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2 - CPR (renal) > Pediatric Renal > Flashcards

Pediatric Renal Flashcards

1
Q

In what gender are UTI’s more common?

A

Girls

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2
Q

What are the main symptoms of a UTI in a child?

A

Fever
Suprapubic pain
Urinary urgency/frequency
Loss of control – accidents/dribbling

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3
Q

What is key to obtaining a good specimen of urine collection for culture/sensitivity?

A

Cleanliness

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4
Q

What is key to obtaining a good specimen of urine collection for culture/sensitivity?

A

Cleanliness

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5
Q

If a child is not potty trained, what are 2 ways to obtain a urine specimen for culture/sensitivity?

A
  1. Straight catheter

2. Supra-pubic aspiration

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6
Q

What is Supra-pubic aspiration and when is it used?

A

Needle inserted into the bladder through the supra-pubic region to get a urine specimen for culture/sensitivity when a child is not potty trained
– mostly used with neonates in the ICU

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7
Q

Bag urine samples are not appropriate for?

A

Culture

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8
Q

Main 3 ways to obtain urine for a culture/sensitivity?

A

Clean catch
Straight catheter
Supra-pubic aspiration

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9
Q

With a clean catch specimen, what is the criteria for a UTI?

A

Pyuria

> 50K colonies of an organism

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10
Q

With a straight catheter specimen, what is the criteria for a UTI?

A

Pyuria

10K-50K colonies of an organism

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11
Q

With a supra-pubic aspiration, what is the criteria for a UTI?

A

Pyuria

ANY growth on culture

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12
Q

What is the most common pathogen for a UTI in children?

A

E. Coli

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13
Q

What are 2 possible imaging studies used for children with UTI’s?

A
  1. Renal and Bladder US

2. Voiding Cystourethrogram

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14
Q

What does a Voiding Cystourethrogram show that a renal and bladder ultrasound cannot?

A

If there is any reflux from the bladder to kidney

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15
Q

With boys, what should be performed after 1 UTI?

A

Renal and bladder ultrasound

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16
Q

With boys, after their first UTI, a Voiding Cystourethrogram should be performed if any one of the following 4 things are present?

A
  1. Renal and bladder ultrasound anomalies
  2. Fever > 102.2 and pathogen OTHER than E.coli
  3. Poor growth and HTN
  4. Repeated UTI’s
17
Q

With boys, after their first UTI, a Voiding Cystourethrogram should be performed if one any of the following 4 things are present?

A
  1. Renal and Bladder ultrasound abnormalities
  2. Fever > 102.2 and OTHER pathogen than E.coli
  3. Poor growth and HTN
  4. Repeated UTI’s
18
Q

With girls, when is a renal and bladder ultrasound recommended?

A

Usually after their 2nd UTI but maybe after the 1st

19
Q

With girls, a Voiding Cystourethrogram should be performed if any one of the following 4 things are present?

A
  1. Renal and Bladder ultrasound abnormalities
  2. Fever > 102.2 and OTHER pathogen than E.coli
  3. Poor growth and HTN
  4. Repeated UTI’s
20
Q

What are the 2 most common causes of obstructive uropathy in children and which one only occurs in boys?

A
  1. Posterior urethral valves – boys only

2. Ureteropelvic junction obstruction

21
Q

Why is it important to recognize a vesicoureteral reflux?

A

It can cause UTI’s and renal damage

22
Q

Most vesicoureteral refluxes will?

A

Resolve on their own

– Grades 4-5 may need surgery

23
Q

Empiric treatment of a child with UTI/pyelonephritis must include what coverage?

A

E.coli

– most common urinary pathogen

24
Q

What is the common triad of symptoms for Acute Post-Streptococcal Glomerulonephritis?

A
  1. Hematuria
  2. Edema
  3. HTN
25
Q

What is the common triad of symptoms for Acute Post-Streptococcal Glomerulonephritis?

A
  1. Hematuria
  2. Edema
  3. HTN
26
Q

What is an important item in the history with a child that may have Acute Post-Streptococcal Glomerulonephritis?

A

History of a recent strep infection

27
Q

What molecular changes will be present with Acute Post-Streptococcal Glomerulonephritis?

A
  • Anti-streptolysin O titer
  • Anti-DNAse B antibody
  • Recent throat culture positive for strep pyogenes
28
Q

What is the prognostic indicator of long-term renal damage in children with Henoch-Schonlein Purpura?

A

Protein in the urine (along with the blood)

29
Q

What is the prognostic indicator of long-term renal damage in a child with Henoch-Schonlein Purpura?

A

Protein in the urine (along with the blood)

2 - CPR (renal) (27 decks)

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