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Flashcards in GU Deck (47):
1

primary vs secondary enuresis

primary: child has never experienced period of dryness

secondary: 6-12 month period of dryness has preceded the onset of wetting

2

sudden, unilateral pain of scrotum with edema, erythema, warmth and positive prehn's sign (lifting of testicle does not relieve pain)

testicular torsion - surgical emergency must be within 6 hours

3

most common cause of painless scrotal swelling

hydrocele

4

cryptorchidism affects __% of LBW and premature males

20-30

5

Amy is 6 month old infant with UTI - first line tx would be?

- hospitalization with IV antibiotics
- bactrim
- amoxicillin
- Ceftin

- bactrim

6

most common pathogen for UTI

e coli

7

inguinal hernias more common in males or females? increased incidence in what population of newborns? direct vs indirect in terms of ages

males

premature infants

direct >3
indirect <3

8

a 2.5 yr old girl present with sx of painful urination, frequency, and occasional incontinence over past week. temp of 101.6. approach to establish diagnosis?

- clean catch midstream collection of specimen for UA
- clean catch midstream collection of specimen for culture
- straight catheterization collection of specimen for urine culture
- voiding cysteaurethrogram (VCUG)

- straight catheterization collection of specimen for urine culture

9

kid presents with abdominal swelling or mass that is firm, contender, and confined to one side, hematuria, fatigue/malaise, weight loss, fever, think

wilms' tumor

10

urethral endpoint on ventral surface of penis

hypospadias

11

which kids should have further testing if UTI? (4)

- under 2
- males
- girls with pyelo/recurrent UTI
- family hx structural renal disease

12

acute posterstreptoccocal glomerulonephritis most frequent in what ages? when do clinical symptoms usually develop after initial strep infection?

5-12 years

1-2 weeks

13

labial adhesions management?

most resolve spontaneously

application of a topical estrogen cream (Premarin) 2x/day

14

most common cause of acute renal failure in kids?

HUS

15

how to dx microscopic hematuria?

serial urines - 3 urine samples over 7-14 days

urine C+S, CBC with diff, chemistry

16

how to manage UTI in infants < 2 months

hospitalization, IV antibiotics

17

bulge in inguinal area that worsens with straining, "silk glove" sign, reducible with pressure

inguinal hernia

18

HUS is one of the most common causes of acute renal failure in children. Which of the following are associated with HUS?

- HTN and hematuria
- rectal prolapse with or without diarrhea
- microangiopathic hemolytic anemia, thrombocytopenia, renal failure
- GABHS

- microangiopathic hemolytic anemia, thrombocytopenia, renal failure

19

etiology of epispadias and hypospadias?

unknown - genetic? environmental? hormonal?

20

difficulty with urinary control, either night or day

enuresis

21

any culture result with > ____ single organism catheter/suprapubic or clean catch = UTI

100,000

22

indications for VCUG in children >2 years of age (5)

- abnormal DMSA scan
- recurrent infections
- febrile UTI
- family hx reflux
- males

23

management of hypospadias and epispadias

- surgical intervention ideal between 6-12 months, do not circumcise prior to surgery (will use foreskin in repair)

24

highest incidence of testicular torsion age

7-12 years

25

therapeutic management for enuresis (6 points)

- limiting fluids after dinner
- frequent voiding
- imagery training
- reward systems
- behavioral conditioning
- medications (imipramine, DDAVP - vasopressin)

26

most common clinical presentation of infants and young children with UTI?

fever

27

cryptorchidism resolution?

most resolve spontaneously in first year of life

28

triad for HUS

- anemia
- thrombocytopenia
- renal failure

29

prognosis for wilms' tumor

survival rates among the highest for childhood cancers - 90% cure

30

Management for inguinal hernia

- reduce if possible
- surgical consult
- refer to ED if incarcerated/strangled

31

a ___ in the absence of RBCs is often considered a UTI pending culture and treated as one

+ nitrite

32

management of UTI (3 main drugs)

- augmenting, bacterium, cephalosporin until sensitivity is known for infants older than 2 months and children

33

what is the only means of identifying reflux?

VCUG

34

resolution periods for non-communicating vs. communicating hydrocele

NC: resolves spontaneously

C: risk for hernia, refer if after 1 year

35

when would you obtain a US in terms of a hernia?

if findings are unclear to differentiate between a hernia or hydrocele

36

most common pathogen for UTI in neonates

GBS

37

urethral endpoint on dorsal surface of penis

epispadias

38

HUS primarily occurs in what age?

6 months-5 years

39

more than ___ infants have renal scarring after just one UTI

1/2

40

follow up cultures for UTI should be done when?

1-2 weeks after antibiotics

41

peak age of dx for wilms' tumor? which kidney?

3 years

more common in left kidney

42

when to refer for cryptorchidism

if not descended by 1 year

at risk for testicular malignancy if uncorrected for 3-5 years

43

risk factors for UTI in infants 2-24 months with no other source of infection (5)

- female
- white
- < 12 mo
- temp > 39
- fever > 2 days

44

undescended testes is known as

cryptorchidism

45

what are labial adhesions caused by?

tissue irritations, inflammation, hypoestrogenization

46

unilateral scrotal edema that's either constant or intermittent, translucent with transillumination would be

hydrocele

47

if child has had a GABHS infection and now has gross hematuria or tea-colored urine, lethargy, anorexia, vomiting, abdominal pain, oliguria, perioribital edema, thnk

acute posterstreptoccocal glomerulonephritis