Peds - GU and GYN Flashcards Preview

NP > Peds - GU and GYN > Flashcards

Flashcards in Peds - GU and GYN Deck (28):
1

Define primary enuresis

bladder control has never been established (in a child old enough that it is expected)

2

Define secondary enuresis

had bladder control for 6-12 months or more and then lost it

3

Define nocturnal enuresis

incontinence during sleep

4

Define diurnal enuresis

incontinence during waking hours

5

What percentage of 10 year olds have enuresis?

up to 3%

6

What percentage of enuresis is functional in orgin (in other words there is no underlying cause)?

95%

7

What diagnostic tests are important to perform in children with enuresis?

urinalysis and urine culture to rule out UTI

8

What is the most effective treatment for enuresis?

Hypnosis and self-hypnosis

9

What medications can be used for enuresis?

o imipramine (Tofranil) -- anti-dep also used in migraine
o Desmopressin (DDAVP)
o oxybutinin (Ditropan)

10

What are important considerations to keep in mind if using medications for enuresis?

o must give drug holiday
o when not on the medication, recurrence is expected

11

What organism is most likely implicated in "uncomplicated" UTI?

E. coli in 80-90% of cases

12

What organism is most likely implicated in "complicated" UTI?

Staph aureus

often seen with catheterization in hospital

13

Predisposing factors for UTI (6)

o urinary STASIS
o OBSTRUCTIVE lesions
o NEUROGENIC bladder
o poor HYGIENE
o CONSTIPATION
o INTERCOURSE

14

Signs of UTI in infants (3)

o may be asypmtomatic
o irritability
o failure to thrive

15

What might urinalysis show in UTI? (3)

o leukocytes
o erythrocytes
o nitrites

16

What might CBC show in UTI? (1)

leukocytosis

17

Duration of antibiotic therapy for younger children with UTI?

7-10 days

18

Antibiotics used for UTI in children (4)

o trimethoprim/sulfamethoxazole - TMP/SMX (Bactrim)
o cephalosporins
o amoxicillin
o nitrofurantoin (Macrobid)

19

Follow up after initiation of therapy in UTI

o follow-up in 2 days and change antibiotic if no improvement
o follow-up in 1-2 weeks
o then every 1-3 months x 1 year

20

What is the treatment of UTI in children < 2 months of age?

Hospitalization
parenteral antibiotics

21

When is a renal ultrasound indicated?

After first UTI in febrile children 2 - 24 months of age

22

When is a VCUG indicated?

If ultrasound is reflective of renal abnormalities

23

What is prime age for hypospadias repair?

6 - 12 months

24

Management of cryptorchidism

o if undescended at 1 year, refer to urology
o teach testicular self examination due to increased testicular cancer probability

25

Define primary dysmenorrhea

pain associated with menses with absence of any pelvic pathology

26

Define secondary dysmenorrhea

pain associated with menses related to an underlying cause such as PID or endometriosis

27

Why is ibuprofen effective for menstrual cramps?

It decreases prostaglandins which are responsible for cramping

28

Most common STD in adolescents (and adults)?

chlamydia