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Paediatrics > Genitourinary/Renal > Flashcards

Genitourinary/Renal Flashcards

0
Q

In MCUG fleuroscopy or plain film X-ray?

A

Fluoroscopy

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1
Q

In micturating cystourethography (MCUG) where does the dye go?

A

Into the bladder through a urethral catheter

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2
Q

What is MCUG used to diagnose?

A

Vesicoureteric reflux

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3
Q

What is the triad of signs of nephrotic syndrome?

A

Proteinuria
Hypoalbuminaemia
Oedema
(High triglycerides)

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4
Q

What 2 drugs can be used short term in nocturnal enuresis?

A

Desmopressin- antidiuretic

Oxybutynin - anticholinergic, reduces detrusor muscle instability

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5
Q

Name some causes of nocturnal enuresis?

A 
Stress
UTI
Constipation
Diabetes
Neurogenic bladder 
Structural abnormality
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6
Q

What is haemolytic uraemic syndrome associated with?

A

Gastroenteritis caused by ecoli 0157:H7

Or occasionally shigella

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7
Q

What is the triad of haemolytic uraemic syndrome?

A

acute renal failure
Microangiopathic haemolytic anaemia
Thrombocytopenia

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8
Q

What is the history might indicate the child has developed HUS?

A

Not passing urine

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9
Q

What is the most common cause of AKI in children?

A

Hypovolaemia

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10
Q

What is the treatment for HUS?

A

Intensive support involving dialysis

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11
Q

What are the complications of HUS

A

Encephalopathy
Hypertension
Chronic renal failure
Future proteinuria

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12
Q

In nephrotic syndrome what is the urine creatinine to protein ratio?

A

It is high

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13
Q

What is the treatment of nephrotic syndrome? How long does this have to be carried out for?

A

Corticosteroid therapy for approx 8 weeks -slowly ween down.

Fluid restriction, regular weight measurements, low salt diet

Penicillin prophylaxis until protein uria has stopped

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14
Q

A child with nephrotic syndrome low urinary sodium and high packed cell volume.. What is happening?

What is the treatment?

A

They are hypovolaemic
At risk of thrombosis and shock

IV albumin 4.5%

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15
Q

What is another word for haematocrit?

A

Packed cell volume

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16
Q

How do you decide whether proteinuria is likely to be transient of not?

A

24 h urine catch
Or
Protein/creatinine ratio - should not be higher than 20

17
Q

What is a common benign cause of proteinuria?

A

Orthostatic proteinuria

18
Q

What is the most common cause of haematuria in children?

A

UTI

19
Q

Name some other causes of haematuria..

A 
UTI
Post strep glomerulonephritis 
Trauma
Poly cystic kidneys 
HSP
Stone/ tumour
Sickle cell
20
Q

What investigations would you do in haematuria?

A

Urine microscopy and culture
Protein and calcium excretion
USS
bloods - U&E, FBC, clotting

21
Q

As well as urine dip what else is it important to measure in HSP?

A

Blood pressure

22
Q

What is the physiology behind nephrotic syndrome?

A

Increase capillary wall permeability in the glomerulus which allows protein to leak through

23
Q

Why might someone with nephrotic syndrome have an increased risk of infection?

A

Because immunoglobulin are lost in the urine

Avoid live vaccines and chicken pox

24
Q

What does C3 complement do in nephrotic syndrome?

A

It will be normal

Is decreased in some glomerulonephritis

25
Q

In those with steroid resistant nephrotic syndrome (10%) what is the management?

A

Renal biopsy

Cyclophosphamide

26
Q

What is paraphimosis?

A

Where the foreskin is trapped in retracted position due to swollen glans

27
Q

What advise can you give for vulvovaginitis?

A

More frequent bathing
No soap
Loose fitting underwear

28
Q

What is the physiology behind vesicouriteric reflux?

A

Ureters are abnormally short and straight where they insert into wall of bladder so they are not properly occluded when bladder contracts

29
Q

What is the treatment for VUR?

A

surveillance monitoring
Prophylactic antibiotics

Surgery in 50% if renal function deteriorates or breakthrough infections

30
Q

When would you do USS in child with a UTI?

A

If they are under 6 months
Or have atypical UTI
Or recurrent UTI

31
Q

What is the definition of recurrent UTI in children?

A

Over 2 upper tract infections

Or over three lower tract

32
Q

In torsion of the testes how quickly can irreversible infarction occur?

A

6-12 hours but tortion should be relieved in 4 hours

33
Q

What is actually twisted in testicular tortion?

A

The spermatic cord

34
Q

What age is teaticular tortion more common?

A

Adolescents

35
Q

Where is tender in testicular tortion compared to tortion of the hydatid morgagni?

A

The actual testicle is painful, in hydatid, the pain is more in the upper pole

36
Q

If there is a blue dot visible on the scrotum when it is transilluminated what is this suggestive of?

A

Tortion of the hydatid morgagni

37
Q

IS the cremaster reflex preserved in tortion of the hydatid morgagni?

A

Yes

38
Q

How is testicular tortion treated?

A

Surgically by manually in twisting the testicle and bilateral fixation to tunica vaginalis

39
Q

Epididmitis and tortion both present with a painful swollen testicle and potential nausea, how do you differentiate?

A

Prehns sign- when tenderness is relieved by lifting the testicle suggests epididimitis

Paediatrics (12 decks)

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