Genitourinary_UW_Pre-test Flashcards
RTA is caused by?
Unable to excrete H+ or reabsorb bicarbonate ions
How does RTA present in infancy?
Failure to thrive and normal anion gap metabolic acidosis
What is the treatment for infant RTA?
Oral bicarbonate replacement
Pyuria?
> = 5 WBC/hpf
What are indications for renal and bladder u/s in UTIs?
kids under 24 months that have first febrile UTI, recurrent febrile UTIs in children of any age, UTI in a child of any age with fam hx of renal disease, HTN or poor growth, children who don’t respond well to antibx
Most common cause of nephrotic sydnrome in pre-adolescent children
Minimal change disease. Shows no change on histopathology. No findings in IF staining. EM: diffuse effacement of foot processes
Neprhotic syndrome clinical PPT
Proteinuria (50mg/kg/day or 40mg/m^2/hr), hypoalbuminemaia, edema (1st sign, especially periorbital, and pretibial), hyperlipidemia, fatigue, abdominal pain
Most common cause of secondary hypertension
Fibromuscular dysplasia
Fibromuscular dysplasia physical findings?
Bruit or venous hum may be heard at CVA
What does angiogram reveal for fibromuscular dysplasia
“String of beads”
Bedwetting is normal before age?
5
What is the most common vaginal foreign body?
Toilet paper
Best way to remove vaginal foreign body like toilet paper?
calcium alginate swab, irrigation with warmed fluids after topical anesthetic.
Why is there polyuria in DM type 1
When renal threshold for glucose is reached, resultant glucosuria leads to osmotic diuresis, polyuria and dehydration
Orchiopexy
Surgery to remove undescended testicle into scrotum and fix it there.
Most common congenital anomaly of the gu tract?
Cryptorchidism
Orchiopexy is done for cryptochidism to do what?
prevent testicular torsion, improve fertility, decrease testicular cancer.
What are the complications of cryptochidism
Subfertility (low sperm count and quality), inguinal hernia, testicular torsion, testicular cancer
Most common cause of urinary tract obstruction in newborn boys?
posterior uretrhal valves
Definitive diagnosis of vesicoureteral reflux is done by?
Contrast voiding cystourethrogram
What infection is a/w membaous nephropathy
Hep B. Vaccination reduces this risk
Membranous nephropathy is a common cause of nephrotic syndrome in
Adolescents and adults
What is the most common cause of isolated proteinuria in children?
Orthostatic protineuria. It can be caused by fever, exercise, seizures, stress or volume depletion.
What should be repeated to rule out persistent proteinruia
repeat urine dipstick on two separate occasions
Vesicoureteral reflux is a risk factor for?
Recurrent UTIs that lead to scarring
Patients 2-24 months with UTI should undergo?
Renal and bladder ultrasound to look for anatomic abnormalities. Patients with recurrent UTIs should undergo VCUG
What is prune belly syndrome?
Appears to be no genetic predisposition. Malformation that occurs mostly in males, lax abdominal wall, dilated urinary tract, intra-abdominal testiuclar tissue and can have significant urinary tract anomalies like renal dysfunction or dysplasia. Oligohydramnios and commonly a/ pulmonary complications.
Goodpasture’s syndrome pathophys
Antibody against collagen in glomureular and alveolar BM - hematuria and hemoptysis, classically in young, adult males.
Goodpasture’s syndomre dx suggested by what in sputum or pulmonary secretions?
Hemosidern laden macrophages on sputum or pulmonary secretions.
What is the tx for nephrogenic diabetes insipidus?
Maintenace of adequate fluid intake and diet, use of saluretic meds
grade V VCUG requires what surgery
Surgical reimplantation of the ureter.
Pain from testicular torsion radiates to
Abdomen
What is acute lobar nephronia?
Middle of spectrum between renal abscess and pyelonephritis.
How do you diagnose a lobar nephronia?
CT sacn but renal U/S can also work.
Tx for lobar nephronia
Prolonged IV and PO antibiotics
What does orchiopoexy do for a young child
Helps eliminate risk of torsion of the testis again.
Majority of all cases of acute scrotal pain and swelling in boys 12 years of age and older are caused by
testicular torsion.
How does epididymitis present?
Redness, warmth, and scrotal swelling but has normal cremastesric reflex. Also pain is posterior (over the epididymis)
Varicocele is a common condition seen after what age
around 10
What is a varicocele
Dilation of the pampiniform plexus due to valvular incompetence of the spermatic vein
What is a hydrocele and how is it treated?
Accumulation of fluid in the tunica vaginalis. Should resolve spontaneously within the first year of life.
