Nephrology Flashcards

1
Q

define urinary tract infections (UTIs)

A

an infection that occurs anywhere from the kidneys to the urethra

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2
Q

clinical features of UTIs in babies < 3mnths

A
fever
vomiting 
lethargy 
irritability 
poor feeding 
failure to thrive 
offensive urine
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3
Q

clinical features of UTIs in babies 3-12 mnths

A

fever
poor feeding
abdominal pain
vomiting

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4
Q

clinical features of UTIs in children >12mnths

A

⬆️ frequency
dysuria
abdominal pain (suprapubic)
incontinence

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5
Q

investigations of paeds UTIs

A

urine dipstick
clean catch MSU for MC&S

if in non-potty trained baby:
urine collection pad

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6
Q

diagnosis of paeds UTIs

A

+ve leukocytes and nitrites on urine dip

+ve urine culture

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7
Q

management of UTIs in babies < 3mnths WITH fever

A
IV antibiotics (ceftriaxone)
full septic screen (e.g. bloods + blood culture + lactate)
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8
Q

management of UTIs in children > 3mnths with lower UTIs

A

oral antibiotic (e.g. nitrofuranotoin)

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9
Q

management of UTIs in children > 3mnths with upper UTIs

A

oral antibiotic (e.g. cephalosporin)

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10
Q

define acute pyelonephritis

A

infection of kidney tissue that can lead to scarring and affect kidney function

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11
Q

when to suspect acute pyelonephritis in paeds

A

temperature >38

loin pain or tenderness

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12
Q

investigations for recurrent paediatric UTIs

A

babies <6mnths:
abdominal US

children:
abdominal US after 6wks
DMSA scan after 4-6mnths

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13
Q

signs of atypical UTIs

A
poor urine flow
abdominal or bladder mass
raised creatinine 
septicaemia 
failure to respond to anitbiotics in 48hrs 
infection with non E.coli
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14
Q

investigations for atypical UTIs

A

abdominal US

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15
Q

define vesicoureteric reflex (VUR)

A

an abnormal flow of urine from the bladder into the upper urinary tract within young children

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16
Q

classification of VUR

A

Grade I: into ureters only
Grade II: into pelvis without dilatation
Grade III: into pelvis with mild dilatation
Grade IV: into pelvis with moderate dilatation
Grade V: through calyces - refer to surgeon

17
Q

clinical features of VUR

A

pain on passing urine

recurrent UTIs

18
Q

investigations for VUR

A

MCUG scan
DMSA test 4-6mnths following
urine dipstick

19
Q

management of VUR

A

prescribe antibiotic prophylaxis

20
Q

define minimal change disease

A

a common cause of nephrotic syndrome in children characterised by minimal histological changes in the kidney structures

21
Q

clinical features of minimal change disease

A

peripheral oedema (e.g. facial swelling)
dyspnoea
abdominal pain
nausea + vomiting

22
Q

risk factors of minimal change disease

A

Hodgkin’s lymphoma
leukemia
recent viral illness

23
Q

investigations in minimal change disease

A

urinalysis
24hr urine protein
bloods (FBC, U+Es, LFTs, RFTs)

24
Q

management in minimal change disease

A

fluid restriction and reduced salt intake
corticosteroids (e.g. prednisolone)
human albumin and furosemide

25
indications for renal biopsy in minimal change disease
unresponsive to steroids haematuria <1 yrs or >12yrs
26
define haemolytic uraemia syndrome (HUS)
a syndrome arising due to thrombosis within the microvasculature due to shiga toxin
27
common causes of HUS
E.coli (O157:H7) and shigella
28
risk factors of HUS
``` children < 5yrs adults >75yrs genetic predisp recent farm visits undercooked meat ```
29
clinical features of HUS
``` bloody diarrhoea vomiting abdominal pain low-grade pyrexia oliguria/anuria haematuria ```
30
signs of HUS
pale or jaundiced bruising abdominal tenderness
31
investigations of HUS
urine dipstick bloods (FBC, U+Es, LFTs and clotting factor) stool culture
32
management of HUS
IV fluids + analgesia antihypertensives referral to paeds for renal dialysis
33
cardinal rule in management of HUS
NO administration of antibiotics as can trigger verotoxin expression and release
34
describe the triad of HUS
microangiopathic haemolytic anaemia thrombocytopenia AKI
35
describe the classic presentation of minimal change disease
peri-orbital oedema proteinuria hyperalbuminaemia