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Toni's Paeds > Renal + GU > Flashcards

Renal + GU Flashcards

1
Q

What is hypospadias

A

Urethral opening on ventral aspect of penis
Often seen with urinary tract abnormalities and undescended testes
Circumcision is absolutely contraindicated

Surgical repair at 1 yr (prepuce required)
Also assoc with: CAH, hermaphroditism

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2
Q

What is acute glomerulonephritis?

A

Presents with periorbital oedema, oliguria, haematuria
Oft follows strep throat
AKI -> hyperkalaemia, htn, fluid overload
Serum u + e, creatinine, bp, weight must be monitored
Urine m, c + s: Presence of hyaline + red cell casts, no infection
To confirm: throat swab, ASOT, complement ( low C 3)

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3
Q

Wilms’ tumour

A

Hypertension
Renal impairment
Malnutrition
Metastasis

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4
Q

Neuroblastoma

A

Neuro last cells in the adrenals

Catecholamine detected in urine

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5
Q

HSP

A

3-10 yrs vasculitis following viral illness
Arthralgia
Rash: urticaria - purpura
Abdo pain
Renal involvement: htn, nephrotic syndrome
Normal observations + normal platelet count

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6
Q

HUS

A

Complication of E.coli (O157H7) or shigella gastroenteritis verocytotoxin
= inflamm reaction in vasc endothelium + neutrophil activation
AKI + thrombocytopenia + microangiopathic haemolytic anaemia
Renal impairment may req dialysis or progress to CKD

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7
Q

Micturating cystourethrogram

A

To investigate suspected bladder outflow obstruction

  • palpable bladder
  • anuria
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8
Q

Posterior urethral valves

A

Bladder outflow obstruction

Poor urinary stream

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9
Q

DMSA

A

Dimercapto succinct acid: radio labelled compound which becomes fixed in functioning proximal renal tubular cells
Not taken up by scarred non functioning areas of the kidney
E.g. Following recurrent UTIs

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10
Q

PKD AR

A

Childhood presentation
Bilat renal masses
Pulmonary hypoplasia = resp distress
Pulmonary HTN
Congenital hepatic fibrosis
Cysts= grossly dilated nephrons, compress normal renal tissue
Affects renal, liver and cerebral vasculature (berry aneurysm)

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11
Q

Torsion of the hydatid of Morgagni

A

Small embryological remnant at upper pole of testes
Most common cause of acute scrotum in children
Benign but needs to be distinguished from testicular torsion a surgical emergency

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12
Q

Complications of HUS

A 
Abdo pain
Myocarditis
Hepatitis
Pancreatitis
Retinal haemorrhages
Encephalitis like features
Renal damage-> htn
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13
Q

Testicular torsion

A

Twisting of spermatic cord in/ below inguinal canal
Strangulation of gonadal vessels -> testicular necrosis + atrophy
More common in adolescents

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14
Q

Hydrocele

A

Tunica vaginalis? Produces liquid

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15
Q

Epididymitis

A 
Inflammation of the epididymis
Swollen painful testicle
Associated fever + nausea
Prehn's sign positive
Assoc urinary Sx
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16
Q

Nephrotic syndrome

A

Proteinuria:
Hypoalbuminaemia:
Oedema
(Also often hyperlipidaemia)

17
Q

Rationale for treating cryptorchidism

A

Prevention of testicular cancer (always once risk tho)
Psychological benefit
To improve fertility slightly (temperature in abdomen too high)

18
Q

Complications of cryptorchidism

A 
Psychological distress
Decr fertility
Incr risk torsion
Indirect hernias
Malignancies
19
Q

Common causes of UTI

A

E.coli
Proteus spp. (More common in boys)
Pseudomonas spp. (Oft assoc with structural abnormalities)

20
Q

How would you acquire a good quality urine sample from a young child?

A

Adhesive bag
Clean catch (sit child on sterile pot)
Catheter insertion (in-out unless req going forward)
Suprapubic aspiration

21
Q

Caricocele

A

Usually L sided
‘Bag of worms’
Varicosities in the pampiniform venous plexus
Assoc with defective spermatogenesis
Do USS: venous dilatation >2mm
Reassurance, supportive underwear
Radiological embolisation of L testicular vein can be performed o ligation and division of the L testicular veins

22
Q

Phimosis

A

Inability to retract the prepuce
Should only be diagnosed after 3 yrs of age
Surgical correction if:
Prepuce remains non retractile
UTI or balantitis occurs secondary to phimosis

23
Q

Paraphimosis

A

Retraction of tight foreskin over glans which impedes venous outflow -> oedema = more difficult to reduce the skin
Administer LA ringblock without adrenaline!!
Squeeze glans and reduce foreskin
Circumcision to prevent recurrence

24
Q

How does Wilms tumour present

A

Unilat abdo mass
Painless haematuria
Flank pain
B sx

25
Q

How is Wilms tumour managed?

A

Nephrectomy
Chemotherapy
If advanced + radiotherapy
Good prognosis, 80% cure rate

26
Q

How would you manage undescended testis?

A

Review at 6-8wks age
Review at 3 months
To be seen by paeds surgeon before 6 months

Toni's Paeds (16 decks)

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