UTIs & Bed wetting Flashcards

1
Q

How would you expect a UTI to present in an infant or child?

A

neonates will have fever, vomiting, lethargy & irritability (basically non-specific signs)

Children will also complain of abdo/loin pain & tenderness
Along with dysfunctional voiding

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2
Q

How do you test for UTI?

A

Try to get a clean catch urine or midstream urine sample (otherwise a catheter sample or suprapubic aspiration)

  • Dipstix (leucocyte/nitrites)
  • Microscopy (Pyuria/bacteria)
  • Culture(>10^5 colony forming units)
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3
Q

What organisms cause UTI in kids?

A

Most E.coli

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4
Q

In what cases of a childhood UTI would you go looking for an underlying cause and how?

A
  • Atypical presentation (e.g. upper tract)
  • Young (<6months)
  • Recurrent
  • Atypical bugs

US for structure & Micturating Cystourethrogram for VUR

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5
Q

What scans can you do to check renal scarring/structure?

A

US for structure
DMSA for scarring
MAG3 (not good in young kids as need continence and to follow instruction)

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6
Q

How do you go about treating a UTI in a kid?

A

Lower tract = 3 days trimethoprim or co-amoxiclav

Upper tract = 7-10 days (IV if systemically unwell)

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7
Q

What can you do to prevent further UTIs?

A

Educate on hygiene and hydration
Look for abnormal tract e.g. VUR
Treat constipation early

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8
Q

How would you manage VUR if you found it?

A

Educate on fluids, hygiene and constipation management
Trimethoprim prophylaxis till 5

STING procedure or Ureteric Reimplantation

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