Urinary Flashcards
What features in the history give increased risk of UTI?
Oligohydramnios
Renal pelvis dilation
FH vesico-ureteric reflux
What are the three features of nephrotic syndrome?
Oedema
Proteinuria
Hypoalbuminaemia
What is nephrotic range proteinuria?
Over 20mg/mmol
What are the features of minimal change nephrotic syndrome?
Glomeruli look normal under light microscopy
Podocytes becomes flattened
What are other causes of nephrotic syndrome?
Membranous nephropathy
Focal segmental glomerulosclerosis
How is MCNS treated?
High dose steroids
1/3 have no remission
1/3 have infrequent relapse
1/3 have frequent relapse
How are frequent relapses of MCNS treated?
Cytotoxics - cyclophosphamide or cyclosporin
What are the three main histological subtypes of congenital renal tract abnormalities?
- Renal hypoplasia
- Renal dysplasia
- Renal agenesis
What are some renal gene mutations?
PAX2 - renal coloboma syndrome
HNF18 - renal cysts and diabetes syndrome
HPSE2 - urofacial syndrome
What suggests upper UTI?
Bacteriuria
Fever over 38
Loin tenderness
Under 3 months
What suggests lower UTI?
Bacteriuria but no systemic symptoms
Age over 3 months
When is renal USS indicated?
Infants less than 6 months with UTI
Children with atypical UTI
What can renal US identify?
Renal pelvic dilation - obstruction or vesicoureteric reflux
Bladder emptying in older children
When is a micturating cystogram indicated?
Younger children with atypical or recurrent UTI
How is a micturating cystogram done?
Child is catheterised
Bladder is filled with a radio contrast agent
X-rays are taken as bladder is voided
