Child health- renal and urology Flashcards
are UTIs more common in boys or girls
girls
what is a urinary tract infection
infection anywhere along urinary tract-urethra, bladder, uterus and kidneys
what should you consider in patients with repeated UTIs
abnormal renal tract
clinical features of UTIs in babies-
very non-specific-
fever
lethargy
irritability
vomiting
poor feeding
increased urinary frequency
clinical features of UTIs in older infants and children
more specific-
fever
abdominal pain, particularly suprapubic pain
vomiting
dysuria (painful urinating)
increased urinary frequency
incontinence
investigation for UTIs
urine clean catch sample
all patients under 3 months with UTI with a fever should be managed how?
IV antibiotics
which antibiotics are used to treat lower UTIs in children <3 months
IV amoxicillin and gentamicin
which antibiotics are used to treat lower UTIs in children >3 months
trimethoprim or nitrofurantoin (3 days)
1st line antibiotics used to treat upper UTIs in children
IV amoxicillin and gentamicin
2nd line antibiotics used to treat upper UTIs in children
IV co-amoxiclav
most appropriate method of obtaining a clean catch urine sample in babies
urine collection pad
foreskin is aka
prepuce
retractability of foreskin increases with age, with full retraction possible in-
10% of boys at age 1
50% of boys at age 10
99% of boys at age 17
what is circumcision
surgical removal of foreskin
what is nocturnal enuresis aka
bed wetting
nocturnal enuresis is considered a typical part of development until the age of what
age 5
underlying physical conditions of nocturnal enuresis
diabetes melitus
UTIs
constipation
trial of what medication can be given for nocturnal enuresis
DDAVP (sympathetic ADH)
what is torsion of testicle
occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum
torsion of testicle typically occurs in what age group
teenage boys
congenital predisposing factor of torsion of testicle
bell-clapper deformity- leaves testes free to rotate
clinical features of torsion of testicle
sudden, severe, testicular pain, and tenderness
associated nausea and vomiting
testis may be higher than normal
mild pyrexia and redness
cremasteric reflex reduced or absent
management of torsion of testicle
surgery
what is Epididymo-orchitis
inflammation of the testes and epididymis secondary to infection
most common causes of epidydymo-orchitis in <35s
STIs eg N. gonorrhoea
clinical features of epididymo-orchitis
acute onset, severe testicular pain
may be unwell and history of dysuria and urethral discharge (from STI)
testes is red, hot, and swollen and tender to touch
classic finding on testicular examination of epidydmyo-orchitis
alleviation of pain upon elevation of testes
management of epidydymo-orchitis
analgesia and antibiotics
the appendix testes aka
hydatid of morgagni
cause of UTI most commonly
E.coli (80%)
what type of bacteria are UTIs
gram-negative, facultative anaerobic, rod-shaped, coliform bacteria
what is the vesicoureteric reflex
abnormal back flow of urine from bladder
