Preventative: constipation, oral fluids, encourage full voiding Glomerulonephritis Haematuria + oliguria (+/- HT + ureamia) produced by immune mechanism in kidney Peak age 7yrs Causes: Strep sore throat or skin infection Malignancies HSP Infection (viruses, SBE, syphilis) Toxins (heavy metals) Renal vein thrombosis Berger’s disease Presentation: Haematuria Periorbital oedema Loin pain Oliguria BP GI dist Ix: MSU: RBCs, WBCs, red cell casts Renal US, renal Bx Bloods: urea, ESR, acidosis, C3 Rx: Restrict protein in oliguric Monitor BP, treat severe HT. Penicillin IV and then PO for strep infection Wilm’s neuroblastoma Malignant tumour composed of embryonic cells Commonest intra-abdominal tumour in children Originates from embryonic tissue Rarely seen after 10yrs Presentation: Abdo mass Fever Flank pain Haematuria Ix: US or CT show intrinsic mass, mixed tissue densities Rx: avoid Bx. Nephrectomy and 4/52 chemo. Radiotherapy may help Enuresis Most children are psychologically and physically normal Different types 1 nocturnal enuresis: common. FHx of delay in acquiring sphincter competence. Day time enuresis: nocturnal enuresis usually also present. Common causes are lack of sensation (behavioural prob), detrusor instability (uncoordinated bladder contraction), bladder neck weakness, UTI, constipation, neurogenic 2 enuresis: is the loss of previously achieved urinary continence, may be due to emotional upset (commonest cause), UTI, polyuria Ix: -MSU, -US, -x-ray (may show vertebral abnorm), MRI (spinal roots) Rx: Avoid acrimonous blame, and reassurance Enuresis alarm Fluid restriction before bed Desmopressin term relief) Star chart Anticholinergic or adrenergic HAEMATOLOGY
Preventative: constipation, oral fluids, encourage full voiding Glomerulonephritis Haematuria + oliguria (+/- HT + ureamia) produced by immune mechanism in kidney Peak age 7yrs Causes: Strep sore throat or skin infection HSP Toxins (heavy metals) Berger’s disease Malignancies Infection (viruses, SBE, syphilis) Renal vein thrombosis Presentation: Haematuria Oliguria BP Periorbital oedema GI dist Loin pain Ix: MSU: RBCs, WBCs, red cell casts Bloods: urea, ESR, acidosis, C3 Renal US, renal Bx Rx: Restrict protein in oliguric Penicillin IV and then PO for strep infection Monitor BP, treat severe HT. Wilm’s neuroblastoma Malignant tumour composed of embryonic cells Commonest intra-abdominal tumour in children Originates from embryonic tissue Rarely seen after 10yrs Presentation: Abdo mass Flank pain Fever Haematuria Ix: US or CT show intrinsic mass, mixed tissue densities Rx: avoid Bx. Nephrectomy and 4/52 chemo. Radiotherapy may help Enuresis Most children are psychologically and physically normal Different types 1 nocturnal enuresis: common. FHx of delay in acquiring sphincter competence. Day time enuresis: nocturnal enuresis usually also present. Common causes are lack of sensation (behavioural prob), detrusor instability (uncoordinated bladder contraction), bladder neck weakness, UTI, constipation, neurogenic 2 enuresis: is the loss of previously achieved urinary continence, may be due to emotional upset (commonest cause), UTI, polyuria Ix: -MSU, -US, -x-ray (may show vertebral abnorm), MRI (spinal roots) Rx: Avoid acrimonous blame, and reassurance Fluid restriction before bed Star chart Enuresis alarm Desmopressin term relief) Anticholinergic or adrenergic HAEMATOLOGY
Paeds-Revision-Notes.docx