GU

Question 1

Infection of one or more structures of the urinary tract

Answer 1

UTI

Question 2

Locations of UTI

Answer 2

Lower: cystitis urethritis
Upper: pyelonephritis; worse

Question 3

Most common site for UTI

Answer 3

Bladder

Question 4

UTI incidence

Answer 4

More common in girls after 1st year of life

Boys who are circumcised

Question 5

Cause of a UTI

Answer 5

E.Coli; bacteria enter through the urethra

Question 6

Who is more at risk for UTI; why?

Answer 6

Females due to the short urethra

Question 7

UTI sx

Answer 7

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

Question 8

UTI diagnosis

Answer 8

Urine culture w/sensitivity

Question 9

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

Answer 9

Vesicoureteral Reflex

Question 10

Vesicoureteral Reflex incidence

Answer 10

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

Question 11

Vesicoureteral Reflex sx

Answer 11

Persistent UTI
Enuresis
Flank pain
Abd. pain

Question 12

Vesicoureteral Reflex diagnosis

Answer 12

Based on cystogram or VCUG

Reflux graded on a scale of I-V

Question 13

Vesicoureteral Reflex tx

Answer 13

Long term prophylactic antibiotics

Surgery to correct reflux

Question 14

Vesicoureteral Reflex mgmt goals

Answer 14

Prevent UTI
^ kidney damage
^ reflux complications (scarring)

Question 15

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

Answer 15

Hypospadias

Question 16

Urethral opening on the dorsal side of the penis

Answer 16

Epispadias

Question 17

Downward curvature of penis

Answer 17

Chordee

Question 18

Hypospadias incidence

Answer 18

Btwn the 5th and 8th month of gestation

Question 19

Hypospadias tx

Answer 19

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

Question 20

An acute or sudden inflammation of the glomeruli within the kidney

Answer 20

Acute glomerulonephritis

Question 21

When do most cases of Acute glomerulonephritis occur?

Answer 21

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

Question 22

What does Acute glomerulonephritis result in?

Answer 22

Acute renal failure

Question 23

Acute glomerulonephritis incidence

Answer 23

Peaks at 7 years; males

Question 24

How does Acute glomerulonephritis occur?

Answer 24

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

Question 25

What is altered by the Acute glomerulonephritis process?

Answer 25

Membrane permeability-> proteins able to leak into urine

Question 26

What does Acute glomerulonephritis lead to?

Answer 26

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

Question 27

Acute glomerulonephritis sx

Answer 27

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

Question 28

Acute glomerulonephritis diagnosis

Answer 28

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

Question 29

Acute glomerulonephritis tx

Answer 29

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

Question 30

Acute glomerulonephritis mgmt

Answer 30

``` 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 ```

Question 31

Massive proteinuria and hypoalbuminemia leading to edema and hyperlipidemia

Answer 31

Nephrotic syndrome

Question 32

Primary nephrotic syndrome

Answer 32

Results from glomerular disease of the kidney

Question 33

Secondary nephrotic syndrome

Answer 33

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

Question 34

Disturbance to the glomeruli leads to what?

Answer 34

^ 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.

Question 35

The shift from intravascular to interstitial space causes what?

Answer 35

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

Question 36

Nephrotic syndrome sx

Answer 36

``` 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 ```

Question 37

Nephrotic syndrome diagnosis

Answer 37

Based on protein and serum albumin levels, which are decreased

Question 38

Nephrotic syndrome tx

Answer 38

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

Question 39

Nephrotic syndrome mgmt

Answer 39

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