PEDs mod 8 Flashcards
Spontaneous descent of testes usually occurs before what age?
6 mo
Which of the following organisms is seen in most uncomplicated cystitis cases in children?
E. Coli
A common cause of renal hepertension in neonates includes which of the following?
Renovascular disease
A 6 month old baby boy is noted to have the urethral valve on the ventral surface of his penis. Which of the following does this describe?
Hypospadias
A 4 year old girl is brought to the clinic for abdominal pain. The urinalysis is suggestive of infection. On PE she is afebrile and appears to be in no distress. Which of the following is the best initial treatment for this child?
Outpatient antibiotics
A child with a pre-renal disorder is most likely suffering from which of the following.
Dehydration
A child who has been previously healthy is diagnosed with nephrotic syndrome. which of the following is mc cause of childhood
Minimal change dz
6 year old with gross hematuria, edema, and hypertension. RBC’s and trace protein.
Glomerulonephritis
MC initial presentation of nephrotic syndrome?
Sudden onset of dependent pitting edema.
Which of the following is a classic feature of HUS?
Thrombocytopenia.
UTI suspicion
< 2yr with fever
Gold standard for UTI
UA and Culture
Sterile inflammation
Sterile pyuria
More specific vs more sensitive for UTI.
Nitrate specific, Leukocyte sensitive.
How to get a urine sample on infants.
Straight cath
Imaging
Renal ultrasound
How to tx UTI in kids younger than 3.
Children < 3 yo Tx emperically.
Grades 1-3 resolve by age 3.
Vesicoureteral reflux.
Cystitis Tx.
Uncomplicated: amoxicillin or sulfamethoxazole or cephalexin
Complicated cystitis: Ceftriazone
Recurrent Cystitis: Sulfamethoxazole and trimethoprim or Nitrofurantoin.
Spagetti and meatballs
yeast
Protein in urine.
If protein in UA need to confirm with Prot to Cr ratio.
If nitrate is negative does that r/o UTI
No
Protein and blood in UA.
Glomerular dz*
RBC casts
Glomerularnephritis
How long do you Tx with antibx?
7-10 days.
retracted foreskin in an uncircumcised male that cannot be returned to normal position (emergency)
Paraphimosis
non-palpable testes • and proximal hypospadias
Intersexuality endocrine problem
Pain, swelling, inflammation of the epididymis • Chlamydia trachomatis • Neisseria gonorrhea • Doppler ultrasound
• STI test
Epididymitis
Bimodal incidence : • Perinatal (extravaginal) • Early puberty (intravaginal)
• Risk: Cryptorchid testes • Pain, swelling, erythema, N/V • Exquisitely tender • High riding testes • Transverse orientation
• Surgical Emergency!
Testicular torsion
Tx for epididymitis
ceftriaxone 250 mg IM once + doxycycline 100 mg PO BID ×10 days
AKA nephroblastoma • Most common form of kidney cancer
• 2nd most common abdominal tumor in children
• Associated with certain birth defects and syndromes
• 2-5 years of age • Abdominal mass/increasing abdomen size
• Overall cure rate about 90%
Wilms tumor
cryptorchism vs other?
Congenital adrenal hyperplasia
Big cause of renal problems in kids.
HTN
