Uro/Renal Flashcards
What is is called when there is a failure of one or both testes to descend
cryptorchidism
what are risks if cryptorchidism is left untreated
infertility and malignancy
how is cryptorchidism diagnosed
Ultrasound
How is cryptorchidism treated
orchiopexy by age 1
- recommended ASAP after 4 months
what is an infection that is limited to the bladder
cystitis
who has the greatest risk for Cystitis
Girls (10x>boys)
what is the most common pathogen associated with bacterial UTI in kids
E. Coli
what are symptoms of cystitis in older children
similar to those in adults:
fever, frequency, urgency, dysuria, incontinence, abdominal pain and hematuria
what are symptoms of cystitis in newborns/infants
non specific: fever, hypothermia, jaundice, poor feeding, irritability, vomiting, FTT, and sepsis
how is cystitis diagnosed
Urinalysis and culture
culture is gold standard
can also do a renal and bladder US
what is the treatment for cystitis
Cephalosporin x 14 days
- first gen (Keflex) for low risk of renal involvement
- 2nd or third gen for higher risk of renal involvement
what is Enuresis
involuntary loss of urine in a child older than 5
What is primary enuretics
pts who have never successfully maintained a dry period
what is secondary enuretics
dry for several months before regular wetting occurs
how is enuresis diagnosed
Urinalysis and culture to rule out infection.
log fluid intake, stool and voiding
what are treatment options for enuresis
behavioral modification - nighttime audio alarm
medications - desmopressive (DDAVP)
what is glomerulonephritis
inflammation of the glomerular basememnt membrane
what is the hallmark sign of glomerulonephritis
hematuria
what are types of acute glomerulonephritides
- postinfectious- group A strep
- Rapidly progressive glomerulonephritis
when is postinfectious group a strep glomerulonephritis seen
10-14 days after infection
What are the two types of rapidly progressive glomerulonephritis
- Goodpastures syndrome
- Vasculitis
what are the chronic glomerulonephritides
- IgA nephropathy (berger disease)
- Alport’s syndrome
- Membranoproliferative glomerulonephritis
what is IgA nephropathy (berger disease)
affects young males within days after URI or GI infection - caused by over production of IgA immune complexes which damages kidneys
what is Alports syndrome
isolated persistent painless hematuria
genetic condition occurs in children resulting in renal failure and hearing loss
what causes membranoproliferative glomerulonephritis
SLE and viral hepatitis
what are the manifestations of glomerulonephritis
proteinuria, HTN, azotemia, oliguria and hematuria
what is a collection of fluid around the testicle or spermatic cord called
hydrocele
how is hydrocele diagnosed
scrotal US or transillumintation
what is the treatment for hydrocele
watchful waiting. usually resolves on its own within first 12 months of life.
occasional needle aspiration or surgery
what is it called when the urethra opens on the bottom of the penile shaft
Hypospadias
what diagnostic tests assists wtih diagnosis of hypospadias
excretory urogram
when is hypospadias typically repaired
before 1-2 years old.
DO NOT circumcise
what is it called when there is an inability to return the foreskin to normal position
paraphimosis
what is the treatment of paraphimosis
applying firm circumferential compression to the glans with the hand.
if manual is ineffective - dorsal slit is used
what is the inability to retract the foreskin called
phimosis
at what age does phimosis usually resolve
around 5yo
what is the treatment for phimosis
betamethasone topically.
if no improvement - circumcision
what is a negative prehn’s sign
lifting of the testicle will not relieve pain
what is seen on exam with testicular torsion
bell clapper deformity - asymmetric high riding testicle
what relfex is affected with testicular torsion
cremaster reflex - absent
what is the blue dot sign
tender nodule 2 to 3mm in diameter on upper pole of testicle - indicative of torsion of testicular apendance
how is testicular torsion diagnosed
US and radionuclide study (GS)
what is the treatment of testicular torsion
surgical emergency: may afffect fertility if left untreated longer than 4-6 hours
what is vesicuoreteral reflux (VUR)
condition in which urine flows retrograde or backward from bladder into the ureter/kidneys
how is VUG diagnosed
VCUG and monitor by using serial US and VCUGs
what is the treatment of VUR
mild to mod: often resolves spontaneously
severe: requires surgical intervention
