to do/pick up:
Positive nitires
Positive leucocytes
What is the treatment for UTI in kids?
< 3 months I.V ceftrioxone and consultant review
> 3 months and Upper UTI - Oral coamoxiclav or ceph - If not possible IV ceftrioxone
> 3 months and Lower UTI - Oral eg trim, nitro, coamox
What are some non concerning causes of proteinuria?
- Transient with febrile illness or exercise
- Postural - confirm with serial measurements
What are the main causes of proteinuria?
Nephrotic syndrome
Glomerulonephritis
- What is nephrotic syndrome and what is the cause?
- What are the signs?
- What are the invesitigations
- What is the management?
- It is when heavy proteinuria causes low albumin and oedema. The cause is unknown but may be secondary to SLE, Infections, Allergens.
- Periorbital/scrotal/vulval/leg oedema, ascitis, pulmonary oedema
- Urine sample (protein) FBC (low albumin) Complement screen/infection screen
- Corticosteroids (10% are resistant)
What is glomerulonephritis?
How can it present?
A term used to describe several diseases which cause inflmammation of the glomerulus or nephrons.
Can present with:
- Haematuria
- Proteinuria
- AKI
- CKD
- Nephrotic syndrome
What are the types of glomerulonephritis?
Membranous eg IgA nephropathy (Bergers disease)
Diffuse proliferative eg Post streptococcal
Minimnal change - Majority of cases. often idiopathic but can be NSAIDS
Focal - HIV
Rapidly progressing - Goodpastures, vasculitis
What is the difference between IgA nephropathy (Bergers) and post strep glomerulonephritis
IgA nephropathy (Bergers)
- Mainly haematuria
- Normal complement
- Immediatly Post URTI
post strep glomerulonephritis
- Mainly proteinuria
- Low complement
- Interal after URTI
What is Henoch-Schonlein purpura?
Small vessel vasculitis which has symptoms like IgA nephropathy but also get:
- a purpuric rash on buttocks
- abdo pain
- Arthritis
Treat with support and analgesia
