urology pediatric-razi Flashcards
what is the Acute kidney injury creatinine/GFR criteria?
RIFLE
Risk
Injury
Failure
Loss of renal function
End stage renal disease
what is the difference between injury and failure?
Injury:
-Increased creatinine x2
or
-GFR decreases >50%
Failure:
-Increased creatinine x3
or
-GFR decreases >75%
or
-Cr>4mg
what is the main type of acute kidney injury in children?
pre-renal
what is the main cause of pre-renal?
acute gastroenteritis and volume loss
…………. is the most important cause of renal injury?
Tubular causes(ATN; lack of blood flow and oxygen to the kidney tissues): prolongation of per-renal injury, snakebite, sepsis, intravascular hemolysis, nephrotoxic agent, rhabdomyolysis, falciparum malaria, leptospirosis
Tubular causes(ATN; lack of blood flow and oxygen to the kidney tissues):
prolongation of per-renal injury, snakebite, sepsis, intravascular hemolysis, nephrotoxic agent, rhabdomyolysis, falciparum malaria, leptospirosis
Most common complication of upper urinary tract infection is …….
Pyelonepritis scarring
Most common colonic bacteria of urinary tract infection?
E coli
And for male: e.coli and proteus
Fever may be the only manifestation of ……..
pyelonephritis in children
What symptom is not present in cystitis?
Fever
Cystitis does not cause …… and does not result in ,,,,,,,,,
Fever
Renal injury
What is the most common cause of hemorrhagic cystitis in children?
Adenovirus 11 and 21 (&influenza)
pharyngitis(infection), gross hematuria, edema, cardiac gallop, rales, and HYPERtension cause which type of AKI?
Acute post-streptococcal glomerulonephritis (PSGN) –> *Intrinsic/Renal AKI *
Tachycardia, dry mucous membrane, poor peripheral perfusion cause which type of AKI?
Pre-renal AKI
hypercalcemia causes ……….
hyperphosphatemia
what are the dialysis indication of AKI?
Hyperkalemia; K+>6.5
Hyponatremia; Na+<120
Metabolic Acidosis; pH<7.2
UTI are common in boys who are…..?
during 1st yrs of age
in uncircumcised boys in 1st year
when do UTI fist start occurring in females?
by the age of 5, with peak during infancy and toilet training
what is the most common microbe causing UTI in girls/boys
girls: Ecoli
boys: proteus is as common as E.coli
symptoms of pyelonephritis?
abdominal, back, flank pain (costolumbar region); fever; tremble; malaise; nausea; vomiting; diarrhea
symptoms of pyelonephritis in newborns?
poor feeding, irritability, jaundice, and weight loss
symptoms of cystitis?
-dysuria
-urgency
-frequency
-suprapubic pain
-incontinence
-dark, cloudy, and malodorous(smelly) urine
what is not a symptom of cystitis?
flank pain, vomiting, diarrhea, & fever
what are the risk factors for UTI ?
*being a female
uncircumcised male
*vesicoureteral reflux
toilet training
voiding dysfunction
is pyuria an indication of infection?
pyuria(white cells in the urine) can occur in infection but they can be independent of each other , meaning pyuria can occur in the absence of infection and infection can occur in the absence of pyuria
what is sterile pyuria and what is it caused by?
persistent finding of white cells in the urine in the absence of bacteria
-caused by high fever
-indicated by negative culture of bacteria
what is the most sensitive indication for acute pyelonephritis
white blood cell casts
what is the time limit for urine to be left out in room temp?
60 min after that it should be thrown out
if a child has had only 1 UTI without fever, what kind of imaging method must be obtained?
sonogram–> if result was abnormal we need to obtain Micturating Cystourethrogram (MCUG)
voiding urethrocystogram is the diagnostic method used for which case ?
for vesicoureteral reflux, which causes frequent UTI in children
