Renal - HUS, HSP, UTI, vesicoureteric reflux Flashcards
HUS
-what is it
-presentation
-investigations
-management
Shiga toxin from 5 day GI infection (Ecoli)
Recent GI infection - bloody diarrhoea
AKI (renal symptoms)
Microangiopathic hemolytic anemia
Thrombocytopenia
FBC - thrombocytopenia, anemia
Blood film - schistocytes and helmet cells
U&E - AKI
Stool - shiga toxin producing Ecoli
Supportive management
-fluids, blood transfusion, dialysis
HSP
-what is it
-presentation
-management
IgA mediated small vessel vasculitis
Palpable purpuric rash - butt, extensor surfaces of arms and legs
Abdo pain
Polyarthritis
IgA nephropathy - hematuria, renal failure
Analgesia - arthalgia
Supportive, self limiting
UTI
-causative organisms
-risk factors
-presentation
Most common - ecoli
-proteus
-pseudomonas
Boys U3months - more congenital abnormalities
Girls - shorter urethras
Incomplete bladder emptying - obstructed from constipation
Vesicoureteric reflux
Nappies, not wiping front to back
Infants - Poor feeding, vomiting, irritability
Younger children - abdo pain, fever, dysuria
Older children - dysuria, frequency, hematuria
Collect urine sample if
-presentation UTI?
-unexplained fever 38C+
-alt site of infection but still unwell
Non-invasive - Clean catch or urine collection pads
Invasive - Suprapubic aspiration
U3months => PAEDS REFERRAL
3months+ UUTRI
-admit or PO cephalosporin/coamox 7-10days
3months+ LUTI
-3 days trimeth/nitro/cephalosporin/amox => reassess if no improvement after 24hrs
Once recovered, investigate for vesicoureteric reflux
Vesicoureteric reflux
-what is it
-presentation
-investigations
-management
Valves that normally prevent backflow of urine into ureters don’t work
Antenatal - hydronephrosis on US
Multiple UTIs
Reflux nephropathy => renal scarring => high renin and HTN
Gold standard - micturating cystourethrogram
DMSA - assessment of renal scarring and functioning areas
UTI prophylactic ABx
Surgical repair
