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349 Peds Exam 2 > Genitourinary Textbook Information > Flashcards

Genitourinary Textbook Information Flashcards

1
Q

What is the primary function of the kidney?

A

Maintain the composition and volume of the body fluids in equilibrium

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2
Q

What are the 3 process of the kidney?

A

Reabsorption - in blood
Secretion - releasing
Excretion - urine

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3
Q

The structural and functional unit of the kidney is called the what?

A

Nephron

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4
Q

The renal pelvis is what shape?

A

Funnel shape

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5
Q

What is the forward movement of urine from the kidney to the bladder called?

A

Efflux

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6
Q

What is the abnormal of flow of urine, typically backward is called?

A

Reflux

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7
Q

What are the 3 big things we are looking at for kidneys in labs?

A

Bun
Creatinine
GFR

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8
Q

The following flashcards are terminology and definition based

A
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9
Q

What does bacteriuria mean?

A

Presence of bacteria in the urine

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10
Q

What does asymptomatic bacteriuria mean?

A

Significant bacteriuria with no evidence of clinical infection

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11
Q

What does symptomatic bacteriuria mean?

A

Bacteriuria accompanied by physical signs of urinary infection
( Dysuria, suprapubic discomfort )

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12
Q

What does recurrent urinary tract infection mean?

A

Repeated episode of bacteriuria or symptomatic UTI

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13
Q

What does persistent urinary tract infection mean?

A

Persistence of bacteriuria despite antibiotic treatment

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14
Q

What is febrile uti mean)

A

Bacteriruria accompanied by fever, usually a presence of a fever means pyelonephritis

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15
Q

What does cystitis mean?

A

Inflammation of the bladder

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16
Q

What does urethritis mean?

A

Inflammation of the urethra

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17
Q

What does pyelonephritis mean?

A

Inflammation of the upper urinary treat and kidneys

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18
Q

What does Urosepsis mean?

A

Febrile UTI coexisting with systemic signs of bacterial illness ; blood culture reveals presence of urinary pathogen

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19
Q

Genitourinary tract disorders
Urinary tract infections!!

A
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20
Q

What is a urinary tract infection?

A

Urinary tract infection is when a variety of organisms, like e.coli go into the uthrea and cause problems

Other pathogens like staphy and enterocccus is common too

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21
Q

What gender has the most common occurrence of UTI?

A

Female

( male who are uncircumcised as well )

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22
Q

After the bacteria invades the body, what will the body do to try to get rid of this infection?

A

Voiding

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23
Q

Why do females tend to get more uti than males?
And explain why?

A

Females have shorter urethras, which measure to 2cm in kids and 4cm in women,

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24
Q

Why do uncircumcised males get more urinary tract infections than those who are circumcised?

A

Because the foreskin can hold pathogens inside
And they can eventually travel the long 8 inch urthrea

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25
Q

Is urine sterilize? And why?

A

No
It isn’t
Because of all the bacteria or waste the body is trying to get rid of

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26
Q

What is another big factor in why kids may get urinary tract infections?

A

Not being able to empty their bladder out complete
Otherwise known as
Urinary stasis

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27
Q

Incomplete bladder emptying ( stasis ) may result in what?

A

Backward travel of the urine into the kidneys
Reflux ^

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28
Q

What is some common clinical manifestation of UTI?

A

Frequency !
Urgency !
Incontienice!
Enuresis
Constipation
Encopresis
Incomplete bladder emptying

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29
Q

What are some other extrinsic factors, other than bacteria that may cause UTI?
Think of surgery??
Think of love??
Think of fun??
Think of medicine??

A

Urinary caths
Intercourse
Bubble baths and shampoo
Antibiotics

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30
Q

Why is it important to pee after sex?

A

To flush out all that bacteria that may have entered

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31
Q

What type of symptoms will an infant show who has UTI?

A

Fever
Hypothermia
Jaundice
Tachypena
Cyanosis

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32
Q

What type of symptoms will toddlers show with UTI!?

A

Fever
Lethargy
Poor feeding
Vomit
Diarrhea

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33
Q

What type of symptoms will school age children will show?

A

Enuresis
Daytime Incontience
Malordois urine

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34
Q

What are some symptoms of dysfunctional voiding?

A

Urinary tract infection without fever
Changes in urinary frequency
Constipation
Squatting to holding to stay dry
Daytime or nighttime pee
Straining to void
Urgency to void

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35
Q

What is the biggest indicator that the infection traveled up to the kidney and causing pyelonephritis?

A

Flank pain!!
Costovertebral angel tenderness

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36
Q

In older children with uti they are the (3?)

A

Urgency
Frequency
No real fever

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37
Q

What do we usually do to test for UTI?

A

Urinalysis and culture

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38
Q

How does the urine usually look like?

A

Hazy
Cloudy
Thick

Noticeable strands of muscus and pus

Malodorous

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39
Q

What is the key distinguishing true UTI is finding what in the urine?

A

Pyuria

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40
Q

What do we usually do for infants and some children in which urine analysis or even collection is hard to do!?

A

Catherization and potential suprapubic aspirations

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41
Q

What and how do we do a clean catch urine!!?

A

When a child sits on the toilet facing the tank and labia are naturally seperated

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42
Q

What is the treatment we do for children with Urinary tract infections?

A

Elimate it by usage of antibiotics

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43
Q

What are some antibiotics we used for UTI?

A

Amoxicillin
Trimethroprim-sulfamethoxazole

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44
Q

What is another thing you may think young girls typically get more UTI?
Think of school age

A

They are not wiping currently
Back to front

EDUCATE TO FRONT TO BACK!!

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45
Q

What are some things we will encourage parents and children to do with UTI?

A

Fluid
Good toilet habits
Fiber
Cleaning front to back

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46
Q

Fluid requirements in children
First 10kg = how much ml/day
Second 10kg ?
Each 1Kg ?

Example
Child weight 25kg
How much of fluid needed

A

100
50
20

1000
5000
20x5= 100

1600

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47
Q

How can we help prevent urinary tract infections?

A

Avoid scratching between legs and anal area
Routine daily hygiene
Girls to pee after sex

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48
Q

Now onto
Vesicoureteral reflux
VUR

A
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49
Q

What is Vesicoureteral reflux??

A

It refers to the retrograde flow of the urine from the bladder into the upper urinary tract

Reflux!

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50
Q

When a bladder pressure is high enough what can occur?

A

Reflux back into the ureter and renal pelvis

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51
Q

There are two types of reflux which are?

A

Primary and secondary

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52
Q

What is primary reflux?

A

Congenital anomaly that effects the ureterovesical junction

This usually is where the bladder has an anti reflux mechanism

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53
Q

What is secondary reflux?

A

Abnormally high pressure in the bladder
Or function bladder obstruction

54
Q

Reflux with infection is most common cause of what?

A

Pyelnoephritis

55
Q

What is the treatment for VUR?
Examples?

A

Continous antibiotic prophylaxis
Trimethoprim-sulfamethoxazole

56
Q

What is the surgical management of VUR!

A

Where they insert refluxing ureter and consisten of open surgical and reimplantation of the ureters

57
Q

When is surgical interventions indicated with VUR?

A

Renal damage
Disease
Scaring
grade 5 reflux

58
Q

What is a minimally invasive treatment for VUR?

A

Injection to help bulk up the ureter and help allow urine to be pushed down and not go back up

59
Q

Overall we want to educate parents and children on what for medication?

A

Follow the regime !

60
Q

Glomerular disease
Acute glomerulonephritis

A
61
Q

What is acute glomerulonephritis?

A

Post infectious gleoneruooneprhotis

Where strep throat goes untreated and leads into the kidneys

Group A beta hemolytic streptococci
Of the throat 3-6 weeks

62
Q

What are clinical manifestation of APSGN?

A

Period oral edema
( face(eyes) then goes to extremities )
Anorexia
Cola colored urine

63
Q

How does the urine look like in ASPGN?

A

Cola colored urine ( or tea )

64
Q

On examination what vital sign will we see?

A

Slight high blood pressure

65
Q

What are some major complications of APSGN?

A

Hypertension
Encephalopathy
Kidney injury
Hypervolemia ( due to that excessive urine inside )

66
Q

What will we see in the urine analysis? (3)

A

Hematuria
Proreinuria
Increased specific gravity

67
Q

How will we manage or treat this disease?

A

Usually we can’t because strep is usually gone but this is the after effect so supportive care really

68
Q

Is bed rest necessary for ASPGN?

A

No not really

69
Q

How are we going to manage fluid balance for ASPGN? Remember edema!

A

Record weight
Monitor intake

Usage of diuretics too

70
Q

How we will treat the edema in ASPGN?

A

Diuretics
(Furosemide, lasix )

71
Q

How we will treat the hypertension in ASPGN?

A

Usually again with thiazide or loop diuretic

72
Q

What type of avoidance of food will we tell these kids ?

A

No sodium!
Because of that edema
We want to reduce it

73
Q

When will we use antibiotics for these ASPGN?

A

Only if the infection still is present

74
Q

What is chronic or progressive glomerulonephritis?

A

The progressiveness of the ASPGN
And usually resulting in worsen outcomes

Everything remains the same just worse and could lead to renal damage and potential kidney disfunction

75
Q

Now onto nephrotic syndrome!

A
76
Q

What is nephrotic syndrome?

A

It is the most common glomerular injury in children

77
Q

What are the big 4 clinical manifestation of nephrotic syndrome?
We often define it as?

A

Proteinuria
Hypoalbuminemia
Hyperlipidemia
Edema

78
Q

What are the 3 nephrotic syndrome types?

A

Minimal change
Secondary
Congenital - Finnish

79
Q

What is minimal change nephrotic syndrome?

A

Usually a nonspecific illness, may be from a viral respiratory infection

80
Q

What is secondary nephrotic syndrome?

A

Damage to the glomerular
AGN or CGN

It’s usually from collagen vascular disease like lupus or toxic drugs or even immune compromise

81
Q

What is congenital nephrotic syndrome, Finnish type?

A

A recessive gene that causes it

Usually babies are super small for age and proteinuira and edema first months of life

82
Q

How does the urine look in nephrotic syndrome?

A

Darkly oplascent and frothy

83
Q

Usually children with nephrotic syndrome will have either weight gain or weight loss?

A

Weight gain due to edema

But weight loss can happen due to all The protein loss but rare

84
Q

What does the hypoalbuminemia due or present to us in children with nephrotic syndrome?

A

Muehrcke, white nails

85
Q

Notes
Periorbial, abdominal, gonadal, lower edema

Weight gain from edema

Decreased urine output

Pallor or fatigue

Neprhotic syndrome

A
86
Q

Again what will we see in that urine test? (3)

A

Proteinuria
Hypoalbumnimemia
Hypercholestrolemia

87
Q

What will be the diet for nephrotic syndrome?

A

NO SALT!

88
Q

What type of medications will we give to nephrotic syndrome? (3)

A

Steroids
Diuretics
Immunosuppressants

89
Q

What is the steroid name for nephrotic syndrome and why do we give it?

A

Prednisone ! With FOOD!
Help with inflammation

90
Q

Why do we give diuretics and name explain for nephrotic syndrome?

A

To reduce edema
Furosemide lasix

91
Q

Nephrogenic diabetes insipidus!

A
92
Q

What is nephrogentic diabetes insipidus?

A

Defect in the ability to concentrate urine

( distal tubules and collecting ducts are insensitive to ADH )

93
Q

What are the clinical manifestation of NDI? (4)

A

Vomit
Unexplained fever
Severe dehydration
Hypernatremia

94
Q

What is the treatment for this NDI?

A

Adequate volumes of water

95
Q

Why would potassium be needed or a concern for us for NDI?

A

Supplemental potassium would be indicted because we are losing a lot of fluid

96
Q

Why might NDAIDS be used for NDI?

A

To help reduce the amount of urination

97
Q

What type of diet for NDI?

A

No salt!

98
Q

Miscellaneous renal disorders

Hemolytic uremic syndrome
Familial nephritis ( alport syndrome )
Unexplained proteinuria

A
99
Q

What is hemolytic uremic syndrome? (3)

A

acute kidney injury
Hemolytic anemia
Thrombocytopenia

100
Q

What is the etiology/cause of hemolytic uremic syndrome?

A

Diarrhea positive (D+)
( ingestion of a toxic )

Diarrhea negative (D-)
( genetic disorders )

101
Q

What is the patho behind hemolytic uremic syndrome?

A

So the infection attacks RBC and these RBC are removed from the spleen causing that acute hemolytic anemia

And thrombocytopenia is shown from the platelet aggregation with the damage blood vessels

102
Q

What are the clinical manifestation of hemolytic uremic syndrome? (2) big ones

A

Diarrhea
Vomiting
Lethargic
Pallor

HEMORRHAGIC MANIFESTATION!!
Bruising, purpura, rectal bleeding

Could potentially be seizures!!

103
Q

What are the labs?
hemolytic anemia

A

Bun and creatinine are high
Low hemoglobin and hematocrit
High reticulocyte

104
Q

What is the treatment for these kids normally?

A

Blood transfusions

105
Q

What medication is contraindicated for this?

A

Heparin!!
More bleeding!

106
Q

What is familial nephritis? Alport syndrome

A

High-tone sensorineural deafness, ocular disorders

Usually hematuria is present and progression of ESRD is not treated

107
Q

What is unexplained proteinuria?

A

Usually no cause of it
May be from exercise or dehydration

But just repeated examination may help

108
Q

Renal failure!!
Acute vs chronic!

A
109
Q

What does renal failure mean?

A

The inability of the ones to excrete waste material, concentrate urine and conserve electrolytes

110
Q

What is acute kidney injury?

A

When the kidneys suddenly are unable to appropriate regulate volume and composition of urine in response to fluid and food intake

111
Q

What is the principle feature of AKI?

A

Oligoanuria
( low urine output )

112
Q

What are some pre reneal causes that can cause AKI?

What about intrinstic?

Post renal?

A

Dehydration
Hypovolemia

Nephrotoxic drugs

Obstruction

113
Q

Is AKI reversible?

A

Yes

114
Q

What are some clinical manifestation of AKI?

A

Oliguria
Dehydration

115
Q

What are some findings with acute rebels failure like
Electrolyte why
Sodium?
Potassium?
Calcium?

A

Hypo natremua
Hyper kalemia
Hypo calcemia

116
Q

What is the treatment for AKI?

A

Fluid therapy!

117
Q

Do we use diuretics in AKI?

A

No!

118
Q

Since patients are losing fluid and calories, how are we going to help them with AKI?

A

Helping control water balance
Intake and output

119
Q

Since the patient develops water intoxication and hyponatremia, these both make it hard to provide calories to help maintain the child need ?

High in (2)
Low in (3)

A

High in carbs & fat
Low in protein potassium and sodium

120
Q

Since hyperkalemia is a thing in AKI, what will we do!?

A

Monitor and ECGS

Avoid any potassium foods too

121
Q

Since hypertension plays a good role in most kidneys problems how are we going to help aid the patient with hypertension who has AKI?

A

Well the most common cause of hypertension in aki is over expansion of the ECF and plasma.

Usually we are going to be given kids beta blocks like labetalol and sodium nitroprusside

122
Q

Anemia is not as common in AKI but a blood transfusion may be indicted if what?

A

They are below 6

123
Q

If a patient has a seizure what do we give?

A

Antipileptic drugs

124
Q

If the patient experiences cardiac failure or pulmonary edema from their hypervolemia

We usually do what?

A

Give diuretics

DOMT GIVE DIGOXIN!

125
Q

Chronic kidney disease
Think CHRONIC!!

A
126
Q

Replacement
Dialysis !!

A
127
Q

What is hemodialysis has what type of line?

Best used for kids who come in how many times?

And it’s best and rapid of?

A

Central line!!

3x for 4-6 hours

Correction of fluid and electrolyte abnormalities

128
Q

What is peritoneal dialysis?
Who is it best for?
Where does it go into?
Fluid always are what?

Is this preference method for kids?

A

Chronic children
Into the abdominus
Warm!

Yes

129
Q

What is Continous venovenous hemofiltration?

A

Usually given to people who don’t tolerate hemodialysis well

130
Q

What is a transplant?

A

Complete removal of the kidney and fixed everything really

349 Peds Exam 2 (7 decks)

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