Renal Flashcards
Cause and treatment of oedema
Heart Failure / frusemide +/- spiro + ACEi
Nephrotic Syn / Oral pred (6weeks) + low Na diet + Frusemide +/- spiro
Liver Failure
Malnutrition / gradually increase to high protein diet
Haematuria - CF / C / I
CF - micro or macro
C - either glomerular or non-glom
GLOM: GN/IgA nephrop/ familial nephritis
NON-GLOM: UTI/stones/tumour/trauma/sickle cell
I - Bloods (FBC/Coag/ANF/C3-C4/ ASO titre)
Urine (MC+S / Calcium creat)
Imaging (abdo xray/ renal USS/ biopsy)
Polyuria - C / I
C - DM/ UTI / polydipsia / vasopressin deficiency, ADH resistance
I - WCC, BM, urine MC+S , water deprivation test, U+E’s
UTI - CF / C / I / T
CF - (in infants)
non-specific signs (fever, vomiting, failure to thrive, colic, PUO), SIRS signs, collapse
C - incomplete urination (leads to vulvitis/infreq voiding/ constipation)
Bacteriuria (e coli/staph) with or without structural abnorm
Pyelonephritis
I - Urine (MC+S and Nitrates)
Imaging (USS for structural abnorm)
T - Depending on Age
3 months = 3 day PO trimeth
+up oral fluids and full voiding
if >3 months and systemic upset give IV Gent
Bedwetting causes
not voiding enough, overactive bladder syn, polydipsia, DM1, spina bifida, UTI
Inguinal hernia - RF / CF / T / Comp
RF - premature/ low birthweight / male
CF - pain??
T - either attempt manual reduction or refer for immediate surgery. If manual reduction is successful then a semi-elective repair will be done to prevent recurrence
Comp - incarceration - strangulation - systemic illness
Hydrocele - ? / C / CF / T
fluid in the scrotum
C - patent processus vaginalis
CF - PAINLESS, but can cause systemic illness (blue balls and transilluminates)
T - 90% resolve spontaneously
differentiating acute scrotum features
blah blah
Abnormal foreskin is called? 3 conditions
hypospadius or epispadius or phimosis
balanitis - CF / C / T
CF - red, swollen, itchy, discharging, rash, dysuria
C - STI / thrush / contact dermatitis / bacterial inf
T - self limiting OR creams (steroid/ ABxs/ anti-fungal)
Dysuria - C /
UTI, cystitis, obstruction (hypertrphic prostate/ urethral stricture)
most common abnorm of uterine tract
absent kidney/ multi-cystic dysplastic kidney/ horse-shoe kidney/ obstruction (often leads to hydroneph)
Hypertension in child - C/I
Renin-dependant / co-arctation aorta/ catecholamine increase / obesity / essential HPT/ endocrine (cushing, congen adrenal hyperplasia, hyperthyroid) or pharmacological
I - Bloods (investigating all above) + Ca + PO4 + LFT’s
plasma renin levels / aldosterone/ plasma catecholamines
Urine - MC+S/ prot:creat ratio / urine catecholamines
Imaging - renal US + doppler / echo / ECG
also check for end-stage damage!
methods of urine collection
clean catch (BEST)
catheter
supra-pubic aspiration (aseptic tech, 1cm above pubic bone + risk of blood in urine afterwards)
