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Paediatrics > Nephrology > Flashcards

Nephrology Flashcards

1
Q

what are common causes of UTIs in the paediatric population ? 5

A

E coli
proteus
pseudomonas
klebisella
enterococcus

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2
Q

….. (organism) is associated with UTIs in paediatric patients who have renal tract abnormalities

A

pseudomonas

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3
Q

what bacteria that causes UTIs predisposes to stone formation ?

A

proteus

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4
Q

most UTIs in children occur due to … (route of transmission)

A

ascending bowel flora

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5
Q

presentation of UTIs in infants?

A
  1. fever
  2. vomitting
  3. lethargy
  4. poor feeding
  5. septicemia
  6. febrile seizures
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6
Q

presentation of UTIs in children?

A
  1. more localized symptoms (dysuria, frequency, urgency)
  2. abdominal pain
  3. fever
  4. septicaemia and febrile seizures
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7
Q

diagnosis of UTI?

A
  1. urinalysis: elevated leukocytes (leukocyte esterase), nitrites
  2. urinary microscopy, cultures and sensitivity
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8
Q

in a child < …. with a UTI it is important to investigate them with … and ….

A
  1. MCUG (micturating cystourethrogram) - for evidence of vesicoureteral reflux
  2. DMSA scan for evidence of kidney scarring
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9
Q

management of UTIs (<2 months and > 2 months old)?

A

< 2 months old: IV amoxicillin + IV gentamicin + IV cefotaxime
> 2 months old: if systemically unwell IV co-amoxiclav + IV gentamicin, if systemically well PO co-amoxiclav

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10
Q

preventive measures for UTIs in paediatric population ?

A
  1. high fluid intake
  2. regular complete voiding
  3. good perineal hygiene
  4. treatment of constipation (pressure on bladder and prone to urinary retention)
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11
Q

nephrotic syndrome is characterized by a traid?

A

proteinuria
hypoalbuminema
edema

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12
Q

most cases of nephrotic syndrome in the paediatric population are caused by …. disease

A

minimal change disease

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13
Q

other causes of nephrotic syndrome in paediatrics besides minimal change disease?

A

congenital nephrotic syndrome

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14
Q

nephrotic syndromes causes the loss of …. and …. in the urine predisposing a child to … and …

A

immunoglobulins – predispose to infection
anti-thrombin 3 - hyper coagulable state

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15
Q

presentation of nephrotic syndrome ?

A
  1. signs of edema (puffy eyes and ankles, dyspnea, abdominal distension and ascites)
  2. normal BP and and no hematuria
  3. may rarely present with infections or thromboembolism due to protein loss
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16
Q

diagnosis of nephrotic syndrome? other investigations?

A
  1. FBC: infections and hematocrit
  2. U and E: for renal function
  3. LFT: for low albumin
  4. urinary dipstick: for proteinuria
17
Q

the cause of nephrotic syndrome can be assumed to be minimal change disease if : (3)

A

age 1-12 years
normal complement levels
no hypertension, no gross hematuria, or high creatinine (which would suggest nephritic syndrome)

18
Q

management of nephrotic syndrome (minimal change)

A

IV fluid and albumin (intravascular volume depletion)
prednisolone for 6 weeks; if non responsive, consider renal biopsy to identify other causes

19
Q

wilms tumour is also known as ?

A

nephroblastoma

20
Q

…. is the most common renal malignancy in children,

A

wilms tumour (nephroblastoma)

21
Q

most cases of wilms tumour occur in children < … years old

A

5

22
Q

Wilms tumour is associated with … syndrome

A

WAGR (Wilms, aniridia, GU anomalies, and retardation)

23
Q

presentation of Wilms tumour?

A
  1. abdominal mass and hematuria
24
Q

any abdominal mass in children should be considered … until proven otherwise

A

Wilms tumour

25
Q

diagnosis of Wilms tumour?

A
  1. abdominal ultrasound to identify mass, followed by CT/MRI
  2. definitive diagnosis biopsy and histological assessment
  3. chest x-ray for metastases
26
Q

neuroblastoma is a malignant tumour originating from …. cells of the … chain…. occurring mostly in children < …. years old

A

neural crest
sympathetic

27
Q

presentation of neuroblastoma?

A
  1. localizing symptoms depending on location
  2. abdominal mass
  3. systemic features: weight loss, fever, fatigue
  4. paraneoplastic/metastatic complications
28
Q

diagnosis of neuroblastoma?

A
  1. elevated serum and urinary catecholamines HVA and VMA
  2. ultrasound and biopsy
  3. staging: CT/MRI and I123-MIBG scan (for bone metastases)
29
Q

what markers are used to monitor response to treatment in a patient with neuroblastoma?

A

urinary and serum catecholamines (VMA, HVA)

30
Q
A

Paediatrics (12 decks)

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