Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paediatrics > Renal > Flashcards

Renal Flashcards

1
Q

What is acute pyelonephritis

A

An upper tract UTI

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

What is acute cystitis

A

A lower tract UTI

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

What increases your risk of developing UTIs

A
  • Urinary Tract normal in most UTIs BUT:
    Vesicoureteric Reflux
    Renal Abnormality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is vesicoureteric reflux

A

Retrograde flow/Reflux of urine from bladder into ureter and sometimes to kidneys usually due to abnormal ureter

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

What are the grades of vesicoureteric reflux

A

Severity grade 1-5: (severity of reflux, dilation)

  1. Incomplete filling of upper urinary tract without dilation
  2. complete filling +/- dilation
  3. ballooned calyces
  4. Megaureter
  5. Megaureter +/- Hydronephrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some examples of renal abnormality

A

Malpositions e.g ectopic kidney
Duplications e.d double ureter
Megaureter + Hydronephrosis
Horseshoe Kidney

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

How may an infant present with a UTI

A

@ Often Non-specific

May present collapse with septicaemia

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

How may a toddler present with a UTI

A 
@ Often Non-specific 
Vomiting, 
'Gastroenteritis symptoms', 
Failure to Thrive, 
Colic, 
Fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What specific symptoms may be seen in an Upper UTI

A

Fever
Systemic Illness (meningitis infancy)
Loin/Abdo Pain
Failure to thrive/Jaundice - infancy

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

What specific symptoms may be seen in a lower UTI

A 
Dysuria
Urinary Frequency/ Urgency 
Incontinence 
Lower Abdo pain
Haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the long term complications of recurrent UTIs

A

Renal Scarring
Hypertension
Renal failure
Chronic Pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does renal failure occur from UTIs

A

Due to renal scarring secondary to UTI +/- VUR and chronic pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does chronic pyelonephritis cause

A

Hypertension

Renal Failure

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

How is a UTI diagnosed

A

MSU sample - dipstick and MC&S

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

What would you likely see on a dipstick if UTI was present

A

Nitrates and WCC +ve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you get a urine sample in a child

A

Clean catch sample - least invasive
Catheter - invasive
Suprapubic Aspirate - invasive

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

When may you investigate UTIs in children further

A

Contraversial but investigate more intensily those under 6 mths - imaging dependent on age and type of infection

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

What investigations may you do to investigate UTIs further

A

US
DMSA scan
Micturating Cystourethrogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can an US detect for UTIs and why may it be used first

A
  • Its cheap/ non invasive and effective!
  • Size, location and drainage of kidney and bladder
  • Scars may be visible
  • Good predictor for abnormal DMSA scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a DMSA scan and what’s it used for

A

Radionucleotide Imaging

Shows Renal scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is micturating Cystourethrogram and what are its disadvantages

A

Its Invasive and Unpleasant

BUT best way of investigating vesicoureteric reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you manage a UTI in those under 3 months

A

IV amoxicillin + Gentamicin

- Increase oral fluids and give pain relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you manage a UTI in those over 3 months

A

Trimethoprim or Nitrofurantoin

  • Increase oral fluids
  • give pain relief
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How can you prevent recurrent UTIs

A
  • Prophylaxis: Trimethoprim
  • Screen for reflux if prophylaxis fails
  • Avoid predisposing factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are predisposing factors for UTIs
- Constipation - Back to front wiping - Nylon - Bubble Bath - Low fluid intake
26
What can cause Enuresis
- Diabetes - UTI - GU abnormality - Overactive Bladder - Child Abuse - Systemic Illness
27
What is secondary Enuresis
- enuresis after >6 mths dryness - Raises concerns - e.g Child Abuse, Systemic illness
28
How is eneureis managed
- Ix possible causes - Reassurance and advice to parents - Avoiding Caffine - Reward Systems
29
What is Hypospadias
Abnormal position of external urethral meatus on ventral penis
30
What is Epispadias
Abnormal position of external urethral meatus on dorsal of penis
31
What may concern people with Hypospadias/Epispadias | How is it managed?
Cosmetic Appearance Difficulty urinating while standing RX: Surgical repair
32
What are the 2 cause of increased interstitial fluid
- Reduced Oncotic pressure due to increased loss of albumin - Nephrotic Syndrome - Salt and Water Retention due to the kidneys impaired GFR - Nephritic Syndrome
33
What is AKI
Rapid increase in creatine or development of oliguria/anuria
34
What can cause AKI
- Cardiac Surgery - Bone Marrow Transplant - Toxicity/Drugs (NSAIDs, Vancomycin, Acyclovir) - Acute Tubular Necrosis - Sepsis - Diarrhoea/Dehydration - Glomerulonephritis - Drug induced haemolysis - Snake Biyes - Haemolytic Uraemic Syndrome
35
What causes Acute Tubular Necrosis
``` Crush Injurys Burns Dehydration Shock Sepsis Malaria ```
36
How is AkI severity assessed
RIFLE criteria - based on changes to eGFR or urine output and outcome measures e.g end stage renal failure/loss of kidney function
37
What investigations may be performed in AKI
Plasma: Increased K+, Creatine and Urea, Low Ca2+, Na+ and Cl, Clotting (DIC) MSU: Red cell casts or dipstick may be +ve for microhaematuria US: Ureters dilated, stones ECG Immunology: C3, C4, ANA, ASO titre
38
How do you treat AKI
- Treat shock and dehydration - Fluid balance: avoid overhydration, replace losses - Monitor BP - and treat with diuretics - Monitor K+ with ECG - tall tented T waves (give salbutamol or glucose with soluble insulin) - Monitor Acidosis - Dialysis - uncommon
39
What is haemolytic Uraemic Syndrome
RARE - Haemolytic anaemia, thrombocytopenia, renal failure + endothelial damage to glomerular capillaries - Typical HUS: Associated with Diarrhoea
40
What is the cause of Typical HUS
Shigella Toxin producing E.coli
41
How does HUS present
1. Colitis 2. Haemoglobinuria 3. Oliguria +/- CNS signs 4. Encephalopathy 5. Coma
42
What may be found on investigations off HUS
LDH high WCC high Coombs -ve PCV low
43
How do you treat HUS
Paediatric Nephrology for early dialysis and treatment of renal failure
44
What causes chronic renal failure
``` Congenital dysplastic kidneys Pyelonephritis Glomerulonephritis Recurrent UTIs and VUR AKI ```
45
What are complications of Chronic renal failure
Acidosis Renal Osteodystrophy - poor mineralisation Anaemia - low erythropoietin
46
How does chronic renal failure present
``` Weakness Tiredness Vomiting Headache restlessness twitches raised BP Anemia Failure to thrive Seizures Coma ```
47
How do you treat chronic renal failure
Haemodialysis | Kidney transplant
48
What are the key features of glomerulonephritis (nephritic syndrome)
Haematuria and Oliguria | +/ raised BP +/- uraemia
49
What are the causes of Glomerulonephritis
* Beta Haemolytic Strep via proceeding sore throat * Henoch - Schonlein Purpura - Others: Toxins, Heavy metals, malignancy , viruses, SLE
50
How does uncomplicated glomerulonephritis present
- Haematuria - Oligouria - BP raised - Periorbital Oedema - Fever - GI disturbance - Loin Pain
51
How does complicated glomerulonephritis present
- Hypertensive Encephalopathy: headache, fits, loss of vision, vomiting, coma - Uraemia: acidosis, twitching, coma - Cardiac: gallop rhythm, cardiac failure
52
What investigations should you do for glomerulonephritis
- FBC & U&Es - Urea and Creatine raised - Compliments - C3 low and C4 normal - ASO titre - ANA and ANCA - Syphillis serology, blood cultures, virolgy - MSU: haematuria, proteinuria, & RBC casts - Throat Swab - Renal US and CXR for fluid overload
53
How do you manage Glomerulonephritis
- Treat the cause! - HTN - Salt restriction and Diuretics - Fluid Management to prevent overload in those with oligouria
54
How does poststreptococcal Glomerulonephritis present
Clinical nephritis 10 days post infection following: - Nasopharyngeal Infection (pharyngitis) - Skin Infection (Impetigo)
55
How does poststreptococcal glomerulonephritis occur
Antigen- Antibody complexes deposited in Glomerus leads to complement activation
56
How does poststreptococcal glomerulonephritis present
``` Gross haematuria and oliguria Oedema and HTN Malaise, Anorexia, Fever, Abdominal pain ```
57
How is post step glomerulonephritis diagnosed
Urinalysis: proteinuria, RBC casts +/- oliguria Blood: raised urea, creatine, low C3 Step infection confirmed - raised ASO titre throat swab
58
How do you treat post strep Glomerulonephritis
Prognosis is good! - HTN: Monitor BP, Na+ restriction, Fluid Balance, diuretics and antihypertensives - Restrict protein in oliguria phase - Give penicillin - Dialysis - uncommon
59
What is Henoch - Schonlein Purpura (HSP)
- Acute immune complex mediated vasculitis caused by IgA deposition in the vessels e.g kidneys - Glomerulonephritis
60
when do most people develop HSP
- most people have a proceeding URTI
61
How does HSP present
The classic Triad: - Purpura (purple spots/nodules) - Arthritis/ Arthalgia often knees/ ankles - Abdo Pain Other signs: renal involvement: haematuria/proteinuria, acute nephritis, renal impairment, HTN
62
What investigations may be performed in HSP
``` ESR raised IgA raised Proteinuria ASO titre raised U&Es BP raised ```
63
What are the complications of HSP
Massive GI bleeds | Acute Renal Failure
64
What is the treatment for HSP
- Usually self limiting - Steroids can be effective e.g prednisalone - Steroid resistant? - Immunosupression with Cyclophosphamide
65
How do you suppress SLE
Steroids and Cyclophosphamide
66
What is nephrotic syndrome
Massive increase of filtration of macromolecules across glomerulus causing massive proteinuria
67
What are the key features of nephrotic syndrome
Heavy Proteinuria Hypalbuminaemia Oedema: pitting oedema, gravitational Hyperlipidaemia
68
How does steroid sensitive nephrotic syndrome present
- normal BP - No macroscopic haematuria - Normal renal function - No features of nephritis - Responds to steroids - Histology: minimal change usually
69
How does steroid resistant nephrotic syndrome present
- Elevated BP - Haematuria - Impaired renal function - features may suggest nephritis - fails to respond to steroids - histology: various underlying glomerulopathy e.g basement membrane
70
What type of nephrotic sndrome is most common in children
Steroid Sensitive - mainly minimal change GN | associated with allergy and IgE production
71
What are the symptoms of Nephrotic Syndrome
``` Oedema Anorexia GI disturbance Infections Irritability ```
72
What would you find on investigation of nephrotic syndrome
urinalysis: frothy, increased protein +/- casts, low sodium Blood: low albumin, urea and creatine usually normal Renal Biopsy: older children/ treatment failures
73
Wha are the complications of nephrotic syndrome
Increased infections - due to Ig loss in urine | AKI doe to hypovolaemia
74
How do you treat nephrotic syndrome
- Prednisolone - If steroid toxic or relapsing - Cyclophosphamide - Eat healthy - Na, protein and fluid moderation - Consider diuretics if very oedematous - Albumin Infusion in symptomatic hypovolaemia - Consider routine vaccination for pneumococcal, Measles etc.
75
Key differences between nephrotic and nephritic syndrome
Nephritic - Haematuria - High BP - Oliguria - Uraemia and high creatine in blood - Slight proteinurea - Normal Albumin Nephrotic - Heavy proteinuriea - Hypoalbuminaemia - Oedema - Usually normal BP - Normal creatine and urea in blood

Paediatrics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions