W7 - Renal Disease Flashcards
most common organism to cause UTI
e coli
how do infants present with a UTI
fever, vomiting, lethargy and lethargy
how do children present with a UTI
similar to adults
dysuria
frequency
urgency
abdo/loin pain
fever and vomiting
what would you do with a child under 3 months with a fever
full septic screen
under 3 months they are more susceptible to sepsis
what is the best way to collect urine from a child
clean catch
what is a complication of pyelonephritis
can cause renal scarring, leading to hypertension and chronic renal failure
when would you do an USS in children 6month - 1 year
if recurrent or atypical UTIs
look for structural abnormalities
what is a DMSA scan
Static Radionuclide scan using Dimercaptosuccinic acid
what is a DMSA scan used for
looking at renal structure and morphology
Detection of scarring and function
what is this DMSA scan showing and what is the most likely cause
shows renal scaring
due to acute pyelonephritis
what is nephrotic syndrome triad
proteinuria
Hypoalbuminaemia
oedema
what is VUR vesicoureteric reflux
urine flows in both directions in the ureter causing dilation
how does nephrotic syndrome present in kids
oedema
swelling of face
belly swollen
joints swollen
what are the key complications of nephrotic syndrome
Hypovolemia
Infection
Hyperlipidaemia
Hypercoagulability
Anaemia
what is the treatemtn of nephrotic syndrome
steroids - prednisolone
20% albumin and fursemide
what are some examles of second line (steroid sparing agents)
Tacrloimus
Levamisole
Ciclosporin
Cyclophosphamide
MMF
Rituximab infusion
what is Henoch-Schonlein Purpura
a systemic inflammation of small vessels caused by an acute perivascular deposition of immunoglobulin A (IgA) and activation of neutrophils.
how does HSP present
rash
joint pain and swelling
abdominal pain
renal - haematuria
what is the complications of HSP
hypertension
blood in urine
protein in urine
when would a child be re-referred back to consultants with HSP
frank haematuria
2+ proteinuria
bp above 90th centile for age on 2 separate occasions
what are glomerular causes of haematuria
Glomerulonephritis
E.g., Post strep
IgA nephropathy
Familial
what are some non-glomerular causes of haematuria
Infection
Trauma
Stones
Tumours
Bleeding disorders
Sickle cell
Renal vein thrombosis
what is wilms tumor
nephroblastoma, is the most common type of kidney cancer in children,
what is GN - APSGN caused by
Post-strep glomerulonephritis
Streptococcal infection
Staphylococcus aureus
Staphylococcus epidermidis
Gram-negative bacteria
what are the 3 key features of haemolytic uraemic syndrome
AKI
Haemolytic anaemia
Thrombocytopenia
what are some pre-renal causes of AKI
sepsis
blood loss
dehydration
cardiac failure
what are some renal causes of AKI
GN
drugs
toxins
prolonged hypotension
interstitial nephritis
what are some post renal causes of AKI
renal calculi
prostate enlargement
cervical cancer
urethral stricture
phimosis
