👧🏾- Genitourinary Test

Question 1

S&S of uti in infancy (1-24mo)

Answer 1

Poor feeding, vomiting, failure to gain weight, excessive thirst, frequent urination, straining or screaming when urinating, foul smelling urine, pallor, fever, persistent diaper rash, seizures, dehydration, enlarged kidney or bladder

Question 2

S&S of uti in childhood (2-14yrs)

Answer 2

Poor appetite, vomiting, growth failure, excessive thirst, enuresis, incontinence, frequent urination, painful urination, swelling of face, seizures, pallor, fatigue, blood in urine, abdominal pain or back pain, edema, HTN, tetany

Question 3

Vesicoureteral reflux

Answer 3

Retrograde flow of bladder urine into ureters

Surgical repair if: frequent uti’s, severe anomalies, non-compliant with meds, intolerance to meds

Ureteral reimplants

Question 4

Phimosis

Answer 4

Narrowing of preputial opening of foreskin

Question 5

Hydrocele

Answer 5

Fluid in scrotum

Question 6

Cryptorchidism

Surgery

Answer 6

Failure of testes to descend

Descends between 7-9 months

Surgery- orchiopexy

Question 7

Exstrophy of bladder

Answer 7

Failure of abdominal wall to fuse & bladder remains outside body

Continually seeps urine

Question 8

Nephrotic syndrome (NEPHROSIS)

Answer 8

2-7 years old
Hyperalbuminuria= ⬆️protein in urine
Leads to edema and hypovolemia

Hypovolemia= secretion of ADH & Aldosterone
Hyperlipidemia

Question 9

S&S of nephrosis

Answer 9

Increased weight gain 
Facial edema 
Ascites 
Irritability & fatigue
⬇️ urinary output
\+ proteinuria 
Hypoalbuminemia 
Hypercholesterolemia 
Decreased serum protein

Question 10

Treatment of nephrosis

Answer 10

Corticosteroids (prednisone 2mg/kg)

Diet restrictions (⬇️ Na & ⬆️ protein)

Fluids are ok

IV infusion of albumin

Diuretics

Question 11

Acute glomerulonephritis

Answer 11

Peak age 6-7yrs

Impetigo

Immune-complex disease that clogs glomeruli

Occurs 1-3wks after strep infection

Causes swelling & exudate in renal capillaries and hematuria

Question 12

S&S of nephritis

Answer 12

Moderate edema 
Loss of appetite 
Oliguria 
Hematuria 
Proteinuria
Hypertension 
Irritability & lethargy 
Azotemia

Question 13

Nephritis

Patho

Answer 13

⬇️ glomerular filtration, oliguria

⬆️ Na & water= hypervolemia

Causes circulatory overload and edema

Leads to hypertension , cerebral edema & seizures

Cardiac enlargement
Pulmonary congestions
+ ASO titer = previous strep infection

Question 14

Nephritis

Treatment

Answer 14

Antihypertensives (aprsoline)

Diuretics (lasix)

Anticonvulsants (phenobarb, Dilantin)

FLUID RESTRICTIONS
Low K+ diet (during oliguria)
Monitor serum compliment 3
Daily weight

Question 15

Hemolytic uremic syndrome

Cause

Answer 15

Acute renal disease

Occurs between 6 months & 5 years

Cause- e.coli 0157:H7

Question 16

Hemolytic uremic syndrome

Patho

Answer 16

• small glomerular arterioles become swollen & occluded with deposits of platelets & fibrin clots (intravascular coagulation)
• RBC’s are damaged as they attempt to move through the blood vessels
• damaged RBC’s are removed by the spleen
• this leads to decrease in RBC (anemia) & decrease Hct and Hgb, and a decrease in platelets (thrombocytopenia)
• renal damage occurs & produces: proteinuria, hematuria, urinary casts, ⬆️ BUN/creatinine/serum reticulocytes

Question 17

Hemolytic uremic syndrome

Treatment

Answer 17

Monitor I & O

Blood transfusions

Dialysis (no urine output is common)

Question 18

Renal failure

Answer 18

Inability of the kidneys to excrete waste material, concentrate urine & conserve electrolytes

Azotemia- nitrogenous waste products in blood

Uremia- toxic amounts of nitrogenous waste products in blood

Question 19

S&S of acute renal failure

Answer 19

Oliguria (output less than 50cc in 24hrs)

N/V

Edema

Lethargic

Circulatory overload (hypertension, SOB, crackles)

Cardiac Arrhythmia (⬆️ K+)

Azotemia= retention of wastes

Question 20

Treatment of renal failure

Diet

Answer 20

Fluid & electrolyte replacement

Monitor VS , I&O

Diuretics

Diet-
⬆️ carbs, fat , calcium
⬇️ protein , k, sodium
FLUID RESTRICTIONS

Treat hyperkalemia (kayexalate)

Antihypertensives

Seizure precautions

Question 21

Hemodialysis

Answer 21

Arterial blood leaves the body & blood is returned via venous supply

4hrs/day 3days/wk

Assess for bruit or thrill - vibration when blood is flowing.

Daily weights before & after treatment

No needle sticks or BP in arm

Question 22

Transplant procedure

Answer 22

Tissue matching (antigen compatible)

Recipient must be immunosuppressed (prednisone) before & after procedure to treat rejection

Question 23

S&S of transplant rejection

Answer 23

Fever

Swelling or tenderness over graft area

⬇️ urinary output

⬆️ BP, serum creatinine

Question 24

Wilms tumor

Diagnosis, treatment

Answer 24

Nephroblastoma

Embryonic tumor of kidney

Peak incidence 2-3 years of age

Diagnosis - X-rays, ct or mri, abdominal ultra sound

Treatment- surgery 24-48hrs , followed by chemo & radiation

Question 25

S&S of wilms tumor

Answer 25

Usually confined to one side (left) and is firm & non-tender

Hematuria 
Fatigue & malaise 
Weight loss 
Anemia 
Fever 
Lymphadenopathy 
Hypertension (releases renin) 
Respiratory symptoms

Question 26

Pre-op care of wilms tumor

Answer 26

DO NOT PALPATE ABDOMEN can cause rupture & metastasis

Question 27

S&S of uti in neonate

Answer 27

Increased association with malformed or low set ears), poor feeding, vomiting, failure to gain weight, respiratory distress, frequency, screaming on urination, dehydration, poor stream, jaundice, seizures, enlarged kidneys or bladder