Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PEDS 2- clinical disciplines > GU > Flashcards

GU Flashcards

1
Q

MC organisms involved in UTIs?

A

e coli
kelbsiella
proteus
enterococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RF for UTIs?

A 
constipation
VUR (vesicoureteral reflux) 
urinary tract obstruction
neurogenic bladder 
poor perineal hygiene
structural abnormalities 
catheterization
sexual activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S/s of UTI in new borns/infants?

A

nonspecific signs: fever, hypothermia, jaundice, poor feeding, irritability, vomiting, FTT, & sepsis

+/- strong, foul-smelling or cloudy urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

s/s of UTIs in pre-school children?

A

abd &/or flank pain, vomiting, fever, frequency, dysuria, urgency, or enuresis

CVA tenderness is unusual in young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

s/s of UTI in school aged children?

A

classic s/sx of cystitis: frequency, dysuria, & urgency

possibly pylonephritits: fever, vomiting, flank pain
CVA ttp(+/-)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dx of UTI?

A

screening UA

  • pyuria
  • Nitrite* (can be - in young children)

GOLD standard: urine culture of properly collected specimen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx for UTI

A

<3mo, septic, dehydrate:
ADMIT to hospital for IV abx

Older infants/children: empiric therapy

  • Amoxicillin, TMP-SMX, 1st gen cephalosporin
  • 7-10days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is vesicoureteral reflux (VUR)

A

Reflux of urine from bladder into the ureter/upper urinary tract

1% of newborns
increases up to 15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Epidemiology of VUR?

A

White > Black

F > M

MC <2yrs

strong fam hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is primary VUR?

A

incompetent or inadequate closure of the ureterovesical junction (UVJ)

Due to a congenitally short intravesicular ureter

MC form of reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is secondary VUR?

A

BLOCKAGE
Due to an abnormally high voiding pressure in bladder which results in failure of the closure of UVJ during bladder contraction

Functional bladder obstruction (neurogenic bladder)

Anatomic dysfunction - Posterior urethral valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

s/s of VUR?

A

Prenatal: hydronephrosis on prenatal u/s

Postnatal: febrile UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Work up for prenatal VUR?

A

Prenatal hydronephrosis (on prenatal u/s):

unilateral: repeat ultrasound at 1wk of age
bilateral: repeat ultrasound + VCUG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

work up for post natal VUR?

A

UTI: renal & bladder u/s

Febrile UTI: Voiding Cystourethrogram (VCUG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Grading for VCUG reflux?

A

Grade 1 (reflex into ureter w/ no dilation) –>

Grade 4 (reflux w/ dilation of ureter & blunting of reflux calyces)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx for grade 1 and 2 VUR?

A

Monitor for spontaneous resolution (by age 5, 80% spontaneously resolve)

Consider prophylactic antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for grade III to V VUR?

A

regardless of age antibiotic prophylaxis:
TMP-SMX (2mg/kg) or nitrofurantoin (1-2mg/kg)
DC when VUR resolves (spontaneously or surgically)

at risk for complications if left untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is posterior urethral valves?

A

Obstructing membranous folds within the lumen of the posterior urethra

obstructs normal flow of urine

MC etiology of UT obstruction in newborn male

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dx of PUV?

A

Prenatal US:
Bilateral hydronephrosis, distended and thickened bladder

+/- oligohydramnios

Post natal:
Failure to thrive, distended abdomen, poor urinary stream

Older boys: straining to urinate, UTIs, daytime & nocturnal enuresis

Dx- VCUG- dilated & elongated posterior urethra during the voiding phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

PUV tx?

A

prenatal: experimental surg

post natal: correct electrolyte abn, foley cath, surg correction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

FU post PUV tx?

A

Bladder dysfunction may require clean intermittent catheterization

Monitor for renal failure- significant risk despite early intervention: Renal transplant

Monitor for UTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is considered daytime freq?

A

voiding >8x/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is enuresis?

A

Repeated urination into clothing (day & nighttime) by a child > than 5y/o

diurnal enuresis = wetting while awake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Primary v. secondary nocturnal enuresis?

A

Primary = occurring in children who have NEVER been consistently dry though the night

Secondary = resumption of wetting after at least 6mo of dryness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
s/s of enuresis?
child > 5yr (developmentally & chronologically) at least 2x per week for 3 months
26
RF for nocturnal enuresis?
often associated w/ underlying constipation runs in families sleep apnea psychological
27
dx of nocturnal enuresis?
H&P: r/o anatomical abn, constipation UA +/- culture
28
Tx of nocturnal enuresis?
pt ed limit liquids before sleep awaken the child at night to bathroom Bedwetting alarms meds if others fail
29
What meds can be used for nocturnal enuresis?
``` Desmopressin Acetate (DDAVP)- synthetic analogue of the antidiuretic hormone (ADH) vasopressin -can be Rx for short term periods ``` Imipramine- high risk ADEs
30
What is considered daytime urinary incontinence?
Wetting accident at least once every 2 weeks Incidence decreases w/ age when continence NOT achieved by 6yrs of age, need to consider underlying cause
31
RF for daytime urinary incontinence?
females hx of nocturnal enuresis UTI encopresis (soiling in underwear)
32
What are some disease assoc. with daytime urinary incontinence?
OAB -urinary urgency is hallmark Voiding postponement & under active bladder Dysfunctional voiding
33
Dx work up for daytime urinary incontinence?
``` Voiding diary VCUG US MRI spine Abd xray Referral to: urology, nephrology, neurosurgery ```
34
Tx of daytime urinary incontinence?
tx underlying path: (i.e. cystitis, DI, DM, seizures, neurogenic bladder, anatomical abn., constipation, psych) Behavioral therapy Anticholinergics – oxybutynin TCAs do not appear to work
35
What is exstrophy of the bladder?
Complex congenital anomaly involving the musculoskeletal system & the urinary, reproductive, and intestinal tracts Open, inside-out bladder - the inner surface is exposed rare! But MC in M >F, white infants, 1st born
36
S/s of exstrophy of the bladder?
Open bladder plate & exposed urethra low set umbilicus diastasis of the symphysis pubis - outward malrotation of pelvic bones (at risk of hip dysplasia) anteriorly displaced anus inguinal hernias genital defects
37
Dx of exstropy of the bladder?
prenatal US- confirmed w/ MRI (sometimes) if missed previously, diagnosed at birth
38
Tx of exstrophy of the bladder?
Prenatal ed and counseling of parents Induced vaginal delivery or planned C-section and surgery within 72 hours of delivery Surgical repair after stabilization
39
What is hypospadias?
Congenital anomaly of male urethra Results in abn ventral placement of the urethral opening The urethral folds fail to completely or partially close
40
Hypospadias can be assoc. with?
chordee (ventral curvature of penis) 10% have cryptorchidism increased risk of inguinal hernia Do not circumcise at birth!
41
Dx of hypospadias?
New born PE: -abdnormal foreskin (dorsal hooded) Abdnormal penile curvature the "presence" of 2 urrethral openings
42
Tx of hypospadias?
Isolated hypospadias: Repair before 18months Hypospadias with cryptorchidism: At Increased risk for disorders of sex development (DSD) - additional workup: - Pelvic U/S - Karyotype - serum electrolytes
43
What is cryptorchidism?
a hidden testis - testis not w/in the scrotum & does not descend spontaneously by 4mo of age MC congenital abnormality of the GU tract may be assoc. with various genetic anomalies
44
pts with Cryptorchidism are at risk for...
At risk for infertility & testicular malignancy (5-10x greater risk)
45
Dx of cryptorchidism?
Clinical- newborn exam cause of most cases is unclear 2-6mo of age: measure LH, FSH,inhibin B, & testosterone (can help determine whether or not testes are present) HCG stimulation test
46
Tx of cryptorchidism?
Surg if descent has not occurred by 6-12mo of age Palpable – orchiopexy Non-palpable – exploratory surgery
47
What is a testicular torsion?
Twisting of testes on the spermatic cord Inadequate fixation of testis to tunica vaginalis venous compression, edema or the testicle & cord, ischemia of the testicle
48
What is the MC abnormality assoc. with testicular torsion?
"bell clapper" deformity -testis lies horizontally testicle lacks normal attachment to tunica vaginalis
49
2 peak incidences of testicular torsion?
Neonatal period (less likely) Puberty (65% btwn 12-18yrs)
50
s/s of testicular torsion?
Abrupt onset of severe testicular or scrotal pain N/V
51
PE in pt with testicular torsion?
scrotum may be swollen and edematous Affected testes is usually tender, swollen, slightly elevated Doppler US/nuclear scan of the scrotum: Decreased perfusion Absent cremasteric reflex negative prehn sign
52
Tx of testicular torsion?
Immediate consult w/ an urologist Surgical detorsion and fixation (orchiopexy) of both testes if viable Orchiectomy if testicle nonviable
53
Time frame for testicular torsion?
Detorsion within 4 to 6 hours-100% viability Detorsion after 12 hours 20 percent viability Detorsion after 24 hours 0 percent viability
54
Manual detorsion of testicular torsion?
If the child presents before scrotal swelling develops: Appropriate sedation and analgesia Rotate outward toward the thigh- “open the book” Will relieve pain
55
What is a hydrocele?
Collection of peritoneal fluid between the parietal and visceral layers of the tunica vaginalis. May be communicating or non-communicating generally present as a cystic scrotal mass
56
Epidemiology of a hydrocele?
Common in newborns May be a sign of concerning etiology in older children Resolve spontaneously, by the 1st birthday
57
What is a communicating hydrocele?
develop as a result of failure of the processus vaginalis to close during development fluid = peritoneal fluid
58
What is a non-communicating hydrocele?
no connection to the peritoneum fluid comes from the mesothelial lining of the tunica vaginalis
59
Dx of hydrocele?
Transillumination of the scrotum that demonstrates a cystic fluid collection Doppler U/S
60
Tx of Hydrocele?
Surgical repair | -if beyond 1 yr of age
61
What is a varicocele?
Collection of dilated and tortuous veins surrounding the spermatic cord MC on the left side
62
s/s of varicocele?
May be asxs Dull ache or fullness of the scrotum upon standing Palpable texture of a "bag of worms”
63
Tx of varicocele?
If varicocele persists in supine position, or is right sided, need to r/o processes that cause IVC obstruction -doppler US conservatively w/ observation Repaired through surg ligation or testicular vein embolization

PEDS 2- clinical disciplines (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions