Renal

Question 1

UTI symptoms in neonates?

Answer 1

Off feeds
Irritable
Foul smelling urine

Question 2

UTI symptoms in young children?

Answer 2

Fever
Dysuria
Suprapubic pain

Question 3

UTI symptoms in older children?

Answer 3

Fever
Dysuria
Frequency
Urgency
Suprapubic pain

Question 4

Investigations in UTI?

Answer 4

Urine dipstick
Urine culture
KUB ultrasound (anatomical abnormalities)
Micturating cystourethrogram
DMSA renogram (function/scaring)

Question 5

Treatment UTI?

Answer 5

Treat according to urine sensitivities
<3 months: refer
>3 months with Lower UTI: Trimethoprim or nitrofurantoin
>3 months with Upper UTI: admit and co-amoxiclav

Question 6

Commonest bacterial cause of UTI?

Answer 6

E. coli

Question 7

Risk factors for UTI?

Answer 7

Female
Genitourinary malformations
Vesicoureteric reflux (VUR)
Diabetes
Immunosuppression
Catheterisation

Question 8

What is haemolytic uraemic syndrome (HUS)?

Answer 8

E. coli O157:H7 or Shigella enteritis

Viratoxin damage to glomerular endothelial cells

Question 9

Symptom triad of HUS?

Answer 9

MhAT
Microangiopathic haemolytic anaemia
Acute kidney injury
Thrombocytopenia

(NO FEVER)

Question 10

Investigations in HUS?

Answer 10

Stool culture
Urinalysis eGFR
FBC, U&E, LFT, LDH
Peripheral blood smear

Question 11

Treatment in HUS?

Answer 11

Notifiable disease
Generally supportive (IV fluids)
Consider CCB if hypertension
Transfusion/dialysis if severe

Question 12

What is Henoch-Shönlein Purpura (HSP)?

Answer 12

Systemic vasculitis that presents with typical signs and symtpoms

Question 13

What causes HSP?

Answer 13

IgA complex deposition in the capillaries, arterioles and venules in organs such as the skin and the kidneys.
Symptoms caused by activation of complement

Question 14

Symptom triad of HSP?

Answer 14

RAP
Renal manifestations: 
- haematuria
- ANCA negative glomerulonephritis
Arthralgia and abdominal pain
Purpura (typically buttocks and lower limb)

Question 15

Investigations in HSP?

Answer 15

Urinalysis and eGFR
FBC, EUC, LFT, LDH, CRP, ESR
IgA levels
Skin biopsy if indicated

Question 16

Treatment of HSP?

Answer 16

Generally supportive (high rates of spontaneous remission)
Analgesia
Steroids if severe

Question 17

Causes of nephritic syndrome?

Answer 17

IgA nephropathy (Berger’s disease)
SLE
HSP
Alport’s syndrome

Question 18

Signs in nephritic syndrome?

Answer 18

PHARAOH
Proteinuria
Haematuria
Azotaemia
Red blood cell casts
Antistreptolysin O titres
Oliguria
Hypertension

Question 19

Causes of nephrotic syndrome?

Answer 19

Minimal change disease
Focal segmental disease
Membranous glomerulosclerosis
Diabetic neuropathy
Amyloidosis
Mesangial proliferative glomerulonephritis
SLE

Question 20

Signs in nephrotic syndrome?

Answer 20

PHHO
Proteinuria
Hypoalbuminemia
Hyperlipidemia
Oedema

Question 21

Nephritic cartoon?

Answer 21

IgA
Berger
Cola
Hypertension

Question 22

Nephrotic cartoon?

Answer 22

Oedema
Protein
Lipid

Question 23

Hernia risk factors?

Answer 23

Boys (9:1)

Premature

Question 24

Hernia management?

Answer 24

<1: Urgent (33% incarcerate)

>1: elective referral and repair

Question 25

Hydrocele?

Answer 25

Common in newborns, painless, increases with crying, bluish colour

Question 26

Hydrocele management?

Answer 26

Conservative until age 5

Question 27

Indications for orchidopexy?

Answer 27

Fertility risk
Malignancy risk
Trauma
Torsion rate higher
Cosmetic

Question 28

Acute scrotum differentials?

Answer 28

Torsion testis
Torsion appendix testis
Epididymitis