Child health- renal and urology

Question 1

are UTIs more common in boys or girls

Answer 1

girls

Question 1

what is a urinary tract infection

Answer 1

infection anywhere along urinary tract-urethra, bladder, uterus and kidneys

Question 2

what should you consider in patients with repeated UTIs

Answer 2

abnormal renal tract

Question 3

clinical features of UTIs in babies-

Answer 3

very non-specific-
fever
lethargy
irritability
vomiting
poor feeding
increased urinary frequency

Question 4

clinical features of UTIs in older infants and children

Answer 4

more specific-
fever
abdominal pain, particularly suprapubic pain
vomiting
dysuria (painful urinating)
increased urinary frequency
incontinence

Question 5

investigation for UTIs

Answer 5

urine clean catch sample

Question 6

all patients under 3 months with UTI with a fever should be managed how?

Answer 6

IV antibiotics

Question 7

which antibiotics are used to treat lower UTIs in children <3 months

Answer 7

IV amoxicillin and gentamicin

Question 8

which antibiotics are used to treat lower UTIs in children >3 months

Answer 8

trimethoprim or nitrofurantoin (3 days)

Question 9

1st line antibiotics used to treat upper UTIs in children

Answer 9

IV amoxicillin and gentamicin

Question 9

2nd line antibiotics used to treat upper UTIs in children

Answer 9

IV co-amoxiclav

Question 10

most appropriate method of obtaining a clean catch urine sample in babies

Answer 10

urine collection pad

Question 11

foreskin is aka

Answer 11

prepuce

Question 12

retractability of foreskin increases with age, with full retraction possible in-

Answer 12

10% of boys at age 1
50% of boys at age 10
99% of boys at age 17

Question 13

what is circumcision

Answer 13

surgical removal of foreskin

Question 14

what is nocturnal enuresis aka

Answer 14

bed wetting

Question 15

nocturnal enuresis is considered a typical part of development until the age of what

Answer 15

age 5

Question 16

underlying physical conditions of nocturnal enuresis

Answer 16

diabetes melitus
UTIs
constipation

Question 17

trial of what medication can be given for nocturnal enuresis

Answer 17

DDAVP (sympathetic ADH)

Question 18

what is torsion of testicle

Answer 18

occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum

Question 19

torsion of testicle typically occurs in what age group

Answer 19

teenage boys

Question 20

congenital predisposing factor of torsion of testicle

Answer 20

bell-clapper deformity- leaves testes free to rotate

Question 21

clinical features of torsion of testicle

Answer 21

sudden, severe, testicular pain, and tenderness
associated nausea and vomiting
testis may be higher than normal
mild pyrexia and redness
cremasteric reflex reduced or absent

Question 22

management of torsion of testicle

Answer 22

surgery

Question 23

what is Epididymo-orchitis

Answer 23

inflammation of the testes and epididymis secondary to infection

Question 24

most common causes of epidydymo-orchitis in <35s

Answer 24

STIs eg N. gonorrhoea

Question 25

clinical features of epididymo-orchitis

Answer 25

acute onset, severe testicular pain may be unwell and history of dysuria and urethral discharge (from STI) testes is red, hot, and swollen and tender to touch

Question 26

classic finding on testicular examination of epidydmyo-orchitis

Answer 26

alleviation of pain upon elevation of testes

Question 27

management of epidydymo-orchitis

Answer 27

analgesia and antibiotics

Question 28

the appendix testes aka

Answer 28

hydatid of morgagni

Question 29

cause of UTI most commonly

Answer 29

E.coli (80%)

Question 30

what type of bacteria are UTIs

Answer 30

gram-negative, facultative anaerobic, rod-shaped, coliform bacteria

Question 31

what is the vesicoureteric reflex

Answer 31

abnormal back flow of urine from bladder