GU 3 - Peds Flashcards
MC peds GU issue
enuresis
Enuresis definition
must occur at least 2x/weekly for three consecutive months
nocturnal enuresis has a strong _____
family history
decreased functional bladder capacity with alteration in circadian vasopressin levels results in ____ enuresis
nocturnal
when working up enuresis you r/o ____
secondary causes: UTI, DM, OAB, spinal cord lesion/abnormality, physical/sexual abuse
management of enuresis
reassurance as many outgrow
vesicoureteral reflux is MC in ____
children with febrile UTI and in young infants/toddlers
types of vesicoureteral reflux (2)
- primary: congenital
- secodnary: abnormally elevated bladder pressure preventing closure of the ureterovesical junction during bladder contraction
why is vesicoureterla reflux something to worry about?
Infected urine refluxing into the kidneys can cause scarring of kidneys and impairment in renal growth and functioning
common PE findings of VUR
usually ASx and can see UTI sx like suprapubic tenderness
why renal u/s with VUR
hydronephrosis or hydroureter
what diagnostic test allows for grading of VUR
voiding cystoureterography (VCUG)
Grade I is mild
Grade V is severe
Treatment of VUR
most spontaneously resolve in several years and severe cases are less likely to resolve
undescended testicle
cryptorchidism
common populations for cryptorchidism
30% of premies and 2-5% of full term births
blue dot sign
torsion of the testicular appendix - an appendage of the testicle becomes torsed and tender causing cyanosis
treatment of torsion of testicular appendage
refer to urology
phimosis
unable to retract foreskin over glans due to chronic infection or from poor hygiene
infection of foreskin showing prepuce tenderness and erythema, edema, smegma, and purulent discharge
balanoposthitis
when does paraphimosis become clinically significant
ages > 4
Congenital malformation of urethral meatus opening to ventral side of penis due to incomplete fusion of uretheral fold in utero
Hypospadias
