Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Week 12 - Nephrology and urology > Pyelonephritis and CAKUT > Flashcards

Pyelonephritis and CAKUT Flashcards

1
Q

Explain the embryology of the kidney

A
  • Pronephros
  • Mesonephros
  • Metanephros
  • At 10 weeks urine production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does nephrogenesis commence?

A

Week 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the different renal investigations?

A
  • Antenatal ultrasound scan
  • Ultrasound
  • MCUG- micturating cystourethrogram
  • Nuclear medicine: DMSA, MAG3
  • CT
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does CAKUT stand for?

A

Congenital abnormalities of kidney and urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the types of anomalies under CAKUT?

A
  • Renal dysplasia/hypoplasia
  • Renal agenesis
  • MCDK
  • Renal cystic dysplasia
  • Genetic cystic disease
  • Obstructive uropathy
  • Vesicle-ureteric reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is renal agenesis?

A

Congenital absence of renal parenchymal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is renal hypoplasia?

A

Reduction in the number of nephrons but a normal architecture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is renal dysplasia?

A

Malformed renal tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is renal hypodysplasia?

A

congenitally small kidneys with dysplastic features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the presentation of renal hypo dysplasia in foetuses?

A

Abnormal growth seen on the prenatal US scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the presentation of renal hypo dysplasia in neonates?

A
  • lung tissue
  • IUGR - intrauterine growth restriction
  • acidosis
  • Increased creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the presentation of renal hypodysplasia in children?

A
  • Failure to thrive
  • Anorexia
  • vomiting
  • Proteinuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the risks of multi cystic dysplastic kidney?

A
  • hypertension

* Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the antenatal presentation of autosomal recessive polycystic kidney disease?

A
  • Seen on antenatal ultrasound

* Oligohydramnios (deficiency of amniotic fluid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the infancy presentation of autosomal recessive polycystic kidney disease (ARPKD)

A
  • Large palpable renal mass
  • Respiratory distress
  • Renal failure
  • Hypertension
  • Hyponatremia: urinary concentrating defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the childhood presentation of autosomal recessive polycystic kidney disease?

A
  • renal failure

* hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is associated with ARPKD?

A

Congenital hepatic fibrosis: subclinical to liver disease (portal hypertension and ascending cholangitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the prognosis of ARPKD?

A
  • 20-30% mortality in the neonatal period
  • 5 year survival 70-88%
  • Progression to ESRF is over 50%, often within 15 years
  • 30-50% progress to ESRF within 10 years
19
Q

State the genetic mutations associated with autosomal dominant polycystic kidney disease

A
  • PKD1 mutation - polycystin 1

* PKD2 mutation - polycystin 2

20
Q

What is the classical ultrasound appearance in ADPKD?

A
  • Large echogenic kidneys

* Macrocysts: occasionally in infancy, multiple in older children

21
Q

What is the pathogenesis of ADPKD?

A

Cysts originate from the renal tubules

22
Q

What is the childhood presentation of ADPKD?

A
  • Haematuria
  • Hypertension
  • Flank pain
  • UTIs
  • Renal ultrasound: may be unilateral
23
Q

What is the adult presentation of ADPKD?

A
  • majority of presentations
  • Renal ultrasound
  • Hypertension
  • haematuria
24
Q

What are the associations with ADPKD?

A
  • Mitral valve prolapse
  • Cerebral aneurysm
  • AV malformation
  • Hepatic /pancreatic cysts
  • Colonic diverticula/hernia
25
Q

What is the management of ADPKD?

A
  • Supportive

* directed: tolvaptan

26
Q

What is the prognosis of ADPKD?

A

•Progression to ESRF in adulthood

27
Q

What is hydronephrosis associated with?

A
  • renal injury

* renal impairment

28
Q

What are the causes of hydronephrosis?

A
  • vesicle-ureteric reflux

* Obstruction of the urinary tract

29
Q

What are the levels of obstruction

A
  • Pelvis/ureter
  • Ureter
  • ureter/bladder
  • bladder
  • Urethra
30
Q

What is the presentation of PUJ obstruction?

A
  • Abdominal mass
  • UTI
  • Failure to thrive
  • Abdominal/flank pain
31
Q

What does vesicle ureteric junction obstruction lead to?

A
  • Megaureter

* ureteric dialtion >7mm

32
Q

What is the most common obstructive uropathy?

A

Posterior urethral valves

33
Q

What are the investigations for posterior urethral valve obstruction?

A

Ultra sound and MCUG

34
Q

what is the management of posterior urethral valve obstruction?

A

Cytoscopy

35
Q

What is the risk of posterior urethral valve obstruction?

A
  • CKD

* bladder dysfunciton

36
Q

What is vesicle-ureteric reflux?

A

Retrograde passage of urine from bladder to upper urinary tract

37
Q

What are the complications of vesicle-ureteric reflux?

A
  • UTIs leading to:
  • hypertension
  • ESRF
38
Q

How do you diagnose vesicle-ureteric reflux?

A

MCUG

39
Q

Urine collection for UTI

A
  • CCU
  • MSSU
  • catheter specimen - suprapubic aspirate
40
Q

Name the 3 most common causative organisms causing UTI

A
  • E coli
  • Klebsiella
  • Pseudomonas
41
Q

What are the host factors in UTIs?

A
  • Age
  • Circumcision
  • Urinary obstruction
  • Vesicle-ureteric reflux
  • Bladder/bowel dysfunction
  • Catheterisation
  • Sexually active
42
Q

What is the presentation of an upper urinary tract infection?

A
  • pyrexia (rigors)
  • Vomiting
  • Systemic upset
  • Abdominal pain
43
Q

What is the clinical presentation of a lower urinary tract infection?

A
  • Dysuria
  • Frequency
  • haematuria
  • Wetting
44
Q

What should you advise for UTI

A
  • Good kidney health:
  • Fluids
  • voiding regularly
  • Avoid constipation

Week 12 - Nephrology and urology (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions