Renal/Urinary Flashcards
What might be the cause of a child who is constantly damp?
ectopic ureter –> picked up on CT
Abdo exam revealed distended bladder, child is also noted to have strange gait. What could be the cause?
Neuropathic bladder
First investigation in child with enuresis?
Urine dip - check for glucose, protein & signs infection
Criteria for nocturnal enuresis?
> 5y, at least twice weekly
Recommended Mx nocturnal enuresis in 5y/o?
Positive reinforcement, star charts etc. Rule out other potential causes?
Potential causes of secondary enuresis?
Emotional upset (most common), UTI, diabetes,
Most common cause UTIs in children? What would suggest an abnormal urinary tract?
E coli (gram -ve) 85% cases. Infection from pseudomonas = abnormality suspected
Signs of potential pyelonephritis?
Bacteruria, fever >38˚C or loin pain
What suggests atypical UTI?
abnormal U&Es, seriously unwell, abdominal mass, no response to Abx in 48h, non- E coli, poor urine flow
What investigations would you do for an atypical UTI?
USS, poss DMSA, MCUG
6m old child presents with general lethargy and a fever of 37.4˚C. On dipstick you find +ve leucocytes & nitrites. What would be appropriate Tx?
Features of lower UTI/cystitis. Tx with 3d oral Abx, either cephalosporin or co-amoxiclav
Tx of 2m old child with UTI?
Admit to hosp, IV Abx, investigate
When must you test a child’s urine?
Any child with unexplained fever >38˚C
Tx of 4y/o child with urinary symptoms whose urine dipstick showed +ve leukocytes, -ve nitrites?
Child has clinical Sx even though no bacteria. Tx as if has UTI - 3d oral Abx, e.g trimethoprim. Send sample to lab for MC&S
+ve what on urine dipstick suggests UTI and should lead to initiation of treatment?
+ve nitrites (bacteruria)
What is the triad of HUS?
Acute renal F
Microangiopathic haemolytic anaemia
Thrombocytopenia
Child has come in following 5 day Hx nausea and vomiting and bloody diarrhoea, and has since been deteriorating. Blood film shows low Hb and schistocytes… Dx?
HUS - blood film = Microangiopathic haemolytic anaemia.
What might you see in blood tests of nephrotic syndrome?
Low plasma albumin
Most common type of nephrotic syndrome?
steroid sensitive –> Tx with prednisone if needed
Difference between nephrotic & nephritic syndrome?
Nephrotic = proteinuria Nephritic = haematuria
Potential cause of a child with a raised BP and positive blood and protein on urine dipstick?
Glomerulonephritis. Inflammation of glomeruli leads to decreased UO & volume overload –> HTN and oedema
Mx of hypospadias?
Surgery before 2y
