Renal and urology Flashcards
Describe the presentation of UTI in infants
In infants, symptoms are non specific:
- Fever (this may be the only symptom)
- Irritability
- Poor feeding
Describe the initial investigation of suspected UTI
Urine dip and MCS
A child with a confirmed UTI may require further investigation…
What are the criteria for further investigation?
Give some examples of further investigation which may be required
Only children with atypical or recurrent UTIs require further investigation
Further investigation may include:
- US scan
- MCUG (micturating cystourethrogram)
- DMSA scan
Describe the management of UTI in…
a) Infants < 3 months
b) Children with cystitis/lower UTI
a) Immediate referral to hospital for IV antibiotic therapy and septic screen
b) Short course of oral antibiotics, e.g. 3 days of trimethoprim or nitrofurantoin
Describe the classic triad of nephrotic syndrome
- Heavy proteinuria
- Low albumin
- Oedema
What is the most common cause of nephrotic syndrome?
Minimal change disease
Describe the medical management of nephrotic syndrome
Prednisolone
Describe the pathophysiology of haemolytic uraemic syndrome
Thrombosis in small blood vessels throughout the body (usually triggered by a bacterial toxin called the shiga toxin so typically occurs following episode of gastroenteritis)
Describe the classic triad of haemolytic uraemic syndrome
- Acute kidney injury
- Haemolytic anaemia
- Thrombocytopenia (haematuria)
Describe the management of haemolytic uraemic syndrome
Treatment is mainly supportive, e.g. fluids, blood transfusion/dialysis if required
What is Wilms’ tumour?
What are the 2 typical features of Wilms’ tumour?
Nephroblastoma
Features:
- Painless abdominal mass (most common presentation)
- Painless haematuria
Describe the management of Wilms’ tumour?
- Nephrectomy
- Chemo/radiotherapy
In most cases undescended testes will descend by (…?) months
If they have not descended by (…?) months, referral to paediatric urology is indicated
3-6 months
6 months
What is hypospadias?
The urethral meatus is abnormally displaced to the ventral (underside) of the penis
Is it more common for hypospadias to be nearer to the glans penis or nearer to the scrotum?
Nearer to the glans penis