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Med Finals - Paediatrics > Urology > Flashcards

Urology Flashcards

1
Q

Define urinary tract infection

A

An infection aywhere in the urethra, bladder, ureters or kidney

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2
Q

Presentation of UTI in babies

A

Fever
Lethargy
Irritabilty
Vomiting
Poor feeding
Urinary frequency

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3
Q

Presentation of UTI in children

A

Fever
Abdo pain - suprapubic
Vomiting
Dysuria
Urinary frequency
Incontinence

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4
Q

Define acute pyelonephritis

A

Systemic signs of infection
Renal angle tenderness

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5
Q

Management of UTI

A

<3 months - IV abx
Trimethoprim
Nitro
Cefalexin
Amoxicillin

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6
Q

Investigations in recurrent UTI

A

US
DMSA scan
Micturating cystourethrogram - Vesico-Ureteric reflux 0

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7
Q

Define vululovaginitis

A

Inflammation and irritation of the vulva and vagina

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8
Q

Causes of vululovagnitis

A

Wet nappies
Chemicals or soaps
Tight clothing - traps moisture
Poor toilet hygiene
Constipation
Threadworms
Pressure on area - horse riding
Heavily chlorinated pools

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9
Q

Presentation of vulvulovaginitis

A

Soreness
Itching
Erythema around labia
Vaginal discharge
Dysuria
Constipation
Leukocytes but no nitirtes

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10
Q

Management of vulvulovaginitis

A

Supportive symptomatic management
Avoid washing
Avoid perfume
Good toilet hygiene
Keep dry
Emollients
Loose cotton clothing
Treat constipation
Avoid activities that exacerbate

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11
Q

Define nephrotic syndrome

A

Nephrotic syndrome occurs when the basement membrane of the glomerulus becomes highly permeable to protein allowing protein to leak from the blood into the urine.

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12
Q

Classic triad in nephrotic syndrome

A

Low serum albumin
High urine protein
Oedema

(deranged lipid profile with high cholesterol, high blood pressure, hyper coagulabilty)

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13
Q

Causes of nephrotic syndrome

A

Minimal change disease!!
Focal segmental glomerulosclerosis
Membranoproliferative glomerulonephritis

2ndry - henoch schonlein purpura, diabetes, infection

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14
Q

Management of nephrotic syndrome

A

High dose steroids
Low salt diet
Diuretics
Albumin infusions
Antibiotic prophylaxis

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15
Q

Complications of nephrotic syndrome

A

Hypovolaemia
Thrombosis
Infection
Acute or chronic renal failure
Relapse

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16
Q

Define nephritis

A

Inflammation within the nephrons of the kidney

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17
Q

Causes of nephritits

A

Post streptococcal glomerulonephritis
IgA nephropathy - Berger’s disease

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18
Q

Define post-streptococcal glomerulonephritis

A

Streptococcal antigens, antibodies and proteins get stuck in the glomeruli of the kidney and cause inflammation leading to acute kidney injury
Often 1-3 weeks post tonsillitis

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19
Q

Define IgA nephropathy

A

Related to henoch-schonlein purpura - IgA vasculitis.
IgA deposits in the nephrons cause inflammation leading to AKI

20
Q

Define haemolytic uraemic syndrome

A

Occurs when there is a thromboss within small blood vessels - usually triggered by the shiga toxin

21
Q

Classic triad in haemolytic uraemic syndrome

A

Haemolytic anaemia
Acute kidney injury
Thrombocytopenia

22
Q

Presentation of haemolytic uraemic syndrome

A

Post gastroenteritis - usually bloody, 5 days ago
Reduced urine output
Haematuria
Abdominal pain
Lethargy
Confusion
Oedema
Hypertension
Bruising

23
Q

Management of haemolytic uraemic syndrome

A

Medical emergency
Supportive management
Renal dialysis
Antihypertensives
Careful management
Blood transfusion

24
Q

Define enuresis

A

Involuntary urination often nocturnal
Primary nocturnal - has never been dry at night
Secondary nocturnal - begins wetting bed when previously been dry for 6 months

25
Q

Causes of primary nocturnal enuresis

A

FH!
Overactive bladder
Fluid intake
Failure to wake
Psychological distress
Secondary causes - constipation, UTI, learning disability

26
Q

Causes of secondary nocturnal enuresis

A

UTI
Constipation
TIDM
Maltreatment
New psychosocial problems - school, home.

27
Q

Pharmalogical management of enuresis

A

Desmopressin - reduces urine volume
Oxybutinin - anticholinergic
Imipramine - relaxes bladder?

28
Q

Define polycystic kidney disease

A

Genetic condition leading to formation of fluid filled cysts in the kidney
Commonly autosomal dominant but recessive is found in neonates
Very poor prognosis - 1/3 die in neonatal period

29
Q

Presentation of ARPKD

A

In utero
Cystic enlargement of the renal collecting duct
Oligohydramnios - pulmonary hypoplasia
Congenital liver fibdrosis
In life
Liver failure
Portal hypertension
Progressive renal failure
Hypertension
Chronic lung disease

30
Q

Define Wilm’s tumour

A

A specific type of tumour affecting the kidney in children - typically under 5

31
Q

Presentation of Wilm’s tumours

A

Abdominal pain
Mass in abomen
Haematuria
Lethargy
Fever
Hypertension
Weight loss

32
Q

Investigations of Wilm’s tumour

A

Ultrasound
CT or MRI for staging
Biopsy for definitive diagnosis

33
Q

Management of Wilm’s tumour

A

Surgical removal!
Adjuvant therapy to reduce size

34
Q

Define posterior urethral valve

A

A pathology where there is tissue at the proximal end of the urethra that causes obstruction to the outflow of urine. Found in newborn boys. Creates back pressure causing hydronephrosis

35
Q

Presentation of posterior urethral valve

A

Difficulty urinating
Weak stream
Chronic retention
Palpable bladder
Recurrent infections
Impaired kidney function

Bilateral hydronephrosis
Oligohydramnios - pulmonary hypoplasia

36
Q

Presentation of posterior urethral valve

A

Difficulty urinating
Weak stream
Chronic retention
Palpable bladder
Recurrent infections
Impaired kidney function

Bilateral hydronephrosis
Oligohydramnios - pulmonary hypoplasiaI

37
Q

Investigations in posterior urethral valve

A

Abdo ultrasound
Micturating cystourethrogram
Cystoscopy

38
Q

Management of posterior urethral valve

A

Catheter for acute management
Ablation of extra tissue

39
Q

Define undescended testes

A

Also known as cryptorchidism
Where testes do not escend from their point of development in the abdomen throgh the inguinal canal

40
Q

Risk factors for undescended testes

A

FH
Low birth weight
Small for gestational age
Prematurity
Maternal smoking history

41
Q

Management of undescended testes

A

Normally resolves in 3-6 months
Orchidopexy

42
Q

Define hypospadias

A

Condition affecting males where the urethral meatus (opening) is abnormally displaced to the ventral side of the penis towards the scrotum.

43
Q

Management of hypospadias

A

Do not circumcise
Surgery at 3-4 months

44
Q

Define hydrocele

A

A collection of fluid within the tunica vaginalis

45
Q

Clinical signs of hydrocele

A

Soft
Non-tender
Unilateral
Infront and below teste
Transilluminate with light

46
Q

Management of hydroceles

A

US
Usually resolve
Surgical repair?

Med Finals - Paediatrics (17 decks)

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