Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 4 Paeds Conditions > renal/urinary system > Flashcards

renal/urinary system Flashcards

1
Q

what is enuresis

A

it is bedwetting when older than 5 yrs old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the different types of enuresis

A

primary enuresis without day time symptoms
primary enuresis with day time symptoms
Secondary enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

aetiology of enuresis

A

inability to arouse + capacity of bladder vs nocturnal urine production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the aetiological theory behind enuresis

A

it is when there is insufficient ADH production at night and so polyuria during the night and the inability of the child to wake up during the night to wee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the normal cut off for enuresis

A

up to 5 yrs old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is primary enuresis

A

it is when the child involuntary urinate during the night older the age of 5 and have never achieved continence before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is secondary enuresis

A

it is when the child involuntary urinate during the night older the age of 5 and have achieved continence before for > 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the general underlying believe of primary enuresis

A

it is when there is a possible developmental delay in the child but will resovle in time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the general underlying believe of secondary enuresis

A

it is regarded as regression of development and will always require investigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can aggravate enuresis

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the absolute cut up point of normal enuresis according to NICE

A

10 yrs old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how common is enuresis in 5 yrs old

A

8-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how common is enuresis in 10 yrs old

A

1.5 - 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how common is enuresis in adult

A

0.5-2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

RF for enuresis

A 
constipation 
poor bedtime hygiene 
caffeine  
stress 
daytime incontinence 
FH 
sleep apnoea or obstructive sleeping - DM 
obese children

underlying neuro conditions - spinal bifida or cerebral palsy
underlying developmental conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

assessment of enuresis

A

determine which type of enuresis it is

look at enuresis diary

associated symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

questions to ask in primary enuresis

A

FH of bedwetting
male?
daytime LUTS - frequency, urgency, incontinence, poor stream even when straining, pain on urination
if it only occurs in partiuclar situations? eg avoiding toilet in school

lifetime stress - bullying. family bereavement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

questions to ask in secondary enuresis

A

medical conditions
physical health
social problems - eg bullying
environmental - school

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

examination findings of enuresis

A

abdo distension - bladder full
palpable feal mass - incontinence
other masses

neuro - leg reflexes

spina bifida occulta - midline lipoma, hairy patch or spinal deformity, legs for neuro signs (neurogenic bladder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ix for enuresis

A

urinalysis not recommended unless recent onst or daytime symptoms

urine MC+S - look for any signs of UTI

renal tract USS - to see pre- and post-micturition residual volume

21
Q

management of primary enuresis

A

with/without daytime symptoms
- intervention not usually advised until age 7 - connection of the brain is still developing

  • avoid caffeine drink before bed, restricted fluid intake before bed
  • good bedtime hygiene
  • star chart - do not offer star for not wetting bed because children can not control it
  • enuresis alarm
  • desmopressin for short term purpose - sleepover
  • oxybutynin
22
Q

when will you refer an enuresis case

A

severe daytime symptoms - because potential developmental delay

secondary enuresis

suspected neuro probs

23
Q

what is the management of secondary enuresis

A

exclude UTI, constipation, emotional/stress related

refer to specialist

24
Q

definition of UTI

A

presence of symptoms - dysuria, frequency and loin pain

+

detection of a significant culture of organisms
(any detected in suprapubic aspirate or > 10(5) organism in MSU, clean catch urine or bag urine

25
Q

what is lower UTI

A

cystitis

26
Q

what is upper UTI

A

pyelonephritis

27
Q

what can pyelonephritis cause

A

scar if the kidney –> HTN

28
Q

epidemiology of UTI

A

3-7% of girl
1-2% of girls
both before 11 yrs old

50% have congenital abnor of the renal tract

29
Q

what are the pathogens that cause UTI in children

A

E.COli - 85%
Kliebsella
proteus
pseudomas

30
Q

what are the causes/RF for UTI

A

bowel flora entering the urinary tract

incomplete bladder emptying

  • infrequent voiding
  • vulvitis
  • incomplete micturition
  • constipation
  • neurogenic bladder
  • vesicoureter reflux - developmental anomaly
31
Q

clinical features of UTI

A 
dysuria 
frequency 
loin pain 
fever +/- rigor
haematuria 
offensive/cloudy urine
febrile convulsion 
enuresis
32
Q

what are the clinical features of UTI in infancy

A

same as symptoms of older children

feeding difficulty
FTT
febrile convulsion
prolonged jaundice

33
Q

what can be a serious cause of UTI that is worth investigation of a social problem

A

sexual abuse

34
Q

what should you do as an examination when a child has UTI

A

plot height and weight on a growth chart
abdo mass
other mass
leg reflex - neurogenic bladder
spin and genitalia examination for any congenital abnor

35
Q

when would you investigation a UTI

A

1+ episode < 6 m - congenital abnor

2+ episodes > 6 m - congenital abnor + sexual abuse

36
Q

when will you not investigate a UTI

A

when a single episode > 6 m

37
Q

what investigations would you do for UTI

A

urinalysis

urine MC+S - MSU, clean catch, bag urine or urine aspirate

USS KUB - abnor structure, always do in acute phase or < 6 m

DMSA scan - to see if there are any scarring in the kidney

MCUG - to see if vesicoureteric reflux present

38
Q

treatment for UTI

A

hygiene, regular voiding, prevent constipation

< 3 m - IV ceftriaxone

> 3 m - oral trimethoprim

39
Q

what Abx should you avoid when treating UTI

A

tetracycline - stain teeth

40
Q

How can haematuria present

A

macroscopic haematuria - causes alarm to child and parents

incidental finding on screening

41
Q

what are some of the kidney cases of haematuria

A

kidney
- acute glomerulonephritis (preceded by Strep infection)
- henoch scholenin purpura - to large so cause kidney damage
- SLE - too large so cause kidney damage
- trauma
- bleeding disorder
- alport syndrome - thin membrane so easier to bleed
- tumour - Wilm’s tumour
exercise induce
drugs
polycystic kidney

42
Q

what are some of the urether cases of haematuria

A

stoens/hypercalcaemia

congenital abnor

43
Q

what are some of the Bladder/ureter cases of haematuria

A

UTI

menstrual blood

44
Q

which drug can cause red urine

A

rifampicin

45
Q

symptoms of haematuria

A 
blood in urine 
abdo pain 
rashes 
abdo mass 
renal colic 
pain
46
Q

what examination would you do for haematuria

A

BP - for all patient with haematuria - HTn can cause kidney damage

skin rashes - HSP

joint pain

oedema - acute to acute glomerulonephritis - periorbital and ankle

renal mass

47
Q

Ix for haematuria

A

urine

  • dip - UTI
  • microscopy - to detect red cell cast, proteinura suggestign to glmoerular dmage
  • MC+S - UTI

Blood

  • FBC/CLotting - coagulopathy
  • U&E/cretinine/albumin - kindey function

USS KUB - detect any congenital abnor

48
Q

treatment for haematuria

A

treat any obvious causes (UTI)

if complex diagnosis eg proteinuria, reduced renal function) –> refer specialist

if not resovle in 6 m - refer specilaist

Year 4 Paeds Conditions (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions