Nephrology Flashcards

1
Q

when should pyelonephritis be suspected

A

unexplained fever of 38°C or more, or loin pain/tenderness

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2
Q

investigation for UTI

A

urine dipstick - ideal is clean catch to avoid contamination

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3
Q

atypical UTI presentation in children

A

poor urine flow
abdominal or bladder mass
raised creatinine
sepsis
failure to respond to treatment within 48hrs
infection with non-e.coli organisms

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4
Q

criteria for USS for UTI

A

atypical infection
recurrent UTI
first time UTI for children under 6months

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5
Q

UTI clinical presentation

A

dysuria
increased frequency
increased bedwetting
foul smelling urine
darker/ cloudy urine
haematuria
abdo pain
loin/ suprapubic tenderness

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6
Q

what is testicular torsion

A

twisting of the spermatic cord with rotation of the testicle

urological emergency

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7
Q

examination findings of testicles in testicular torsion

A

firm swollen testicle
retracted testicle
absent cremasteric reflex
abnormal testicular lie
rotation

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8
Q

USS result showing positive testicular torsion

A

whirpool sign

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9
Q

management of testicular torsion

A

analgesia
orchiopexy
orchidectomy if surgery is delayed or there is necrosis

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10
Q

clinical presentation of testicular torsion

A

unilateral testicular pain
abdominal pain
vomiting

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11
Q

risks of undescended testes

A

higher risk of testicular torsion, infertility, testicular cancer

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12
Q

management for undescended testes

A

watch and wait in newborns - should descend in first 3-6months

if not by 6months - paeds urologist

orchidopexy carried out between 6-12months

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13
Q

what is nocturnal enuresis

A

involuntary bedwetting in the night
over the age of 5

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14
Q

risk factors of nocturnal enuresis

A

fh
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psychological and behavioural disorders

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15
Q

causes of nocturnal enuresis

A

UTI
polyuria e.g. dm
bladder dysfunction e.g. overactive bladder
sleep arousal difficulties e.g. inability to wake to noise, sensation of full bladder

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16
Q

management for nocturnal enuresis without daytime symptoms

A

explain it is not the child’s fault
toilet patterns e.g. encouraged to empty bladder regularly during the day and before sleep
positive reward systems who have dry nights

17
Q

management for children aged 5yrs or older who have not responded to conservative/ lifestyle management for nocturnal enuresis

A

alarm or desmopressin

18
Q

management of primary bedwetting with daytime symptoms

A

refer to secondary care or enuresis clinic

19
Q

what is hypospadias

A

congenital condition where the urethral tabularisation is abnormally displaced on the ventral (underside ) of the penis

20
Q

classification of hypospadias

A

glanular (may be solely cosmetic)
midshaft
penoscrotal (most severe - can cause genitourinary problems)

21
Q

what conditions is hypospadias associated with

A

chordee
inguinal hernia
cryptorchidism
psychological problems

22
Q

management of hypospadias and aims

A

surgery before 2yrs of age

aims
- terminal urethral meatus so they can micturate in normal standing position
- straight erection
- normal looking penis

23
Q

what is phimosis

A

inability to retract the foreskin
this is normal before the age of 2

24
Q

cause of phimosis

A

balantis xerotica obliterans
causes inflammation and lesions (dry white thickened plaques)
as a result foreskin adheres to glans and pulling it back is painful and difficult

25
clinical presentation of normal phimosis
end of penis may balloon when passing urine recurrent UTI
26
clinical presentation of abnormal phimosis
haematuria painful erections pain weak urine stream recurrent UTI
27
management for phimosis
steroid creams or gels personal hygiene surgery or circumcision for persisting abnormal phimosis