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Child health > Introduction to Paediatric Renal disorders and UTIs > Flashcards

Introduction to Paediatric Renal disorders and UTIs Flashcards

1
Q

What percentage of boys and girls will have a UTI by age 11

A

3% girls

1% boys

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2
Q

What categories are UTIs divided into?

A

Lower tract, Pyelonephritis, Urosepsis

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3
Q

How might a lower tract UTI present

A

Dysuria, frequency, abdominal pain, vomiting

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4
Q

Why might a UTI be more difficult to identify in a younger child

A

Before the child is verbal and or potty trained, it might be difficult to know the pain is associated with urination

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5
Q

How might pyelonephritis present

A

Unwell, fever and rigors, loin pain, dysuria

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6
Q

How might urosepsis present

A

Cardiovascular instability/shock

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7
Q

What is the typical organism causing UTI

A

E. Coli

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8
Q

What is an immediate diagnostic tool for UTI? What would be a positive result

A

Urine dip-stick test

Leucocytes and nitrites

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9
Q

What can be done to identify the causative organism in UTI

A

Urine microscopy and culture

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10
Q

Due to the difficulties in collecting urine, what are the alternative options for collection?

A

Catheter urine

Suprapubic aspiration

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11
Q

What are the risk factors for developing a UTI

A

Female
Constipation
Neuropathic bladder
Structural abnormalities of the urinary tract

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12
Q

What structural abnormalities of the urinary tract increase risk of UTI

A

Posterior urethral valves

Vesico-ureteric reflux

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13
Q

What is vesico-ureteric reflux

A

When the bladder constricts it causes reverse flow of urine into the kidneys, resulting in damage/scarring to the kidneys, and residual urine increases risk of UTI

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14
Q

What is posterior urethral valves

A

Tissue near the outflow of the bladder causes residual urine to build up, dilatng the bladder and ureters and damaging the kidneys

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15
Q

Whilst oral abx is fine for most children, when is IV administration indicated

A

When the child is very unwell or very young

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16
Q

What are the atypical organisms in UTI

A

Klebsiella, Pseudomonas, proteus

17
Q

What can atypical UTI indicate

A

An underlying pathology

18
Q

What are the aims of further investigation in UTI

A

Identifying renal tract abnormalities

19
Q

Preventing recurrence

A

Protecting kidneys in the long term

20
Q

What investigation looks at the structure and growth of the kidney and what else can it show

A

Renal USS

Pockets of infection

21
Q

What radioisotope is used in DMSA

A

MAG3

22
Q

What does the DMSA show and what does this indicate

A

Areas of poor uptake which correlate to poor function (scarring or non-functioning anatomy)

23
Q

What does MCUG stand for

A

Micturition Cystourethrogram

24
Q

What is an MCUG and what can it identify

A

A dynamic test looking at the flow through the renal tract

Can identify reflux and obstructions

25
Q

What is the process of an MCUG

A

Fill the bladder with contrast and then watch the micturition

26
Q

What are the NICE guidelines regarding a UTI in a child <6 months that responds well to treatment

A

USS

27
Q

What are the NICE guidelines regarding a UTI in a child <6 months that is very unwell or has an atypical UTI

A

USS, DMSA, MCUG

28
Q

What are the NICE guidelines regarding a UTI in a child 6 months to 3 years that responds well to treatment

A

No investigations

29
Q

What are the NICE guidelines regarding a UTI in a child 6 months to 3 years that has an atypical or recurrent UTI

A

USS, DMSA, MCUG

30
Q

What are the NICE guidelines regarding a UTI in a child >3 years that responds well to treatment

A

No Ix

31
Q

What are the NICE guidelines regarding a UTI in a child >3 years that has an atypical UTI

A

USS

32
Q

What is the management plan if an abnormality is detected

A

Surgical correction
Prophylactic abx
Monitoring to renal function to protect kidneys and anticipate ESRF

Child health (9 decks)

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