Ch 25 ATI and Ch 26

Question 1

Age that structural defect should be repaired

Answer 1

Bewtween 6-12 months but before 3 years of age

Question 2

Chordee information and repair

Answer 2

Ventral curvature of the penis
Release of the band

Question 3

Obstructive Uropathy repair

Answer 3

Divert flow of urine to bypass obstruction

Question 4

Bladder exstrophy information and repair

Answer 4

Eversion of the bladder and abdominal wall.
The bladder, urethra, and uretal orifice are exposed.
Epispadias is present

Repair is to cover with sterile dressing and prep for immediate surgery

Question 5

Hypospadias

Answer 5

Urethral opening just below the glans penis, behind the glans, or on the ventral surface of the shaft
meatus opening is below the glans but can open along the scrotum or perineum.

Question 6

Epispadias

Answer 6

Widened pubic symphysis,
Urethra open on the dorsal surface of the penis

Female:
Wide urethra
Bifid clitoris

Question 7

Phimosis

Answer 7

Narrowing of the preputial opening of the foreskin
No surgery done, as it normally goes way with age

Question 8

Cryptorchidism

Answer 8

Undescended testes

Needs a surgical orchiopexy, done between 6-24 months of age

Question 9

Hydrocele

Answer 9

Fluid in the scrotum
Can resolve spontaneously, though surgery is needed if not resolved in 1 year

Question 10

Varicocele

Answer 10

Elongation, dilation, and tortuosity of the veins within the spermatic cord. A varicocelectomy may be needed

Question 11

Ambiguous genitalia

Answer 11

Erroneous or abnormal sexual differentiation

Karyotyping is performed to determine the infant’s chromosomal pattern and gonadal function tested.

Question 12

Acute Glomerulonephritis

Answer 12

Benign inflammation of the glomeruli, causes intravascular coagulation

Question 13

Expected findings of Acute Glomerulonephritis

Answer 13

Hematuria
Irritability
Cloudy tea color urine
Edema
Encephalopathy
Lowgrade fever

Question 14

Nephrotic Syndrome

Answer 14

Alterations in the glomerular membrane allowing proteins to pass into the urine. Results in decreased OSMOTIC Pressure.

Question 15

Risk factors for Nephrotic syndrome

Answer 15

MCNS [Unknown in cause, can be multifactorial. peak incidence is 2-3 year of age]
Congenital or secondary nephrotic syndrome.

Question 16

Findings of Nephrotic syndrome

Answer 16

Muehrcke lines, white lines that run parallel to the lunula

Question 17

Blood chemistry of Nephrotic syndrome

Answer 17

Hypoalbuminemia
Hyperlipidemia
Hemoconcrentration [High Hgb, Hct, and Platlets]
Possible Hyponatremia
GFR is high or normal
Decreased serum calcium
Erythrocyte sedimentation rate.

Question 18

Hemolytic Uremic syndrome

Answer 18

Acute renal disease is characterized by renal failure, hemolytic anemia, and thrombocytopenia.

One of the leading causes of AKF in early childhood.

Essentially is the breakdown of RBCs clogging the kidneys

Question 19

Findings of HUS

Answer 19

Accurs after prodromal period

Lethargy
Irritability
Stupor
Hallucinations
Edema
Pallor
Bruising, purpura or rectal bleeding

Question 20

Lab values indicative of HUS

Answer 20

Decreased Hgb and Hct
Elevated reticulocyte count
Elevated BUN and Creatinine
Bribrin in blood and Urine [thrombocytopenia]

Question 21

Meds for HUS

Answer 21

Plasma infusion is being studied
No evidence for heparin, corticosteroids, or fibrinolytic agents

Question 22

Most common cause of ARF

Answer 22

Prerenal

Question 23

How is ARF classified

Answer 23

Prerenal
Intrarenal
Postrenal