Pediatrics - Nephrology And Urology

Front 1

cystitis presentation

Back 1

dysuria, urgency, frequency, suprapubic pain, no fever

Front 2

pyelonephritis presentation

Back 2

abdominal or flank pain, fever, malaise, nausea, vomit, diarrhea

Front 3

asymptomatic bacteriuria presentation

Back 3

positive urine culture without signs or symptoms

Front 4

urinary tract infection diagnosis

Back 4

urine culture from midstream collection shows >100,000 colonies or >10,000 if symptomatic
if not toilet trained then suprapubic or catheter collection

Front 5

urinary tract infection treatment

Back 5

cystitis --> amoxi, TMP-SMX or nitrafurantoin
pyelonephritis --> IV ceftriaxone OR ampicillin + gentamicin

Front 6

urinary tract infection follow-up

Back 6

urine culture 1 week after stopping antibiotics
ultrasound if there was fever for anatomy, abscess or hydronephrosis
obtain voiding cystourethrogram

Front 7

vesicoureteral reflux etiology

Back 7

abnormal backflow of urine from bladder to kidney when submucosal tunnel between mucosa and detrusor is absent
predisposes to pyelonephritis --> scarring --> reflux nephropathy --> proteinuria --> hypertension --> ESRD

Front 8

vesicoureteral reflux diagnosis

Back 8

VCUG for diagnosis and grading
renal scan for size and scanning; if scar --> follow creatinine

Front 9

vesicoureteral reflux treatment

Back 9

continous antibiotic prophylaxis
surgery if breakthrough UTI, new scars, failure to resolve

Front 10

obstructive uropathy presentation

Back 10

hydronephrosis
upper abdominal or flank pain
pyelonephritis
failure to thrive

Front 11

obstructive uropathy diagnosis

Back 11

palpable abdominal mass in newborn --> hydronephrosis or PCKD
can be diagnosed prenatally with ultrasound
obtain VCUG in all cases of congenital hydronephrosis

Front 12

obstructive uropathy treatment

Back 12

void bladder with catheter
IV antibiotics
surgical correction

Front 13

acute poststrep GN presentation

Back 13

1-2 weeks after GAS throat infection or 3-6 weeks after GAS skin infection
edema
hematuria
hypertension
proteinuria
flank pain

Front 14

poststrep GN diagnosis

Back 14

urinalysis --> RBC casts, proteinuria
low C3
best single test is anti-DNAse antigen OR positive throat culture OR increasing antibody titter

Front 15

poststrep GN treatment

Back 15

penicillin X 10 days
sodium restriction and diuresis
fluids
control hypertension with CCB, or ACEI
complete recovery in 95%

Front 16

IgA nephropathy

Back 16

most common chronic glomerular disease worldwide
hematuria + URI + proteinuria + hypertension
normal C3
treat blood pressure most importatnly

Front 17

Alport syndrome

Back 17

X-linked dominant nephritis
intermittent gross hematuria 1-2 days after URI
hearing deficits
ocular abnormalities (protrusion of lens into anterior chamber)

Front 18

hemolytic uremic syndrome presentation

Back 18

bloody diarrhea 5-10 days after infection
oliguria
hematuria
microangiopathic hemolytic anemia
thrombocytopenia
uremia

Front 19

hemolytic uremic syndrome treatment

Back 19

manage fluids and electrolytes
treat hypertension
total parenteral nutrition
early peritoneal dialysis
if O157:H7 is suspected NO ANTIBIOTICS

Front 20

infantile polycystic kidney disease presentation

Back 20

autosomal recessive
bilateral kidney enlargement with multiple cysts
may have Potter sequence
hypertension
oliguria
renal failure

Front 21

infantile polycystic kidney disease diagnosis

Back 21

bilateral flank masses in ultrasound in infant with pulmonary hypoplasia

Front 22

diseases with nephrotic syndrome

Back 22

minimal change disease
membranous nephropathy
membranoproliferative nephropathy

Front 23

nephrotic syndrome

Back 23

massive proteinuria
hypoalbuminemia
edema
hyperlipidemia

Front 24

minimal change disease diagnosis

Back 24

proteinuria
hypoalbuminemia <2.5 g/dL
hyperlipidemia
biopsy if hematuria, hypertension, heart failure or no response to treatment after 8 weeks

Front 25

minimal change disease treatment

Back 25

prednisone 4-6 weeks than taper out for 2-3 months
if severe --> albumin infusion + diuretic

Front 26

minimal change disease complications

Back 26

infections to pneumococcus and varicella
spontaneous bacterial peritonitis

Front 27

undescended testes

Back 27

should descend by 6 months
surgical correction to avoid seminoma

Front 28

testicular torsion

Back 28

acute testicular pain and swelling with tenderness to palpation
diagnosis --> Doppler
treatment --> emergency surgery

Front 29

undescended testes Vs. refractile testes

Back 29

refractile --> brisk cremasteric reflex in 1 y/o but can manipulate back into scrotum
undescended usually in the inguinal canal

Front 30

torsion of appendix testes

Back 30

gradual onset testicular pain in 2-11 y/o which naturally resolves in 3-10 days
diagnosis --> blue dot seen through scrotal skin; ultrasound if uncertain

Front 31

epididymitis

Back 31

ascending retrograde urethral infection with acute scrotal pain and swelling in adolescents
diagnosis --> pyuria in urinalysis
treat with bedrest and antibiotics

Front 32

varicocele

Back 32

abnormal dilation of pampiniform plexus presents with painless paratesticular mass
surgery if significant difference in size of testes, pain or if contralateral testis is diseased or absent

Front 33

testicular tumors

Back 33

palpable painless mass that does not transilluminate; 65% malignant
diagnosis --> ultrasound, serum AFP and beta-hCG
treatment --> radical orchiectomy