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Jaundice, hypothermia, sepsis, vomiting, lethargy, abdominal distention in neonates.
UTI
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Malaise, irritability, poor feeding, fever, vomiting, malodor, dribbling, abdominal pain in infants.
UTI
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Altered voiding, malodor, abdominal or flank pain, vomiting, enuresis, fever, diaper rash in toddlers or preschoolers.
UTI
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Dysuria, frequency, urgency, malodor, enuresis, abdominal or flank pain, vomiting, fever, chills, malaise 5yrs - 18 yrs
UTI
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What 3 things should make you think UTI with babies?
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What is the most accurate way to test for UTI in kids (esp who are not potty trained)? Second best?
- suprapubic aspiration
- sterile catheterization
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What is needed to dx a UTI?
presence of at least 50,000 CFUs per mL of a single pathogen
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When should you retest for UTI?
After finishing abx, so around day 12
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Most common abnormality found in kids with UTI.
Vesicoureteral Reflux (VUR)
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_________ is the most common abnormality that contributes to pyelonephritis.
VUR
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Workup for VUR
- ultrasound
- VCUG
- sometimes nuclear scan (less radiation than VCUG)
- sometimes IV pyelograms if VCUG is (+)
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Tx for VUR?
- Most will outgrow; grade 5 will not usually resolve
- (refer to nephrology)
- Grades 1-2 resolve spontaneously in 85%
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Most common malignancy of GU in kids.
Wilms tumor
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Wilm's tumor is usually dx by what age? What is the peak age?
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Fever, dyspnea, v/d, wt loss, malaise, large belly, firm, smooth abdominal mass.
Wilm's tumor
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When should a baby with cryptoorchidism be referred to urology?
if hasn't resolved by 6mos
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Cryptoorchidism should be repaired by _________ to prevent fertility problems.
2 yrs old
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A foreskin that is too tight to be retracted over the glans penis. When is this normal?
- Phimosis
- in uncircumsized males in first 6 yrs of life (primary)
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A retracted foreskin that cannot be reduced back to normal position.
Paraphimosis
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What is secondary phimosis?
foreskin cannot be retracted after previously being retracted
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inflammation of the foreskin and glans penis occurring with phimosis or in uncircumcised males
Balanoposthitis
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inflammation of the glans
Balanitis
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Elevation of the testicle will decrease pain with _________ and increase pain with _______; both of these are surgical emergencies.
- testicular trauma
- testicular torsion
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What, on microscopy, is specific for pyelonephritis? Glomerulonephritis/glomerular damage?
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Gold standard testing for proteinuria.
- 24-hr urine
- 24-hr protein to cr ratio
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Define hematuria.
3 or more RBCs per HPF from 2 or more urines
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Medical conditions that are RF for UTI.
- Diabetes
- Urinary tract calculi
- Catheterizations
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Complicated UTI is if someone has had symptoms how long?
> 7 days
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Most common cause of sepsis.
UTI
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Most common complication of UTI.
pyelonephritis
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Most common bacterial infection in older adults.
UTI
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What foods contain purines?
meat, seafood, organ meats
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What food & drinks contain oxalates?
- colas, tea
- chocolate
- beans
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