Urological Conditions Flashcards
List 6 possible causes of antenatal hydronephrosis
PUJ obstruction Vesico-Ureteric Reflux VUJ obstruction Posteriod urethral valves Duplex urinary tract systems Multicystic dysplastic kidney
What is the treatment (if any) for PUJ obstruction
Most cases are transient so do not require intervention. More severe cases require ‘pyeloplasty’ where the PUJ is stented to give a wider diameter for flow.
What is vesicle-ureteric reflux?
Retrograde flow of urine back into the kidneys caused by a deficiency in a valve at the vesico-ureteric junction
What is the ‘triad’ in haemolytic uraemic syndrome?
Haemolytic anaemia
Acute renal failure
Thrombocytopenia
What condition do you need to exclude when bilateral hydronephrosis is detected on antenatal ultrasound with a male baby?
Posterior ureteric valves
What is cryptorchidism?
Maldescent of the testes
What is the management of cryptorchidism?
Orchidopexy - Surgical placement of the testis into the scrotum
What is the most common cause of hydronephrosis detected antenatally?
PUJ obstruction
What is the main concern in vesico-ureteric reflux?
Ascending infection which causes scarring at the renal pole
What is the treatment for vesico-ureteric reflux?
Prophylactic treatment with antibiotics
What is the treatment of posterior urethral valves?
Surgical (laser) resection corrects the abnormality
How might posterior urethral valves be detected antenatally?
Ultrasound scan shows bilateral dilatation of the urinary tract. There may be oligohydramnios.
What is meant by a duplex kidney?
2 ureters
What is hypospadias?
Congenital malformation of the position of the urethral meatus, such that it emerges on the ventral aspect of the penis
What advice should be given to parents of children with hypospadias?
Do not circumcise - The skin from the foreskin may be used in surgical reconstruction
What is the triad in haemolytic uraemic syndrome?
Acute renal failure
Haemolytic anaemia
Thrombocytopaenia
What might be visible on blood film of a patient with haemolytic uraemic syndrome?
Schistocytes (fragmented RBCs)
What is the cause of haemolytic uraemic syndrome?
Gastroenteritis caused by E. coli
What is the most common cause of renal failure in children?
Haemolytic uraemic syndrome resulting from E. coli gastroenteritis
True / False: Fluids and antibiotics are the mainstay of treatment for haemolytic uraemic syndrome?
False - Antibiotics are contraindicated as they increase expression of the verotoxin produced by E. coli. Treatment for HUS is supportive and fluids are required.
Why is surgical correction of an undescended testis indicated?
Increased fertility rates
Reduces rate of malignancy
What are the symptoms of haemolytic uraemic syndrome?
Oliguria
Diarrhoea and vomiting
May be jaundice (sign of haemolysis)
What are the clinical features of nephritic syndrome?
Hypertension
Proteinuria
Oedema
Haematuria
What is the triad of features in nephrotic syndrome?
Hypoalbinaemia
Proteinuria
Oedema
What is the most likely cause of nephritic syndrome in children?
Post-streptococcal glomerulonephritis
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
What is the classification of nephrotic syndrome?
Steroid sensitive (90%) Steroid resistant (10%)
True / False: Haematuria is common in nephrotic syndrome
False - This is a feature of nephritic syndrome
When would you see red cell casts on urine microscopy?
Nephritic syndrome
What is the treatment for nephrotic syndrome?
Several week course of prednisolone
What is a Wilm’s tumour?
Nephroblastoma - most common childhood renal tumour
When does a Wilm’s tumour arise?
80% present before age 5, and they are rare after age 10
What are the presenting features of Wilm’s tumour?
Abdominal mass
Haematuria
Abdominal pain
