PreTest Pediatrics: "The Urinary Tract"

Question 1

Why might you use estrogen cream in a preadolescent female?

Answer 1

Preadolescent females can have labial adhesions, treatable with estrogen cream.

Question 2

Describe the pathophysiologic manifestations of prune belly syndrome.

Answer 2

• Dilated urinary tract with hydronephrosis
• Lax abdominal wall
• Intra-abdominal testicular tissue
• Renal dysfunction with oligohydramnios (and potential Potter sequence)

Question 3

Congenital _____________ presents with polyuria and polydipsia soon after bither; there is a hereditary form.

Answer 3

diabetes insipitus

Question 4

Describe Fanconi syndrome.

Answer 4

• Can be hereditary or acquired (from tubular necrosis)
• Presents with hyperchloremic metabolic acidosis
• Glucosuria with normal serum glucose
• High urine pH (from unabsorbed HCO3)

Question 5

If someone has scrotal pain and hematuria, then you need to order a _______________.

Answer 5

CT to look for kidney stones

Question 6

If a kid gets a cystourethrogram and it comes back with contrast in the ureters, then you know ___________.

Answer 6

that the kid has vesicoureteral reflux (VUR)

Question 7

How should VUR be managed?

Answer 7

• UAs and cultures every couple months

* Daily low-dose antibiotics

Question 8

Posterior urethral valve can cause _______________.

Answer 8

bilateral hydronephrosis from urinary retention

Question 9

What is nephronia?

Answer 9

• A condition between pyelonephritis and renal abscess
• It can present with a wedge-shaped area of minimal enhancement
• Treat with prolonged antibiotics (like an abscess but without need for drainage)

Question 10

What children are at risk of renal vein thrombosis?

Answer 10

• Those born to mothers with GD
• Polycythemia (itself more common in LGA infants)
• Dehydrated infants

Question 11

True or false: you should order a doppler ultrasound to evaluate testicular torsion.

Answer 11

False. If you suspect testicular torsion –from acute onset of pain in the absence of trauma – then he needs a surgical consult immediately.

Question 12

Nonspecific vulvovaginitis usually presents with what discharge?

Answer 12

Brown fetid

Question 13

True or false: hydroceles usually do not require surgery.

Answer 13

True

However, if they are large, persist past the first few years of life, or change in volume with alternating positions (indicating that there is a communication with the abdomen), then they need to be repaired.

Question 14

Explain Alport syndrome.

Answer 14

• X-linked dominant disorder

* Affects kidneys (hematuria and hereditary nephritis), ears (deafness), and eyes