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Peds: GU/Renal
Peds GU Renal Exam 1
31
Anatomy
Graduate
02/21/2012

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Term
infant presentation with UTI:
Definition
- fever
- vomiting
- anorexia
- failure to thrive
- irritability
- asymptomatic jaundice
Term
Ages 2-5 UTI presentation:
Definition
- fever
- abdominal pain
- enuresis
- may have frequency/urgency
Term
ages 5 and older UTI presentation;
Definition
classic
Term
UTI in neonates:
Definition
group B strep
Term
MC UTI pathogens:
Definition
- E. coli
- Klebsiella
- Enterococcus
Term
UTI Risk Factors:
Definition
- Female, short urethra
- Uncircumscribed males
- Neonates
- Incomplete bladder emptying: neurogenic bladder, constipation, dysfunctional voiding
- Poor hygiene
- Sexual activity
- Catheterization
- Structural abnormalities of urinary tract (posterior urthral valves, vesicourethral reflux (VUR))
Term
child with UTI before age 6:
Definition
- has 20-40% chance of VUR
Term
Neurogenic bladder is associated with __ __. PE findings of this include:
Definition
- Spina Bifida
- sacral dimples, pits, sacral fat pad
Term
Birth to 30 days UTI workup:
Definition
- Admit
- UA
- Urine culture
- Blood cutlure
(have to do septic eval in theses pts)
Term
1 -24 months UTI evaluation:
Definition
- cath UA or suprapubic aspiration and urine culture
Term
older children UTI eval:
Definition
- mid-stream clean catch sample for UA and urine culture
Term
Dx of UTI:
Definition
culture showing greater than 10 to the fifth colonies/ml of single organism

if cathed specimen, greater than 10 to the second= ifnection
Term
UTI tmt options:
Definition
- TMP/SMZ
- Cefprozil
- Cefixime
- Amoxicillin
Term
peds uncompliticated UTI treat for :
Definition
7-10 days
Term
peds pyelonephritis treat for:
Definition
10 days (7-14)
Term
symptoms of glomerularnephritis:
Definition
- hematuria
- edema
- HTN
- oliguria
Term
Dx of Post-Strep Glomerularnephritis:
Definition
- UA: blood, protein, RBC casts
- Elevated ASO titer
- Decreased complement (C3, C4)
- Elevated Cr and BUN
Term
poststreptococcal glomerulnephritis tmt:
Definition
- decrease sodium
- diuretics
Term
With IgA Nephropathy aka Berger's Disease (MC glomerulonephritis world wide), ther is a __ __ __ with minor febrile illness (URI). Possible __ and __. There are IgA deposits in the __ of __.
Definition
- asymptomatic gross hematuria
- htn and edema
- msangium of glomeruli
Term
IgA Nephropathy Berger's Disease Dx:
Definition
- UA: blood and proteinuria < 1gm/day
- Elevated serum IgA
- Elevated BUN and Cr
- Normal complement levels
Term
tmt of Berger's disease:
Definition
- usually resolves within days- no tmt needed
- HTN or more significant proteinuria present> corticosteroids
Term
HSP symptoms:
Definition
- Rash
- Arthralgia
- Abdominal pain
- Bloody diarrhea
- Hematuria
- Possible HTN
Term
HSP dx:
Definition
- UA: hematuria, proteinuria < 2 gm/day
- Elevated serum IgA
Term
IgA Nephropathy aka Berger's Disease has proteinuria < 1gm/day whereas HSP has proteinuria < 2 gm/day.
Definition
Term
HSP tmt:
Definition
- corticosteroids for renal disease
Term
Hemolytic Uremia Syndrome UA:
Definition
- Proteinuria
- Anemia
- Thrombocytopenia
- Elevated bilirubin
Term
HUS presentation:
Definition
- prodrome of abdominal pain, diarrhea, and vomiting
- followed by HTN, edema, oliguria, and GI bleeding
Term
HUS tmt:
Definition
- supporitve
- maintain fliuds/electrolyes
- control HTN
- transfusion if necessary
Term
HUS follow up:
Definition
- monitor renal function 1-2 years
- monitor blood pressure 5 years
Term
patient education with HUS:
Definition
- avoid eating raw/undercooked meats
- educate about proper tmt of drinking water
- discuss proper hygiene
Term
Asymptomatic isolated microscopic hematuria in peds what do you do?
Definition
- first make sure its blood with microscopy
- second have pt repeat UA in one week, if still abnml> further eval
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