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Peds 2 > Exam: Urinary > Flashcards

Exam: Urinary Flashcards

1
Q

What are the contraindications to circumcision?

A

Unstable infant and congenital penile anomalies

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2
Q

Does physiologic or pathologic phimosis typically require treatment?

A

Pathologic

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3
Q

What is phimosis?

A

Inability to retract the foreskin

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4
Q

What is paraphimosis?

A

UROLOGIC EMERGENCY.

Retracted foreskin in a uncircumcised male that cannot be returned to natural position

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5
Q

What are the causes of paraphimosis?

A

Forcible retraction of partically phimotic skin by caretaker, infection/inflammation, GU procedures, and penile trauma

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6
Q

What is the treatment of paraphimosis?

A
  • pain control
  • timely manual reduction in office/ED
  • Surgical intervention (dorsal slit procedure)
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7
Q

What is epispadias?

A

an uncommon congenital anomaly, abnormal dorsal displacement of the urethral opening

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8
Q

What does epispadias commonly occur with?

A

Bladder exstrophy (exposed bladder on the lower abdomen)

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9
Q

What is hypospadias?

A

A congenital anomaly, abnormal ventral displacement of the urethral opening

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10
Q

What is Chordee?

A

Abnormal penile curvature

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11
Q

What is the most common GU abnormality?

A

Cryptorchidism

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12
Q

What is Cryptorchidism?

A

Testis that is not within the scrotum and does not spontaneously descend into the scrotum by 4 months of age

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13
Q

What does Cryptorchidism increase risk of?

A

Testicular torsion, subfertility, and testicular CA

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14
Q

What is the most common location for undescended testis?

A

Suprascrotal

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15
Q

What is the treatment for Cryptorchidism?

A

-urology referral and surgery recommended as soon as 4 month of age because spontaneous descent is rare after 4 months.

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16
Q

What is orchiopexy?

A

Surgery to correct Cryptorchidism, the testicle is repositioned and attached into the scrotum

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17
Q

What is testicular torsion?

A

Twisting of the spermatic cord due to a poorly anchored testicle which may cause vascular compromise

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18
Q

What are the two peak time frames for testicular torsion?

A
  • neonatal period

- during puberty

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19
Q

You have a patient with abrupt onset of severe testicular pain with nausea and vomiting. Patient has an edematous, infuriated, and erythematous scrotum and the affected testicle is high riding. Prehn sign is negative. What are you most suspicious for?

A

Testicular torsion

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20
Q

When is prehn sign usually positive?

A

Epididymitis

21
Q

How is testicular torsion diagnosed?

A

confirmatory test of choice is Doppler US

22
Q

What bacteria is responsible for 80% of UTIs?

A

E. Coli

23
Q

What is positive on urinalysis in a patient with a UTI?

A
  • Significant bacteria and pyruria
  • leukocyte esterase
  • nitrite
24
Q

How long should a pediatric patient with a UTI be on antibiotics if they are febrile? Afebrile?

A

Febrile: 10 days
Afebrile: 3-5 days

25
Q

What is the first line UTI antibiotic in children?

A

Cephalosporin

26
Q

What is the first line imaging study for patients with UTI when indicated?

A

Renal and bladder US (RBUS)

27
Q

When is RBUS indicated?

A
  • 2yo with first febrile UTI
  • Children of any age with recurrent UTI
  • Children of any age with UTI and FH of renal or urologic disease, poor growth, or HTN
  • Children who do no respond to appropriate Abx therapy
28
Q

What is the test of choice to detect Vesicoureteral reflux (VUR)?

A

Voiding cystourethrogram (VCUG)

29
Q

What is VUR?

A

When there is retrograde passage of urine from bladder to upper urinary tract, usually due to inadequate closure of ureterovesicular junction

30
Q

When is VCUG indicated?

A
  • Children of any age it’s >2 febrile UTIs
  • Children of any age with first febrile UTI AND any anomaly on RBUS, temp >102.2, pathogen other an E. coli, and poor growth or HTN
31
Q

What is renal scintigraphy?

A

Nuclear medicine scan using radioisotope dimercaptosuccinic acid (DMSA) to detect acute pyelonephritis and renal scarring

32
Q

What indicates scarring on a renal scintigraphy?

A

Areas of decreased uptake up DMSA indicate scarring or inflammation

33
Q

What is the most common type of renal fusion?

A

Horseshoe kidney

34
Q

What is the most common renal malignancy in kids?

A

Wilms tumor

35
Q

What does horseshoe kidney increase risK for?

A

Wilms tumor

36
Q

How is horseshoe kidney diagnosed?

A

US, VCUG, and serum creatinine

37
Q

If creatinine is normal in horseshoe kidney, what is the next step?

A

No further evaluation is needed

38
Q

If VUR is present with horseshoe kidney, what should you consider?

A

Prophylactic Abx

39
Q

What is the pharmacologic therapy for nocturnal enuresis?

A

Desmopressin (synthetic ADH), given after 6 yo. Effective short term but high relapse rate after d/c

40
Q

What is considered microscopic hematuria?

A

> 5 RBCs per hpf

41
Q

Poststreptococcal glomerulonephritis typically follows an infection with ***.

A

Group A Beta hemolytic strep

42
Q

What are the acute onset symptoms that occur with poststreptococcal glomerulonephritis?

A
  • edema (periorbital and peripheral)
  • Cola-colored urine (gross hematuria)
  • Elevated BP
  • renal insufficiency
43
Q

What disease is throat, bloat, and coke associated with?

A

Poststreptococcal glomerulonephritis

44
Q

What lab finding is diagnostic of glomerulonephritis?

A

RBC casts

45
Q

What is the classic tetrad of Immunoglobulin A vasculitis Henoch-Schonlein Purpura (HSP)?

A
  • palpable purpura (no thrombocytpenia/coaguloapathy)
  • arthritis/arthralgia
  • abdominal pain
  • renal disease
46
Q

What is the treatment for HSP?

A

Supportive care, symptoms spontaneously resolve

47
Q

What is the classic triad of hemolytic uremic syndrome?

A
  • hemolytic syndrome
  • thrombocytopenia
  • AKI
48
Q

What is the most common cause of HUS?

A

Shiga toxin producing E. Coli

Peds 2 (1 decks)

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