Urology and Renal Flashcards
biochemistry of Bartter’s syndrome
low K+
low Cl-
high urinary calcium (stones)
metabolic alkalosis
Ix of ?impalpable testes
re-examine at 5 months
go straight to laparoscopy at 5 months
(USS is not sensitive)
management of retractile testes
annual f/u and exam until after puberty
(risk of ascending testes)
who gets an IP USS KUB for UTI
septic
poor urine flow
abdominal/bladder mass
raised Cr
failure to respond to suitable abx within 48 hrs
non E coli infection
VUR abx prophylaxis
grade 1-2 with recurrent UTI/not toilet trained
grade 3 + all
eGFR for dialysis
10 (15 if diabetic)
Who gets an USS KUB within 6 weeks for UTI
<6/12 and first
>6/12 and recurrent
Who gets a DMSA in 4-6/12 for UTI
any age and recurrent
<3y and atypical
Who gets an MCUG for UTI
<6/12 and recurrent or atypical
abnormal USS
FH of VUR
treatment of BXO
1) 1% hydrocortisone for 7-14 days +/- PO abx or clotrimazole cream
2) circumcision with urethral calibration if chronic
aetiology and causes of secondary VUR
(increased voiding pressure)
posterior urethral valve
neurogenic bladder e.g. spina bifida
ureterocele
ectopic ureter
Features of posterior urethral valves
boys only
bladder hypertrophy and hydronephrosis
poor stream and UTIs
oligohydramnios
USS and MCUG
ablation via cystoscopy
RENAL FAILURE
signs of an upper UTI in young children
fever 38 or more
bacteruria
management of an upper UTI
<3/12 IV abx
>3/12 PO abx
complement levels in PSGN
low C3
normal C4
immunoglobulin in HSP
IgA
which molecules does haemodialysis work best for
low molecular weight
not highly protein bound
when to avoid using a reward system for nocturnal enuresis
if the child has no dry nights
blue dot sign suggests…
torsion of the hydatis cyst of the testis
cause of absolute incontinence and dribbling
ectopic ureter and duplex kidney
causes of renal stones in children
Bartter’s syndrome
CF
cystinuria
tumour lysis syndrome
crohn’s
Abx for MCUG
3 days with MCUG on day 2
