Pediatric GU & GYN Flashcards
Enuresis
Primary- never established control
Secondary- restarted after 6 months of control
check UA, culture
Treat- enuresis alarm, bladder control training, hypnosis, medications (imipramine, desmopressin, oxybutynin)
Treatment of UTI in kids
- Oral antibiotics for 10-14 days (Bactrim, cephalosporins)
- Hospitalize under 2mo old for IV antibiotics
- Follow up in 2 days: change antibiotic if no improvement, then follow up in 1-2 weeks, then every 1-3 months for one year
- Renal US after first UTI in febrile infants, or 2-24 months old
Prehn’s sign
Relief of scrotal pain with elevation of the scrotum occurs with epididymitis, and no relief of pain with testicular torsion
testicular torsion
acute severe pain, cremasteric reflex absent
emergent surgery
Dysmenorrhea
Primary: no pathology
Secondary: underlying cause (pregnancy, PID, endometriosis)
Heat, ibuprofen, NSAID, OCPs, refer to GYN if needed
Chlamydia
most common cause of cervicitis and urethritis in adolescents
S/sx: asymptomatic, dysuria, postcoital bleeding, discharge, pelvic pain, testicular pain
Dx: culture, or enzyme immunoassay (EIA) (quick urine test)
Tx: azithromycin 1 gm x1, OR doxycycline 100mg BID x7 days
Gonorrhea
leading cause of infertility in females
S/sx: dysuria, urinary frequency, discharge, labial pain/swelling, lower abdominal pain, fever, dysmenorrhea, nausea/vomiting, penile discharge, testicular pain
Dx: Culture
Tx: Ceftriaxone (Rocephin), co-treat chlamydia
Syphilis stages
Primary: painless chancre, adenopathy 2-6 weeks after exposure
Secondary: flu symptoms, adenopathy, rash (palms/soles/mouth) 6-8 weeks later
Latent: asymptomatic
Tertiary: leukoplakia, cardiac insufficiency, tumors, CNS involvement
Syphilis
VDRL/RPR to screen, and confirm with treponemal tests
Pencillin G (or if allergic, doxycycline, or erythromycin)
Herpes
initial- fever, malaise, dysuria, painful/pruritic ulcer for 12 days
recurrent- less painful/pruritic ulcer for 5 days
diagnose- viral culture
treat- acyclovir or valacyclovir
HIV/AIDS
Screen with HIV PCR in infants, and ELISA in older kids
Western blot to confirm
Monitor CD4 and viral load
Refer to ID/HIV specialist
CD4 count in HIV/AIDS management
Normal CD4 >800
Start antivirals and prophylactic drugs when CD4