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GU > urinary problems in pediatrics > Flashcards

urinary problems in pediatrics Flashcards

1
Q

day time urinary continence by age…

A

4

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2
Q

daytime and night time continence by age…

A

5

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3
Q

an infant voids approx ___ times per day

A

20 (small voided volumes and incomplete bladder emptying)

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4
Q

increased daytime frequency = voiding ___ or more times during waking hours

A

8

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5
Q

decreased daytime frequency= voiding ___ or less

A

3

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6
Q

abnormal frequent small voids in a previously toilet-trained kid (with NO evidence of polyuria or uti)

A

pollakiuria

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7
Q

T/F intermittent stream is normal physiologic pattern in kids <3y.o

A

TRUE

  • voiding stream of urine that occurs in several discrete bursts rather than the normal continuous stream
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8
Q

polyuria= urine output exceeding __L/m2

A

2 L/m^2 in kids and 3L in adults

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9
Q

primary enuresis

A

80% of cases

involuntary urination in kids who has never established continence for more than 6 months

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10
Q

secondary enuresis

A

20% of cases

resumption fo enuresis after at least 6 mo of continence

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11
Q

monosymptomatic enuresis

A

aka uncomplicated enuresis

enuresis without lower urinary tract symptoms other than nocturia

no hx of bladder dysfunction

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12
Q

nonmonosymptomatic enuresis

A

enuresis with lower urinary tract symptoms:

  • incr/decr voiding frequency
  • daytime wetting, urgency, hesitancy
  • straining, weak, intermittent stream
  • posturination dribbling, holding maneuvers
  • sensation of incomplete emptying
    lower abd or genital discomfort
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13
Q

nocturnal enuresis= discrete episodes of urinary incontinence during sleep in kids > ___ yo

A

5

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14
Q

causes of monosymptomatic nocturnal enuresis

A
  1. detrusor over-activity
  2. disturbed sleep
  3. psychologic (bx)
  4. neuropsych (intellectual disability, low self-esteem, adhd)
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15
Q

when would you get a renal US and VCUG (voiding cystourethrogram)

A
  • kids with significant daytime complaints
  • uti that hasnt been evaluated
  • signs of structural urologic abnormalities
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16
Q

US helpful to determine

A

post-void residual volume

bladder wall thickness

17
Q

abd xray for…

A

to determine presence and extent of stool retention

18
Q

MRI for…

A

kids with lower lumbosacral spine abnormality

abnormal neuro exam of the perineum and lower extremities

19
Q

kids who have BOTH bladder and bowel symptoms are described as ___

A

bowel and bladder dysfunction

complex/ complicated enuresis

20
Q

overactive bladder

A

abnormal bladder contraction during the filling phase
[
2nd MC bladder dysfunction (nocturnal enuresis is #1)

main symtom= URGENCY

21
Q

girl with h/o never gaining urinary control prob has ___

A

ectopic ureter

anatomic cause of dysfunctional voiding

duplex collecting system

22
Q

t/f boys with ectopic ureter is always proximal to the external urethral sphincter

A

TRUE

this is why males w ectopic ureter dont present with incontinence

23
Q

posterior urethral valves (PUV)

A

obstructing membranous folds within the lumen of the posterior urethra

obstructs bladder outlet

results from disruptions in male embryologic urethral development

MC cause of chronic renal dz d/t urinary tract obstruction

24
Q

how are PUVs diagnosed?

A

prenatal US

as kids: UTI
- presumptive diagnosis w VCUG, confirmation by cystoscopy

25
Q

PUV can lead to ___-

A

vesicoureteral reflux

26
Q

vesicoureteral reflux

A

voiding against closed sphincter increases bladder pressure

27
Q

what does a urinalysis measure?

A

leaukocyte esterase (from neutrophils)

nitrites (gram-neg bacteria)

both can be detected by color change on dipstick test

28
Q

what test is used to definitively diagnose UTI?

A

urine culture

29
Q

what is the test of choice to establish vesicoureteral reflux

A

VCUG
- voiding cystourethrogram/ renal scintigraphy

involved catheterization to fill the bladder with a radioopaque or radioactive liquid and recoridng images during voiding

GU (4 decks)

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