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Pediatrics > Exam 2 - GU > Flashcards

Exam 2 - GU Flashcards

1
Q

when do the kidneys reach near adult functioning level

A

6-12 y/o

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2
Q

why are children predisposed to UTIs

A

shorter urethras

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3
Q

when should complete bladder control be achieved

A

4-5 y/o

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4
Q

can infants concentrate urine as efficiently as older children and adults

A

No

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5
Q

what is enuresis

A

involuntary discharge of urine (Tabor’s)

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6
Q

what is nocturnal enuresis

A

bed-wetting

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7
Q

when is nocturnal enuresis a concern

A

> 6 y/o

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8
Q

what is diurnal enuresis

A

urgency, frequency, and inappropriate wetting during the day

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9
Q

primary vs. secondary enuresis

A

P: child has never had bladder control

S: bladder control at least 6 months, begins wetting again

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10
Q

avoiding caffeine and sugar after ___ will help with nocturnal enuresis

A

1600

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11
Q

how does DDAVP help with enuresis

A

synthetic ADH (reduced volume of fluid)
hyponatremia risk
low dose (0.25mg) gradual increase (0.6mg)

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12
Q

DDAVP contraindication

A

< 6 y/o

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13
Q

how does Tofranil help with enureiss

A

inhibits urination
only used for 6-8 weeks (must taper)

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14
Q

when to administer Tofranil

A

1-2 hours before bedtime

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15
Q

Tofranil risk

A

SI

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16
Q

how does Ditropan (anticholinergic) help with enuresis

A

decrease bladder contractions
starts at 5 mg daily, can increase to 20 mg daily

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17
Q

Ditropan contraindications

A

< 5/6 y/o

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18
Q

what is vesicoureteral reflux (VUR)

A

retrograde urine flow (back flow into kidneys)

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19
Q

UTI can lead to ___ ___ and decrease ___ function

A

nephrotic scarring; kidney

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20
Q

2 bacterias r/t UTI

A

E. Coli
group B strep

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21
Q

frequent UTI < 1 can lead to ___

A

HTN

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22
Q

how many grades of vesicoureteral reflux (VUR) are there?

A

1-5

1: least invasive (reflux into ureter, no dilation)
5: worst (gross dilation, reflux involves kidneys)

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23
Q

VUR is often a ___ malformation

A

congenital

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24
Q

s/sx UTI in infants

A

fever or HYPOtermia***
irritability
dysuria (cries with voiding)
change in urine color, odor
poor weight gain
feeding difficulties

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25
Q

s/sx of UTI in children

A

abdominal, suprapubic pain
voiding frequency, urgency
dysuria
new or increase enuresis
fever

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26
Q

parent education for UTI

A

take meds as Rx
wipe front-back
avoid “holding” urine (void 4-5 times daily)
plenty of fluids
cotton underwear
avoid bubble baths
good hygiene for sexually active adolescent girls

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27
Q

epispadias vs. hypospadias

A

E: urethral opening ABOVE normal location

H: urethral opening BELOW normal location (most common)

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28
Q

when is there a higher incidence of epispadias and hypospadias

A

if father or brother had

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29
Q

there is usually a ____ issue involved with epispadias

A

bladder

30
Q

what is cryptorchidism

A

at least 1 undescended testicle at birth

greatest risk for premature infants

31
Q

major risk with cryptorchidism

A

infertility
lifetime risk of testicular cancer

32
Q

what is orchiopexy and when it is performed

A

surgical repair of cryptorchidism
6-12 months

33
Q

cryptorchidism: retractile vs. ectopic testis

A

R: descends but retracts with exam and physical stimulation

E: outside of normal pathway (groin, abdomen, perineum)

34
Q

acute post-strep glomerulonephritis

A

hematuria ***
proteinuria
HTN
edema
renal insufficiency

35
Q

acute post-strep glomerulonephritis occurs ___ and ___ ___ on its own

A

suddenly; resolves completely

36
Q

which age group is acute post-strep glomerulonephritis most commonly seen

A

school-aged children

37
Q

what are some illnesses associated with acute post-strep glomerulonephritis

A

pharyngitis
strep
impetigo

illnesses occur 1-2 weeks prior to onset

38
Q

acute post-strep glomerulonephritis: ASO titer

A

elevated

strep antibodies

39
Q

acute post-strep glomerulonephritis: RBC, cast, proteinuria

A

0-3 (small amounts)

40
Q

acute post-strep glomerulonephritis: albumin, cholesterol, and triglycerides

A

WNL

41
Q

acute post-strep glomerulonephritis: H&H

A

low or WNL

42
Q

acute post-strep glomerulonephritis: electrolytes, BUN, crt

A

electrolytes: altered
BUN, Crt: elevated

43
Q

if BUN is elevated, what should be restricted

A

protein

44
Q

when is improvement noted with acute post-strep glomerulonephritis

A

increase UOP

45
Q

acute post-strep glomerulonephritis diet

A

low salt

possible fluid restriction

46
Q

what is nephrotic syndrome

A

disorder of renal system
excessive protein is excreted in urine

47
Q

s/sx of nephrotic syndrome

A

edema (insidious, rapid onset)
anorexia
fatigue
pallor
abdominal pain
increased weight
respiratory infection

48
Q

lipid and albumin level with nephrotic syndrome

A

lipids: high
albumin: LOW in BLOOD; HIGH in URINE

49
Q

nephrotic syndrome is caused by a ___

A

virus

50
Q

nephrotic syndrome is treated with ___

A

corticosteroids

51
Q

what 2 age group does nephrotic syndrome effect

A

toddler, school aged

52
Q

what should be avoided in the diet of someone with nephrotic syndrome

A

salt

low salt, low fat, low cholesterol diet

53
Q

what will parents needs to monitor with nephrotic syndrome

A

protein levels in urine using a dipstick

54
Q

what should not be administered to a child receiving corticosteroids

A

live virus vaccines

55
Q

acute renal failure is a rapid onset d/t ___ or ___

A

ischemia; trauma

56
Q

acute renal failure diet

A

low salt, low potassium, low protein

57
Q

what to monitor with acute renal failure

A

BP
UOP

58
Q

what is chronic renal failure

A

irreversible loss of kidney function over months to years

59
Q

what is the end goal with chronic renal failure

A

kidney transplant

required for a normal life + growth + development

60
Q

GFR must be __% to be placed on the transplant list

A

10%

61
Q

what is exstrophy of the bladder

A

bladder is exposed outside of the body through an opening in the lower abdominal wall

62
Q

does the bladder store urine with exstrophy of the bladder

A

No, bladder and urethra are not closed so it drains into an open area

63
Q

what is hydrocele

A

collection of fluid in the scrotal sac

64
Q

hydrocele treatment

A

usually resolves on its own by 1 year, sx if not

65
Q

what is testicular torsion

A

spermatic cord twists, cutting off the testicles blood supply

requires immediate surgery

66
Q

what is phimosis

A

foreskin can not be retracted

67
Q

what is phimosis r/t

A

infection
inflammation
congenital

68
Q

how to treat phimosis

A

circumcision

69
Q

what is paraphimosis

A

retracted foreskin can not be returned to its normal position

70
Q

s/sx of paraphimosis

A

blue discoloration of glands, foreskin
edema

71
Q

what risk is associated with paraphimosis

A

necrosis to penis

Pediatrics (12 decks)

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