UTI, renal conditions Flashcards
Under what age is urine dipstick unreliable
Under 3 years old
What antibiotics are given for UTI in children
- cefuroxime
- trimethoprim
do NOT give nitrofurantoin
Type of urine you would get with nephrotic syndrome
White frothy urine
Type of urine you would get with diabetes insipidus
Clear urine
Type of urine you would get with haematuria
Dilute coke coloured urine
Type of urine you would get with UTI
Smelly, cloudy urine
3 main symptoms of UTI (related to urine)
Dysuria, frequency, smell
Non-urine symptoms of UTI
- swinging fever
- vomiting
- lethargy, irritability
- off-feeds
- jaundice in babies <3 months (for any kind of infection)
Why is constipation a risk factor for UTI
o Faeces may irritate bladder
o Children won’t like going to toilet because it hurts, can cause urinary retention
Reasons why children may not want to/ not be able to urinate properly
- Phimosis
- Ballinitis
- Meatal ulcer
- Vulvovaginitis
- Nappy rash
- Dehydration
- Neurological deficit eg spina bifida
4 conditions that can cause proteinuria
- transient proteinuria after exercise/ febrile illness
- nephrotic syndrome
- nephritic syndrome
- glomerulonephritis
in what 5 cases should urine be sent to the lab
- All under 3 years with suspected UTI
- Nitrite and/or leukocyte positive
- Strong indication of UTI despite negative dipstick
- Recurrent UTIs
- UTI unresponsive to treatment after 24-48h
In what age group is vesico-urethral reflux more common
Under 5
Usually resolved by 5 years. As child grows, ureter lengthens and straightens
What family history might increase a child’s risk of enuresis
- enuresis
- renal hx
- learning difficulties
- diabetes mellitus, insipidus
What does a USS look for in assessing UTI
- Kidney shape, size
- Number of kidneys
- Cysts, abscesses
What does a micturating cystogram look for in assessing UTI
- Bladder emptying
2. Bladder reflux
What does a DMSA/ MAG3 look for in assessing UTI
Isotope scan
Looks for
- Scarring
- Structure
- Kidney fx
Definition of nocturnal enuresis
Involuntary wetting during sleep
without any inherent suggestion of frequency or pathophysiology
Definition of diurnal enuresis
Involuntary wetting during day
Up to 12 years,
how to calculate bladder capacity
[age+1] x30
in mls
3 medicines for enuresis
- Desmopressin
- Imipramine
- Oxybutinin
MoA of desmopressin
Antidiuretic
increases water reabsorption from urine
MoA of imipramine
TCA
shortens stage of sleep where wetting occurs
Features of a lack of vasopressin
- Pass large amount of urine early in night
2. Pass dilute urine in morning and night
Pathophysiology of nephrotic syndrome
- Inflammation of glomeruli
- Permeable to large protein losses
- Hypoalbuminaemia
- Oedema
Signs of nephrotic syndrome
- Oedema (periorbital, ankles, genitals, pulmonary)
- Ascites
- Hypovolaemia (due to fluid shift)
- White frothy urine
- Leukonychia
