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CPNP EXAM PREP > Gu > Flashcards

Gu Flashcards

1
Q

UA normal , edema and warmth of testicle and pain. Elevation increases pain

A

Testicular torsion

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2
Q

Elevation of testicle relieves pain

A

Epididmytis

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3
Q

Prehn sign

A

Elevation relieves pain in epididymitis not seen in testicular torsion

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4
Q

Causes of epididmytis

A

Gonorrhea/ chlamydia
Sexually active teen or sex Truama common risk factors
Chemical irritant
Structural abnormalities

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5
Q

Epididmytis s/s

A 
scrotum pain SLOW BUT WORSENS
OBSTRUCTIVE VOIDING
dysuria
Can have blood in urine
Abnormal Ua could be or uti
Fever 
N/v 
Edema and erythema 
Tender spermatic cord 
Normal cremation reflex
Urethra discharge
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6
Q

Epididmytis dx

A

Ua : pyuria or bacteruria can be present
CBC: wbc increased
VCUG if urogenital issue or + Ua
STI/Std testing

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7
Q

Epididmytis management

A 
Ice pack
Elevation 
NSAIDS
1st: ceftriaxone 
250 IM x1 dose & Doxycycline 100mg BID x10 days

Alternative:
Ofloxcin 300 mg BID X10 days
cephlexin 40 mg /kg/day x dose

Treat sex partners
Referral if only unilateral involvement
Avoid sex until cured

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8
Q

Testicular torsion management

A

EMERGENCY

SURGERY 6-12 hours

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9
Q

Hypospadias

A

Congenital abnormality urethra located in abnormal position or even ventral surface underside of penis

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10
Q

10% also have undescended testes , Inguinal hernia or hydrocele

A

Hypospadias

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11
Q

Dorsally hooded foreskin in newborn , and chordee

A

Chordee=bowing of penis

Hypospadias

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12
Q

Management of hypospadias

A

NO CIRCUMCISION
refer Peds urologist
Done at 6-12 months

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13
Q

Testicular decent occurs when

A

At 7 to 8 months gestation

Undescended testes is common and preterm at 30% low birth weight and twin infants

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15
Q

Cryptorchidism

A

Undescended testes
Cannot be manipulated into the scrotum

Understand a testes after birth can occur spontaneously in the first 3 -6 months

Bilateral is rare 10% cases

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16
Q

Retractable testes

A

A retractable testes is out of the scrotum but can be brought into the scrotum and remains there

Bilateral more common 5-6 year old boys

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17
Q

Gliding testes

A

Can be brought into the screen and returns to a high position once released

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18
Q

Etopic testes

A

Lies outside the normal path of descent

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19
Q

Risk factors Cryptorchidism

A

Family history
Testicular malignancy
Prematurity, hypospadias, low birth weight, down syndrome, Klinefelter syndrome

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20
Q

Cryptorchidism dx &mangement

A

Frog leg position

Refer at 6 months for surgical intervention

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21
Q

Hydrocele

A

Painless scrotal swelling with a collection of serous fluid in the scrotal sac

Scrotal size increases with activity and decreases with rest
Testes descended

22
Q

Noncommunicating hydrocele

A

Collection of fluid is only in the scrotum

No treatment fluid is absorbed unless persists >1 heat or painful

23
Q

Communicating hydrocele

A

Fluid moves from the abdomen to the scrotum is more likely associated with hernia

Can Resolved without surgery if hernia persist more than one year referral for surgical intervention

24
Q

Phimosis

A

Foreskin that’s too tight to be retracted over the glans penis

can be physiologic over the first six years of life or pathologic when the foreskin cannot be retracted after previously being retracted after puberty

Can have urinary obstruction or ballooning of the foreskin

25
Q

Phimosis mangement

A

Normal cleansing with gentle stretching of the foreskin can retract by five or six years old never forcefully retract the foreskin

Can get a circumcision

Persistent phimosis can be treated with corticosteroid cream TID for a month

26
Q

Paraphimosis

A

More common and adolescents it is a retracted foreskin that cannot be reduced to the normal position causes constriction on the penis and result in pain Adema of the glands and possible necrosis

Seen in sexually active adolescences sexual abuse and forceful retraction

27
Q

Paraphimosis management

A

Reduction by lubricating the foreskin and pulling back the glands if not successful may need surgery

28
Q

Wilms tumor

A

Mass in the abdomen or flank

Can have fever, dyspnea, diarrhea, vomiting, weight loss, or malaise, pain if mass has undergone rapid growth or hemorrhage

29
Q

Ascended testes

A

Testicles that have fully descended but has spontaneously re-ascended and lies outside the scrotum

30
Q

Pain and cramping with the absence of any pelvic pathology

A

Primary dysmenorrhea

Occurs 6 to 12 months after first menses
ovulation is needed
Primarily in adolescence

31
Q

Painful menses, lore of Domino pain, back pain, nausea, vomiting, fatigue, headache, and diarrhea

A

Symptoms of dysmenorrhea

32
Q

Painful menses results from my underlying cause such as pelvic disease ,pregnancy, PID, and Endometriosis, cyst, tumors

A

Secondary dysmenorrhea

33
Q

treatment for mild dysmenorrhea

A 
Heat application
exercise
Tylenol
good diet
Motrin 400 mg Q6 to 8 hours, 1 to 3 days
34
Q

Primary dysmenorrhea moderate

A

NSAIDS inhibit prostaglandin synthesis
Naproxen sodium 500 mg PO then 250 mg Q6 to 8 hr

mefenamic 500 mg PO, 250 mg every 6-8 h

Assess 2 to 3 cycles if effective NSAID Tx

No NSAIDS for clotting disorders, renal, or peptic ulcer‘s, preop, or allergy

35
Q

Primary severe dysmenorrhea treatment

A

If unresponsive to inserts and mild treatments start with OCP‘s

Check in 3 to 4 cycles to see improvement
A continuous >4 months GYN referral

36
Q

Hydronephrosis

A

Blocks urine from the kidney

S/S: nausea; flank pain; decreased urine

TX: surgery

37
Q

Bacterial infection of the urinary tract

A

UTI

38
Q

UTIs are greater in_____In the first year of life ____ especially if they are _______. Then it’s more common in______.

A

Males in the first year of life especially if they are uncircumcised and then more common in females

39
Q

Biggest pathogen of a UTI

A

E. coli 80 to 90% of cases

40
Q

Pathogens of UTI

A

Viral but rare adenovirus

E. coli 80 to 90%
Staphylococcus aureus
Klebsiella
Staphsaprophyticus

41
Q

Infants have a weight loss, failure to thrive, irritable

Teens experience dysuria, nocturia, frequency, urgency, hematuria, fever, abdominal pain

A

s/s uti

42
Q

Cath culture sensitivity

A

Positive > 1000 CFU Single or multiple organism

43
Q

Clean catch sensitivity is performed when

A

Done with mild symptoms or follow up

44
Q

Positive UTI for a clean catch specimen

A

Positive at 50,000 to 100,000 CFU single organism

45
Q

A positive UTI on a UA shows what

A

Leukocytes, erythrocytes, nitrates, Estrace, leukocytosis in a CBC

46
Q

When should Reno or bladder ultrasound be performed in a UTI

A

Febrile infants
First UTI, children 2 to 24 months
Symptoms of pyelonephritis at any age
UTI <3 months —hospital

47
Q

When should a VCUG be performed

A

If abnormal ultrasound

Increase blood pressure symptoms

48
Q

Anabiotic for UTI

A

Bactrim/cephalosporin/nitrofurtin/Augmentin

10 to 14 days; follow up to days if no improvement change antibiotic

49
Q

Common history for primary nocturnal enuresis

A

Positive family history, related to maturational delay, some nighttime winters can stop wetting without treatment

50
Q

Common in enuresis type for school-age children

A

Primary diurnal enuresis

CPNP EXAM PREP (17 decks)

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