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Paediatrics > Paediatric Nephrology > Flashcards

Paediatric Nephrology Flashcards

1
Q

What gender is most susceptible to UTI <2months

A

Males

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2
Q

What are UTIs in kids associated with?

A

Vesico-ureteric reflux

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3
Q

What are the causative organisms of UTI’s in kids?

A

E coli
Klebsiella
Proteus
Enterococci

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4
Q

What does proteus cause?

A

Stag head calculi

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5
Q

What enterococci cause UTI in neonates?

A

Strep faecalis

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6
Q

What are the symptoms of lower UTI in neonates?

A

Abdo pain
Haematuria
Offensive urine

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7
Q

What are the symptoms of lower UTI in toddlers?

A

Haematuria
Offensive urine
Failure to thrive

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8
Q

What age group are dipsticks unreliable?

A

<2yrs

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9
Q

Symptoms of upper UTI in neonates?

A 
Fever
Vomiting
Lethargy
Poor feeding 
FTT
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10
Q

Sx of upper UTI in toddlers?

A 
Fever
Abdo tenderness/loin pain
Vomiting
Poor feeding
Lethargy
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11
Q

Ix for UTI?

A

Dipstick >2yrs
Urine culture

USS if proteus

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12
Q

What is treatment for simple lower UTI in kids?

A

Trimethroprim
Co-trimoxazole
Cephalosporin

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13
Q

Tx for upper UTI?

A

Gentamicin
Co-amox
Cephalosporin

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14
Q

What is investigation for vesico-ureteric reflux?

A

MAG3 (tecnetium-99 filtered by kidneys then imaged)

DMSA (for scarring)

Micturating cystourethrogram

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15
Q

What is the grading of VUR?

A

Grade I: ureter only
Grade II: ureter, calyces, pelvis
Grade III: ureter dilatation
Grade IV: moderate dilatation/torsion/fornice obliteration
Grade V: gross dilatation or tortuous ureter

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16
Q

Treatment of VUR?

A

Voiding advice

Prophylactic trimethroprim

STING procedure

17
Q

What is a STING procedure?

A

Injection of a polymer into the VU junction that reduced the diameter of the ureters and allows them to close properly under action of the bladder

18
Q

What is typical vs atypical glomerulonephritis?

A

Typical = minimal change
Typical means it responds to normal steroid treatment

Atypical = focal segmental
Atypical means it is steroid resistance

19
Q

What is a congenital glomerulonephritis?

A

NPHS1 - gene for nephrin

Leads to loss of podocytes

20
Q

What causes nephrotic syndrome?

A

Loss of protein through the glomeruli leading to decrease in oncotic pressure, causing proteinuria and leading to oedema as water moves out of vascular system due to hydrostatic pressure

21
Q

What is the triad of nephrotic syndrome?

A

Hypoalbuminaemia
Hyperlipidaemia
Proteinuria

22
Q

What indicates nephrotic syndrome on dipstick?

A

Protein >250mg

23
Q

What is gold standard investigation for nephrotic syndrome?

A

24hr urine collection

24
Q

Tx typical nephrotic syndrome?

A

Prednisolone

25
Q

Tx atypical nephrotic syndrome?

A

Ciclosporin

26
Q

What must be checked before starting prednisolone in kids?

A

Varicella status

27
Q

What % of nephrotic remit?

28
Q

What % of nephrotic relapse?

Paediatrics (8 decks)

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