PAEDS SC1 > GU > Flashcards

GU Flashcards

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1
Q

corrected GFR in a kid

A

15-20ml/min/1.73m^3

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2
Q

GFR in 1-2 yo, same as adult

A

80-120ml/min/1.73m^3

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3
Q

Age of multi cystic dysplastic kidneys

A

2 years old

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4
Q

Prune Belly Syndrome

A

= absence/lack of musculature of anterior abdo wall

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5
Q

Prune Belly syndrome a/w

A

MEGAcystitis
MEGAureters
cryptochric

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6
Q

sites of obstruction to urine flow

A
  • peliureteric junction
  • bladder neck
  • posterior urethral valves
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7
Q

renal dysplasia a/w

A

SEVERE VUR in isolation or apart of rare genetic syndromes

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8
Q

antenatal or postnatal treatment of congenital kidney anomalies?

A

POSTNATAL

since antenatal: intrauterine bladder drainage procedures (NOT VERY GOOD)

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9
Q

postnatal treatment of congenital kidney anomalies- bilateral hydro

A

48hrs after birth- US

posterior urethral valves?
Y-MCUG-Sx: cystooscopic ablation
N-stop antibiotics and repeat US 2-3 months

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10
Q

postnatal treatment of congenital kidney anomalies- unilateral hydro

A

4-6weeks after birth- US

any anomaly?
Y-further investigations
N-stop antibiotics and repeat US 2-3 months

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11
Q

NB rf’s UTI’s

A 
Hydration?
Completely empty bladder?
Holds onto urine?
Constipation?
Neuro problems?
Born with congenital urinary abnormalities?
Frequent infections?
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12
Q

infant UTI don’t forget

A

Jaundice

Febrile convulsions

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13
Q

child UTI don’t forget

A

Rigors/ febrile convulsions

Recurrence of enuresis

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14
Q

NB urine questions

A 
Pain
Frequency
Smell
Stones
Colour
Cloudy
Tea coloured
Red
       Frank
       dipstick
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15
Q

Dx UTI

A
  1. urine collection/ MSU
  2. C+S: 10^5 colony/ml
  3. dipstick
    - nitrites
    - leukocyte esterase
  4. US
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16
Q

ULTRASOUND/ Imaging UTI

A

3 yo= US

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17
Q

Tx UTI

A

IV cefotaxime

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18
Q

Tx UTI >3 months + acute pyeloneph

A

bacteriuria + fever+ >38

bacteriuria + loin pain +

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19
Q

Tx cystitis/lower UTI

A

oral antibiotics 3 days

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20
Q

Prevention UTI’s

A
  • hydration
  • voiding
  • constipation
  • hygeiene
  • acidophilus
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21
Q

Abx prophylaxis UTI’s

A

trimethoprim OR
nitrofurantoin OR
cephalexin

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22
Q

age definition of daytime enuresis

A

should be continent– >3-5yo

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23
Q

DDx daytime enuresis

A

neuro

  • psychogenic
  • developmental
  • neuropathic bladder

kidney

  • detrusor instability
  • UTI
  • ectopic ureter

CONSTIPATION

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24
Q

DDx secondary onset enuresis

A 
EMOTIONAL
UTI
POLYURIA
- DM
- DI
- sickle cell
- CRF
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25
two types of proteinuria
transient | persistent
26
transient proteinuria
- febrile illness | - post- exercise
27
persistent proteinuria
urine protein: creatinine
28
DDx proteinuria
1. orthostatic hypoTN 2. glomerular 3. increase glomerular filtration pressure 4. reduced renal mass 5. HTN 6. tubular proteinuria
29
NB investigations for nephrotic syndrome
- Complement: c3,4 - ASOT, DNAse B, throat swab - urine [Na] - hep B and C screen - malaria
30
1/3 rule steroids
1/3 responsive 1/3 infrequent relapses 1/3 frequent relapses= resistant
31
nephrotic syndrome
1. steroid responsive= MCD 2. steroid unresponsive= FSGS, membranoprolif, membranous nephropathy 3. congenital
32
epidemiology congenital nephrotic syndrome
Finnish consanguinity PC: 3 months
33
epi MCD
asian boys 1-10years old | a/w ATOPY
34
TRIAD HSP
Purpura arthritis abdo pain
35
PC HTN kids
``` FACIAL PALSY headache HTN retinopathy vomiting proteinuria ```
36
PC HTN infants
FTT + HF
37
DDx unilateral renal mass
5 1. MCDK 2. Compensatory hypertrophy 3. obstructive hydronephrosis 4. renal tumor 5. renal vein thrombosis
38
DDx bilateral renal mass
4 1. ARPCK 2. ADPCKD 3. TUBEROUS SCLEROSIS 4. renal vein thrombosis
39
Side effect of furosemide in neonate
NEPHROCALCINOSIS
40
causes of fanconi syndrome
1. idiopathic 2. secondary to IEM 3. acquired: - drugs/ toxins - heavy metals - vit D deficiency
41
IEM--> fanconi syndrome
``` WTF.G.? LC. G. Wilsons Tyrosinaemia Fructose intolerance Galactosemia Lowe syndrome Cystinosis Glycogen storage disorder ```
42
Lowe Syndrome
= oculocerebrorenal syndrome
43
PC fanconi syndrome
- dehydration - polyuria/ polydipsia - rickets/ FTT - hyperchloraemic met. acidosis
44
Definition AKI
45
Dx AKI
1. Fluid and circulation status | 2. Ultrasound--> obstruction
46
Tx pre-renal AKI
- circulatory and fluid support
47
Tx renal AKI
- fluid restriction - diuretics - high calorie diet, normal protein, uraemia, hyperK - biopsy: GN--> immunosuppression
48
Tx post-renal AKI
RELIEVE OBSTRUCTION - nephrostomy - bladder catheterisation - surgery after corrected electrolytes
49
Tx metabolic acidosis
bicarbonate
50
Tx hyperiP
- calcium carbonate | - dietary restriction
51
Tx hyperK
- calcium gluconate-- if ECG change - Ca resins - glucose/ insulin - salbutamol-- neb or IV - dietary restrictions - dialysis
52
DIALYSIS indications
- failed conservative tx - failure multiorgam - hyperK - hypo/hyperNa - pulmonary edema or HTN - severe acidosis
53
PC chronic renal failure
EXACT SAME AS ADULTS
54
Tx chronic renal failure
1. diet- NG/gastrotomy-- want the protein without XS NH3 2. phosphate restriction and active vit D-- less milk products and calcium carbonate 3. salt supplements + water + bicarb 4. EPO 5. GH 6. transplant 7. dialysis
55
R or L inguinal hernias more common
RIGHT
56
palpable cryptorchid
can palpate in groin, but cannot manipulate into scrotum = ECTOPIC - perineum - femoral triangle
57
Sx of hydrocele
> 18-24 months
58
Dx cryptorchid
1. US-- check if other pelvic organs present 2. Hormonal: IM hCG 3. Lapro- BEST for impalpable esp-- check inguinal canal
59
Tx for cryptochid
- orchiopexy (infertility, malignancy, cosmesis) | - orchiectomy: if older and very high up, or intra-abdominal
60
Tx varicocele
OBLITERATE VEINS: - radiao embolisation - conventional surgery - laproscopic
61
Age of testicular torsion
adolescent, or ANY age
62
Age of testicular appendage
PRE-puberty
63
Age of epididymitis, epididymorchitis
infant/toddler-- a/w UTI
64
Age of idiopathic scrotal oedema
PRE-schooler
65
scrotal pain increasing over 1-2 days
torsion of testicular appendage
66
blue dot sign
torsion of testicular appendage (tender nodule felt)
67
Diagnosis of testicular torsion
CLINICAL 2. lapro exploration 3. US doppler US -- testicular blood vessels
68
Ddx acute scrotum
1. testicular torsion 2. torsion hydatid morgagni 3. epididmyitis 4. epididmyorchitis 5. idiopathic scrotal edema 6. incarcerated inguinal hernia
69
3 features of hypospadias
ventral meatus ventral-- hooded dorsal foreskin ventral chordee
70
sx of hypospadias age
before 2 years old
71
paraphimosis
foreskin trapped in retracted posiiton proximal to swelling
72
tx paraphimosis
no need to circumcise-- REDUCE WITH ANALGESIA
73
indications for circumcision
1. phimosis
74
Alternatives to circumcision
1. preputioplasty | 2. topical steroids
75
treatment of labial adhesions
1. topical oestrogen cream 2 X a week for 1-2 weeks | 2. anaesthesia-- separate adhesions
76
treatment of vulvovaginitis
antibiotics-- swab oestrogen cream-- sparingly used on vulva ADVISE: - no bubble baths - loose fitting underwear - salt baths
PAEDS SC1
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