Peds: Renal

Question 1

What to presribed a baby who has a UTI in the hospital? What medication to discharge her on?

Answer 1

IV ceftriaxone, ampicillin gentamicin. Give Oral Bactrim.

Question 2

Pt with recurrent UTIs, what diagnostic study to order?

Answer 2

Voiding cystourethrogram. VCUG. Patients can be followed up with radionuclide cystogram.( less radation)

Question 3

2 month old male infant presents with fever, vomiting and decrease fluid intake. Dx? Test? Rx? Outpatient

Answer 3

Most likely UTI caused by E. Coli. Urine analysis first then Urine culture. Bactrim or Nitrofurantoin

Question 4

Presents with hydronephrosis. On physical exam there is abdominal mass in newborn; most common cause is hydronephrosis due to uteropelvic junction obstruction or multidysplastic kidney disease. Dx? Test? Rx?

Answer 4

Obstructive Neuropathy. Can be diagnosed prenatally US. Get VCUG in all cases of congenital hydronephrosis and in any with ureteral dilatation to tule out posterior urethral valves. Decompress bladder with catheter and abx.

Question 5

Most common cause of severe obstructive uropathy? What can this lead to? Rx?

Answer 5

Posterior urethral valves that lead to end-stage renal disease. Decompress with catheter and abx.

Question 6

Palpable mass that does not transilluminate. Dx? Test? Rx?

Answer 6

Testicular Tumor. US. Radical Orchiectomy.

Question 7

When would you treat bag of worms testes?

Answer 7

If the testicles are significantly different size.

Question 8

Ascending retrograde urethral infection that causes acute scrotal pain and swelling. Seen in sexually active males. UA shows pyuria. Dx? Rx?

Answer 8

Epidytimitis. N. Gonorrhea or Chylamydia Trachomatis. Bed rest and abx.

Question 9

Most common cause of testicular pain >12 years age. Dx? Clinical diagnosis? Rx?

Answer 9

Testicular Torsion. Acute Pain and swelling tenderness to palpation. Testicle in transerves lie and retracted no cremateric reflex. Rx: urology consult

Question 10

Failure to thrive, family hx of nephrolithiasis. Acidosis with hypokalemia, low bicarb, elevated chloride. Urine pH is elevated. Normal anion gap.

Answer 10

Rental tubar acidosis type 1. Cant excrete hydrogen. Genetic

Question 11

Urine pH is decreased. Associated with fanconi syndrome. Normal anion gap acidosis.

Answer 11

Cant reabsorb bicarb