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Paediatrics > Nephrology > Flashcards

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
Q

indications for renal biopsy in minimal change disease

A

unresponsive to steroids
haematuria
<1 yrs or >12yrs

26
Q

define haemolytic uraemia syndrome (HUS)

A

a syndrome arising due to thrombosis within the microvasculature due to shiga toxin

27
Q

common causes of HUS

A

E.coli (O157:H7) and shigella

28
Q

risk factors of HUS

A 
children < 5yrs 
adults >75yrs 
genetic predisp
recent farm visits 
undercooked meat
29
Q

clinical features of HUS

A 
bloody diarrhoea 
vomiting 
abdominal pain 
low-grade pyrexia 
oliguria/anuria 
haematuria
30
Q

signs of HUS

A

pale or jaundiced
bruising
abdominal tenderness

31
Q

investigations of HUS

A

urine dipstick
bloods (FBC, U+Es, LFTs and clotting factor)
stool culture

32
Q

management of HUS

A

IV fluids + analgesia
antihypertensives
referral to paeds for renal dialysis

33
Q

cardinal rule in management of HUS

A

NO administration of antibiotics as can trigger verotoxin expression and release

34
Q

describe the triad of HUS

A

microangiopathic haemolytic anaemia
thrombocytopenia
AKI

35
Q

describe the classic presentation of minimal change disease

A

peri-orbital oedema
proteinuria
hyperalbuminaemia

Paediatrics (9 decks)

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