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exam 3 > GU > Flashcards

GU Flashcards

1
Q

Infection of one or more structures of the urinary tract

A

UTI

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2
Q

Locations of UTI

A

Lower: cystitis urethritis
Upper: pyelonephritis; worse

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3
Q

Most common site for UTI

A

Bladder

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4
Q

UTI incidence

A

More common in girls after 1st year of life

Boys who are circumcised

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5
Q

Cause of a UTI

A

E.Coli; bacteria enter through the urethra

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6
Q

Who is more at risk for UTI; why?

A

Females due to the short urethra

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7
Q

UTI sx

A 
Foul smelling urine
Dysuria
Freq./ enuresis
Fever
Vomiting
Diarrhea
Irritability
Poor feeds / loss of appetite 
Hematuria
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8
Q

UTI diagnosis

A

Urine culture w/sensitivity

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9
Q

Back-flow of urine from the bladder up the ureter to the kidney

A

Vesicoureteral Reflex

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10
Q

Vesicoureteral Reflex incidence

A

Common in children who’ve had a UTI
Familial reflux common
Females

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11
Q

Vesicoureteral Reflex sx

A

Persistent UTI
Enuresis
Flank pain
Abd. pain

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12
Q

Vesicoureteral Reflex diagnosis

A

Based on cystogram or VCUG

Reflux graded on a scale of I-V

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13
Q

Vesicoureteral Reflex tx

A

Long term prophylactic antibiotics

Surgery to correct reflux

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14
Q

Vesicoureteral Reflex mgmt goals

A

Prevent UTI
^ kidney damage
^ reflux complications (scarring)

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15
Q

Common congenital malformation in which the urethral meatus is on the ventral surface (underside) of the penis

A

Hypospadias

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16
Q

Urethral opening on the dorsal side of the penis

A

Epispadias

17
Q

Downward curvature of penis

A

Chordee

18
Q

Hypospadias incidence

A

Btwn the 5th and 8th month of gestation

19
Q

Hypospadias tx

A

Surgery before the child is 18 month; prior to toilet training

20
Q

An acute or sudden inflammation of the glomeruli within the kidney

A

Acute glomerulonephritis

21
Q

When do most cases of Acute glomerulonephritis occur?

A 
Post infection (pneumo, strep or viral)
*Group A strep
22
Q

What does Acute glomerulonephritis result in?

A

Acute renal failure

23
Q

Acute glomerulonephritis incidence

A

Peaks at 7 years; males

24
Q

How does Acute glomerulonephritis occur?

A

Bacterial or viral agent invades the child’s body->immune system responds-> antibodies to attach the foreign antigen->immune complexes->inflammation

25
Q

What is altered by the Acute glomerulonephritis process?

A

Membrane permeability-> proteins able to leak into urine

26
Q

What does Acute glomerulonephritis lead to?

A

Decreased filtration of plasma results in excessive accumulation of water and retention of sodium

27
Q

Acute glomerulonephritis sx

A 
Hematuria/ deep smoky brown urine
Dependent and periorbital edema
Decreased urinary output
Proteinuria
Hypertension
Fatigue
Elevated serum sodium/ potassium
Anorexia
28
Q

Acute glomerulonephritis diagnosis

A 
Dependent upon the symptoms
WBC with diff
Urinalysis (RBCs, protein, increased Specific Gravity
Normal electrolytes
Throat culture
29
Q

Acute glomerulonephritis tx

A

Depends on the degree of kidney damage
Aim is to identify the causative agent
Children with normal blood pressure/urine output managed at home
Children with edema, htn, oliguria, and gross hematuria should be hospitalized

30
Q

Acute glomerulonephritis mgmt

A 
1-3 weeks of antibiotic therapy
Low sodium diet
^ lower extremities to reduce edema
Frequent rest periods
Maintain fluid balance
Daily weights
Frequent b/p measurement
31
Q

Massive proteinuria and hypoalbuminemia leading to edema and hyperlipidemia

A

Nephrotic syndrome

32
Q

Primary nephrotic syndrome

A

Results from glomerular disease of the kidney

33
Q

Secondary nephrotic syndrome

A

Result of systemic disease, drugs, or toxins such as liver malfunction, lupus, lead poisoning, cancer or cancer therapy

34
Q

Disturbance to the glomeruli leads to what?

A

^ permeability to protein, especially albumin->leaks it into the urine. This reduces the serum albumin level-> reduces colloidal osmotic pressure in the capillaries. Fluid accumulates in the interstitial spaces and body cavities.

35
Q

The shift from intravascular to interstitial space causes what?

A

Decreased vascular fl. volume-> release ADH and aldosterone
Edema
Ascites
Hypovolemia

36
Q

Nephrotic syndrome sx

A 
Anorexia
Abdominal pain/swelling
b/p normal or slightly decreased
Decreased urine volume
Edema (generalized)
Fatigue
Facial puffiness
History of recent respiratory infection
Increased weight
Irritability
Proteinuria
37
Q

Nephrotic syndrome diagnosis

A

Based on protein and serum albumin levels, which are decreased

38
Q

Nephrotic syndrome tx

A

Goal is to reduce proteinuria, control edema and prevent infection
Sodium restricted diet
Treated w/ steroids for as long as 4-8 weeks
Gradually tapered

39
Q

Nephrotic syndrome mgmt

A 
Abdominal girths
Daily weights
Maintain fl. and el. balances
Monitor VS especially b/p
Preventing infection
Prevent skin breakdown w/ careful positioning

Urine checks

exam 3 (6 decks)

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