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Nephrology and Urology > Pyelonephritis and Congenital Abnormalities of the Kidney and Urinary Tract > Flashcards

Pyelonephritis and Congenital Abnormalities of the Kidney and Urinary Tract Flashcards

1
Q

At what week of gestation does urine production start?

A

10 weeks

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2
Q

At what week of gestation do no new nephrons develop?

A

36 weeks

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3
Q

What is the GFR of a baby at birth?

A

40-60mls/min/1.73m^2

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4
Q

What renal investigations can be conducted in children?

A 
Anetnatal US
ultrasound
Micturating cystourethrogram
Nuclear medicine
CT
MRI
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5
Q

List common congenital abnormalities of the kidneys/urinary tract

A 
Renal dysplasia/hypoplasia
Renal agenesis
MCDK
Renal cystic dysplasia
Genetic cystic disease
Obstructive uropathy
Vesicle-ureteric reflux
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6
Q

What is renal genesis?

A

The congenital absence of renal aprenchumal tissue at the metanephric stage

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7
Q

What is the prognosis of unilateral renal agenesis?

A

Excellent - many people will go through life not knowing the have the condition

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8
Q

What is the prognosis of bilateral renal agenesis?

A

Not compatible with life.

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9
Q

Bilateral renal agenesis is usually sporadic. T/F?

A

True

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10
Q

Which sex is usually affected by renal agenesis?

A

Males

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11
Q

What is renal hypopalsia?

A

A reduction in the number of nephrons but with normal architecture

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12
Q

What is renal dysplasia?

A

Malformed renal tissue

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13
Q

What. is renal hypodysplasia?

A

Congenitally small kidneys with dysplastic features

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14
Q

How does renal hypodysplasia present?

A

Present antenatally as US growth
In the neonate with lung issues, low birth weight, acidosis and raised creatinine
In children as failure to thrive, anorexia, vomiting, proteinuria

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15
Q

What are the associated risks of multicystic dysplastic kidney disease?

A

Hypertension

Malignancy

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16
Q

There can be spontaneous involution of multicystic dysplastic kidney disease. T/F?

A

True

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17
Q

What are the signs of ARPKD antenatally?

A

Seen on ultrasound

Oligohydraminos (less than expected amniotic fluid volume)

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18
Q

What are the signs of ARPKD in infancy?

A 
Large palpable renal mass
Respiratory distress
Renal failure
Hypertension
Hyponatraemia
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19
Q

What are the associated abnormalities of ARPKD?

A

Congenital hepatic fibrosis (causes portal hypertension and ascending cholangitis)

20
Q

What is the prognosis fo ARPKD?

A

20-30% mortality in neonatal. period

Progression to end stage renal failure in 50% of cases over 15 years

21
Q

What are the signs ADPKD in children?

A 
Haemturia
Hypertension
Flank pain
UTIs
Renal US
22
Q

In what age group does ADPKD usually present?

A

Adults

23
Q

What are the associated conditions of ADPKD?

A 
Mitral valve prolapse
Cerebral aneurysm
AV malformation
Hepatic/pancreatic cysts
Colonic diverticula/hernia
24
Q

What are the associated abnormalities of hydronephrosis?

A

Renal injury and impairment

25
Q

What signs of hydronehprosis can be seen on antenatal ultrasound?

A

Transient, increased. AP diameter

26
Q

What signs of hydronehprosis can be seen on post-natal ultrasound?

A

Renal pelvic diameter >10mm

27
Q

What are the possible causes of hydronephrosis?

A

Vesicle-ureteric reflux and obstruction of the urinary tract

28
Q

What is a pelvic/ureteric junction obstruction?

A

A total of partial blockage of urine at the junction of. the ureter with the kidney

29
Q

At what point can pelvic-ureteric junction obstruction be diagnosed?

A

Antenatally

30
Q

What are the signs/symptoms of pelvic-ureteric junction. obstruction?

A

Abdominal mass
UTI
Failure to thirve
Abdominal/flank pain

31
Q

A vesicle-ureter junction obstruction will cause megaureter. How is this defined?

A

Ureteric dilation >7mm

32
Q

What is the most common obstructive uropathy?

A

Posterior urethral valve

33
Q

How is posterior urethral valve investigated?

A

Ultrasound

Micturating cystourethrogram

34
Q

How are posterior urethral valves managed?

A

Cystoscopy

35
Q

What complications result from posterior urethral valves?

A

Hydronephrosis

UTI

36
Q

What is vesicoureteral reflux?

A

Retrograde passage of urine from the bladder into the upper urinary tract

37
Q

How is vesicoureteral reflux diagnosed?

A

Mictruating cystourethrogram

38
Q

What grades of vesicourethral reflux need intervention?

A

Grades 4 and 5

39
Q

In which sex are UTIs more common?

A

Females

40
Q

What is the diagnostic criteria for UTI in children?

A

Significant bacteriuria >10^5 cooling forming units/ml

and a single pathogenic bacteria

41
Q

How can urine collection in suspected UTI be done in children?

A

Clean catch urine collection
Mid-stream sample
Catheter specimen
Supra-pubic aspirate

42
Q

What bacteria usually causes UTI in children?

A

E.coli

43
Q

How does upper tract UTI present in children?

A

Pyrexia
Vomiting
Systemic upset
Abdominal pain

44
Q

How does lower tract UTI present in children?

A

Dysuria
Frequency
Haematuria
Wetting

45
Q

How can suspected pyelonephritis in children be investigated?

A

Ultrasound
Microrating cystourethorgram
nuclear medicine

46
Q

What are the complications of pyelonephritis?

A

Scarring
Hypertension
End stage renal failure

Nephrology and Urology (13 decks)

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