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PAEDS SC1 > GU > Flashcards

GU Flashcards

1
Q

corrected GFR in a kid

A

15-20ml/min/1.73m^3

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2
Q

GFR in 1-2 yo, same as adult

A

80-120ml/min/1.73m^3

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3
Q

Age of multi cystic dysplastic kidneys

A

2 years old

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4
Q

Prune Belly Syndrome

A

= absence/lack of musculature of anterior abdo wall

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5
Q

Prune Belly syndrome a/w

A

MEGAcystitis
MEGAureters
cryptochric

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6
Q

sites of obstruction to urine flow

A
  • peliureteric junction
  • bladder neck
  • posterior urethral valves
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7
Q

renal dysplasia a/w

A

SEVERE VUR in isolation or apart of rare genetic syndromes

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8
Q

antenatal or postnatal treatment of congenital kidney anomalies?

A

POSTNATAL

since antenatal: intrauterine bladder drainage procedures (NOT VERY GOOD)

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9
Q

postnatal treatment of congenital kidney anomalies- bilateral hydro

A

48hrs after birth- US

posterior urethral valves?
Y-MCUG-Sx: cystooscopic ablation
N-stop antibiotics and repeat US 2-3 months

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10
Q

postnatal treatment of congenital kidney anomalies- unilateral hydro

A

4-6weeks after birth- US

any anomaly?
Y-further investigations
N-stop antibiotics and repeat US 2-3 months

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11
Q

NB rf’s UTI’s

A 
Hydration?
Completely empty bladder?
Holds onto urine?
Constipation?
Neuro problems?
Born with congenital urinary abnormalities?
Frequent infections?
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12
Q

infant UTI don’t forget

A

Jaundice

Febrile convulsions

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13
Q

child UTI don’t forget

A

Rigors/ febrile convulsions

Recurrence of enuresis

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14
Q

NB urine questions

A 
Pain
Frequency
Smell
Stones
Colour
Cloudy
Tea coloured
Red
       Frank
       dipstick
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15
Q

Dx UTI

A
  1. urine collection/ MSU
  2. C+S: 10^5 colony/ml
  3. dipstick
    - nitrites
    - leukocyte esterase
  4. US
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16
Q

ULTRASOUND/ Imaging UTI

A

3 yo= US

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17
Q

Tx UTI

A

IV cefotaxime

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18
Q

Tx UTI >3 months + acute pyeloneph

A

bacteriuria + fever+ >38

bacteriuria + loin pain +

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19
Q

Tx cystitis/lower UTI

A

oral antibiotics 3 days

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20
Q

Prevention UTI’s

A
  • hydration
  • voiding
  • constipation
  • hygeiene
  • acidophilus
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21
Q

Abx prophylaxis UTI’s

A

trimethoprim OR
nitrofurantoin OR
cephalexin

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22
Q

age definition of daytime enuresis

A

should be continent– >3-5yo

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23
Q

DDx daytime enuresis

A

neuro

  • psychogenic
  • developmental
  • neuropathic bladder

kidney

  • detrusor instability
  • UTI
  • ectopic ureter

CONSTIPATION

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24
Q

DDx secondary onset enuresis

A 
EMOTIONAL
UTI
POLYURIA
- DM
- DI
- sickle cell
- CRF
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25
Q

two types of proteinuria

A

transient

persistent

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26
Q

transient proteinuria

A
  • febrile illness

- post- exercise

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27
Q

persistent proteinuria

A

urine protein: creatinine

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28
Q

DDx proteinuria

A
  1. orthostatic hypoTN
  2. glomerular
  3. increase glomerular filtration pressure
  4. reduced renal mass
  5. HTN
  6. tubular proteinuria
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29
Q

NB investigations for nephrotic syndrome

A
  • Complement: c3,4
  • ASOT, DNAse B, throat swab
  • urine [Na]
  • hep B and C screen
  • malaria
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30
Q

1/3 rule steroids

A

1/3 responsive
1/3 infrequent relapses
1/3 frequent relapses= resistant

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31
Q

nephrotic syndrome

A
  1. steroid responsive= MCD
  2. steroid unresponsive= FSGS, membranoprolif, membranous nephropathy
  3. congenital
32
Q

epidemiology congenital nephrotic syndrome

A

Finnish
consanguinity
PC: 3 months

33
Q

epi MCD

A

asian boys 1-10years old

a/w ATOPY

34
Q

TRIAD HSP

A

Purpura
arthritis
abdo pain

35
Q

PC HTN kids

A 
FACIAL PALSY
headache
HTN retinopathy
vomiting
proteinuria
36
Q

PC HTN infants

A

FTT + HF

37
Q

DDx unilateral renal mass

A

5

  1. MCDK
  2. Compensatory hypertrophy
  3. obstructive hydronephrosis
  4. renal tumor
  5. renal vein thrombosis
38
Q

DDx bilateral renal mass

A

4

  1. ARPCK
  2. ADPCKD
  3. TUBEROUS SCLEROSIS
  4. renal vein thrombosis
39
Q

Side effect of furosemide in neonate

A

NEPHROCALCINOSIS

40
Q

causes of fanconi syndrome

A
  1. idiopathic
  2. secondary to IEM
  3. acquired:
    - drugs/ toxins
    - heavy metals
    - vit D deficiency
41
Q

IEM–> fanconi syndrome

A 
WTF.G.?
LC. G.
Wilsons
Tyrosinaemia
Fructose intolerance
Galactosemia
Lowe syndrome
Cystinosis
Glycogen storage disorder
42
Q

Lowe Syndrome

A

= oculocerebrorenal syndrome

43
Q

PC fanconi syndrome

A
  • dehydration
  • polyuria/ polydipsia
  • rickets/ FTT
  • hyperchloraemic met. acidosis
44
Q

Definition AKI

A
45
Q

Dx AKI

A
  1. Fluid and circulation status

2. Ultrasound–> obstruction

46
Q

Tx pre-renal AKI

A
  • circulatory and fluid support
47
Q

Tx renal AKI

A
  • fluid restriction
  • diuretics
  • high calorie diet, normal protein, uraemia, hyperK
  • biopsy: GN–> immunosuppression
48
Q

Tx post-renal AKI

A

RELIEVE OBSTRUCTION

  • nephrostomy
  • bladder catheterisation
  • surgery after corrected electrolytes
49
Q

Tx metabolic acidosis

A

bicarbonate

50
Q

Tx hyperiP

A
  • calcium carbonate

- dietary restriction

51
Q

Tx hyperK

A
  • calcium gluconate– if ECG change
  • Ca resins
  • glucose/ insulin
  • salbutamol– neb or IV
  • dietary restrictions
  • dialysis
52
Q

DIALYSIS indications

A
  • failed conservative tx
  • failure multiorgam
  • hyperK
  • hypo/hyperNa
  • pulmonary edema or HTN
  • severe acidosis
53
Q

PC chronic renal failure

A

EXACT SAME AS ADULTS

54
Q

Tx chronic renal failure

A
  1. diet- NG/gastrotomy– want the protein without XS NH3
  2. phosphate restriction and active vit D– less milk products and calcium carbonate
  3. salt supplements + water + bicarb
  4. EPO
  5. GH
  6. transplant
  7. dialysis
55
Q

R or L inguinal hernias more common

A

RIGHT

56
Q

palpable cryptorchid

A

can palpate in groin, but cannot manipulate into scrotum
= ECTOPIC
- perineum
- femoral triangle

57
Q

Sx of hydrocele

A

> 18-24 months

58
Q

Dx cryptorchid

A
  1. US– check if other pelvic organs present
  2. Hormonal: IM hCG
  3. Lapro- BEST for impalpable esp– check inguinal canal
59
Q

Tx for cryptochid

A
  • orchiopexy (infertility, malignancy, cosmesis)

- orchiectomy: if older and very high up, or intra-abdominal

60
Q

Tx varicocele

A

OBLITERATE VEINS:

  • radiao embolisation
  • conventional surgery
  • laproscopic
61
Q

Age of testicular torsion

A

adolescent, or ANY age

62
Q

Age of testicular appendage

A

PRE-puberty

63
Q

Age of epididymitis, epididymorchitis

A

infant/toddler– a/w UTI

64
Q

Age of idiopathic scrotal oedema

A

PRE-schooler

65
Q

scrotal pain increasing over 1-2 days

A

torsion of testicular appendage

66
Q

blue dot sign

A

torsion of testicular appendage (tender nodule felt)

67
Q

Diagnosis of testicular torsion

A

CLINICAL

  1. lapro exploration
  2. US doppler US – testicular blood vessels
68
Q

Ddx acute scrotum

A
  1. testicular torsion
  2. torsion hydatid morgagni
  3. epididmyitis
  4. epididmyorchitis
  5. idiopathic scrotal edema
  6. incarcerated inguinal hernia
69
Q

3 features of hypospadias

A

ventral meatus
ventral– hooded dorsal foreskin
ventral chordee

70
Q

sx of hypospadias age

A

before 2 years old

71
Q

paraphimosis

A

foreskin trapped in retracted posiiton proximal to swelling

72
Q

tx paraphimosis

A

no need to circumcise– REDUCE WITH ANALGESIA

73
Q

indications for circumcision

A
  1. phimosis
74
Q

Alternatives to circumcision

A
  1. preputioplasty

2. topical steroids

75
Q

treatment of labial adhesions

A
  1. topical oestrogen cream 2 X a week for 1-2 weeks

2. anaesthesia– separate adhesions

76
Q

treatment of vulvovaginitis

A

antibiotics– swab
oestrogen cream– sparingly used on vulva

ADVISE:

  • no bubble baths
  • loose fitting underwear
  • salt baths

PAEDS SC1 (13 decks)

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