Genitourinary sx

Question 1

Polycystic kidney disease, ssx

Answer 1

congenital:  disorder wit cystic involvement of both kidneys
Ultrasound  masses
palpaple kidneys
respiratory distress
hepatomegaly
HTN
polydipsia and polyuria

Question 2

what can cause UTI

Answer 2

Ascending infection - diapers
dysfunctional voiding: delayed maturation, constipation
Urinary tract abnormalities/obstruction, etc

Question 3

sign of UTI in infant

Answer 3

non specific
vomiting, irritability, poor feeding and fever
suspect in any febrile baby less than 1 year, uncircumscised male, and preschool aged girls

Question 4

Sign in UTI child

Answer 4

urgency, prequency, dysuria, hesitancy, suprapubic discomfort.

Question 5

DX UTI

Answer 5

clean catch, urinalysis, , culture

>10*5

Question 6

COmplications in UTI

Answer 6

repeat UTI can cause scarring leading to renal disease and HTN in adult

Question 7

treatment for pyelo

Answer 7

IV antibiotics for infants and neonates with abnormalities. and those to young to take oral antibiotics, ampicillin, gentamicin

Question 8

treatment for cyxtitis

Answer 8

oral antibitoics, amoxicillin

Question 9

Proteinuria

Answer 9

> 100mg day

REfer

Question 10

Labs for proteinuria

Answer 10

urine dipstick

24hr urine protein

Question 11

when should you not worry about proteinuria

Answer 11

when its transient because it can be caused by fever, cold, stress, dehydration and exercize

Question 12

Nephrotic syndroe

Answer 12

glomerular disorder with proteinuria, hypoproteinemia, edema, hypercholestrolema

Question 13

Onset of nephrotic syndrom

Answer 13

boys, 3yo
Fatigue, reduce appetite, facial and abdominal swelling
foamy urine.

Question 14

physical exam findings of nephrotic syndrome

Answer 14

pitting edema,
white nails, soft ear cartilage,
hepatomegaly
htn

Question 15

Labs for nephrotic syndrome

Answer 15

4+ on urine dipstick
24 hr urine protein >40/day
Urine protein/creatinine ration >1
renal ultrasound

Question 16

Treatment for nephrotic syndrome

Answer 16

refer

restrict salt, low protein, corticosteroids.

Question 17

Gomerulonephritis presentation

Answer 17

hematuria
oliguria
htn
jujular venus distention
hematomegaly
impetigo
vasculitis

Question 18

causes of glomerulonephritis

Answer 18

• autioimmune diseases and vasculitis
• Renal disease and low serum complement
• systemic disease with normal serum complement
• renal disease and low serum complement

Question 19

acute glomerulonephritis when

Answer 19

5-15

chronic 10 to adulthood

Question 20

labs for glomerulonephritis

Answer 20

throat culture
urine microscopy for RBC and casts
serum chemistries
ASOT
complement 3
ECG

Question 21

treatment for Glomerulonephritis

Answer 21

refer
loop diruetics, antihypertensives,
low protein
low acid

Question 22

enuresis

Answer 22

involuntary loss of urine in children over 6 years old

mostly primary: not go 3 month wo wetting bed

Question 23

secondary enuresis

Answer 23

child dry for 6 months then relapse of enuresis.
- uti
emotiona sttress

Question 24

PE for enuresis

Answer 24

neuro exam
abdominal exam
genital exam
rectal exam.

Question 25

meds for enuresis

Answer 25

desmopressin, imipramine, tricyclic antidepressants

Question 26

vulvovaginitis

Answer 26

inflammation of vulva and vagina caused by infection, foreign bodies and irritants.

Question 27

normal physiologic leucorrhea

Answer 27

clear or white, non puritis, non irritating and non malodorus

Question 28

vulvovaginitis labs

Answer 28

Culture, wet prep for yeast GC/CT Pap if sexually active

Question 29

labial adhesions

Answer 29

often resolve after 6-18 months or do surgery, topical estrogen.

Question 30

hypospadium, spispadius

Answer 30

displacement of meatal opening surgery don't recommend circumcision

Question 31

meatal stenosis

Answer 31

mostly circumscized boys, narrowing due to irritaiton

Question 32

phimosis

Answer 32

in those not circumscised | attachment of prepus to glans, firbrotic tissue. can be caused by irritation

Question 33

phimosis treatment

Answer 33

circumcision or betamethasone cream.

Question 34

Balantitis

Answer 34

glans infection from yeast and gram + bacteria

Question 35

treatment balanitis

Answer 35

barrier creams, treat yeast or bacteria with antifuncal or antibiotic

Question 36

circumcision

Answer 36

forescin may not be fully retractable untill second or 3rd year. leave alone untill retracts easily (6ms and 3 years) teach kid to start cleaning it well

Question 37

Inguina hearnia

Answer 37

common 3-5 %, mostly boys

Question 38

PE inguinal hernia

Answer 38

bulge that is apparent upright not supine.

Question 39

dx hernia

Answer 39

clinical and ultrasound then surgery.