GENITOURINARY PROBS IN CHILDREN

Question 1

PEDI antibiotics for UTI

Answer 1

Penicillin
Sulfamide
Cephlasporin

• take full course of antibiotics

Question 2

Medication for cystitis

Answer 2

PO antibiotics or meds

Question 3

Medication for pyelonephritis

Answer 3

IV antibiotics

Question 4

Voiding systourograph (VCUG)

Answer 4

Take pictures of dye going in NS out
Child needs to know its ok to void on table (potty trained child)
Assess for allergies, shell fish, and iodine
Check kidney function (BUN and creatine)
Drink lots of fluid to flush dye out

Question 5

Grade 1 of vesicoureteral reflux

Answer 5

Reflux is only into the ureter

Question 6

Grade 2 of VUR

Answer 6

Goes up into the renal pelvis

Question 7

Grade 3

Answer 7

In renal pelvis but causing mild hydronephrosis
So swelling and distention of kidney

Question 8

Grade 5

Answer 8

Severe hydronephrosiis causes ureters to twist and obstruct

Question 9

Treatment for grades 1-3

Answer 9

Conservative , daily dose of antibiotics

Question 10

Treatment for grade 4-5

Answer 10

Surgical

Question 11

Med therapy for grades 1-3

Answer 11

Daily low dose dose of antibiotic therapy

Question 12

Reasons for ureteral implantation in VUR

Answer 12

Severe form
Significant abnormality
Non compliance w med or antibiotic intolerance
Not able to go in every 2-3 mo for culture and sensitivity

Question 13

Treatment for phimosis

Answer 13

Steriod cream for a month x2 a day (mild case)

Option of surgical treatment for severe

Question 14

Meds 1st line meds for nephrotic syndrome

Answer 14

Corticosteroids- prednisone 2/m/kg/day x6 was
Then 1.5 every other day for 6 wks

We would increase dose long term so at risk for immunosuppressive so on top of already being immunoocomprimised w nephrotic syndrome

Question 15

What drug do we use for nephrotic syndrom if prednisone is not working for the child or have repeated relapses

Answer 15

Cyclosporin/cyclophosphamide or cyclosporin

Question 16

Medication to help minimize swelling nephrotic syndrome

Answer 16

Furosemide (temporary) (helps edema does not replace protein)

25% albumin -decreases edema& replaces protein

Question 17

Long term steroid use in nephrotic syndrome

Answer 17

Weight gin
Irritability
Insomnia
Abnormal hair growth (female)
Hypertension
Increase glucose
Increase infection
Growth retardation
GI bleeding
Bones weak

Question 18

Antihypertensives and diuretics for acute glom
nephritis

Answer 18

To manage hypertension and fluid overload

Typically w kids do not need dialysis because they are healthier than adults

Question 19

Tricyclic anti depressant , high cholinergic meds for enuresis if behavioral treatment is not working

Answer 19

Imipramine (tofranil) and desmopressin

Side effect- dry mouth , headache , constipation and cardiac toxic if over dose of tricyclic antidepressant