GU dysfunction

  1. Production of this helps the regulation of BP. Its release is stimulated primarily by decrease of pressure in the afferent arterioles of the glomerulus.
    Renin
  2. Release of erythropoietin stimulates the production of this in the bone marrow
    RBC
  3. The shorter urethras in infants have increased risk of this
    UTI
  4. By how many months will an infant have kidney function close to an adult?
    6-12 months
  5. In premature infants,, the reabsorption of these 4 solutes are reduced.
    • glucose
    • sodium
    • bicarbnate
    • phosphate
  6. In the first few weeks of life, why are the kidneys unable to concentrate urine efficiently?
    Because the loops of Henle arenot yet long enough to reach the inner medulla, where concentration and reabsorption occur
  7. When can the kidneys of an infant have the ability to acidify the urine with that of an adult? 

    What do you have to look out for?
    After the first few weeks of life: icidosis d/t only a small increase in acid secretion
  8. Involuntary urination, especially by children at night.




    B.
  9. This term means hidden or obscure testis and generally refers to undescended testis. 




    D.
  10. This is a kidney disorder that causes your body to excrete too much protein in the urine




    D. .
  11. Fill in:

    __a__ is usually caused by damage to the clusters of small blood vessels in you kidneys that filter waste and excess water from your blood.

    It can increase risk of __b__ and __c__. 

    It will cause excretion of protein in the urine.
    • a. Nephrotic syndrome
    • b. infectons
    • c. blood clots
  12. Is this primary or secondary enuresis:

    Child never achieved bladder control
    Primary
  13. Is this primary or secondary enuresis:

    child achieved a period of bladder control, and is now having episodes of wetting
    secondary
  14. What are the FIVE main causes of secondary enuresis?
    • UTI
    • DI
    • Constipation
    • Pinworm infestations
    • Stressors (family disruption, sexual abuse, inadequate attention, etc.)
  15. Enuresis will have repeated involuntary urination after what age?
    5 years old
  16. What 4 tests are given with enuresis?
    • Urinalysis
    • Urine culture
    • Blood studies
    • Kidney fxn
  17. What do these meds do for Enuresis

    1. Tofranil or Desmopressin
    2. Oxybutynin (Ditropan)
    3. DDAVP
    • 1. Tofranil is a TCA antidepressant. It relaxes bladder muscle and lightens sleep. Given to child older than 5-6 y/o, before bedtime 
    • 2. Oxybutynin is an anticholinergic and antispasmodic that decreases uninhibited bladder contractions.
    • 3. DDAVP functions by increasing water permeability in renal tubular cells, which in turn decrease uin volume by increasing urine osmolality.
  18. This drug, given for enuresis, is a TCA antidepressant. It relaxes bladder muscle and lightens sleep. Given to child older than 5-6 y/o, before bedtime.



    A.
  19. This drug is an anticholinergic and antispasmodic that decreases uninhibited bladder contractions



    B.
  20. This drug functions by increasing water permeability in renal tubular cells, which in turn decrease urine volume by increasing urine osmolality.



    A.
  21. 90% of UTI is caused by this fecal bacterial contamination
    E. coli
  22. Fill in: in newborns, bacteria in the blood may seed the kidneys and produce ____.
    UTI
  23. This term is the backward flow of urine from the bladder into the kidneys. Normally, urine flows from the kidneys through the ureters to the bladder.
    VUR: prophylactic abx maybe given
  24. This complication of VUR is the dilation of the renal pelvis and the swelling of one or two kidneys.
    Hydronephrosis

    (VUR: This term is the backward flow of urine from the bladder into the kidneys. Normally, urine flows from the kidneys through the ureters to the bladder.)
  25. How is BP affected by VUR?
    There are HTN complications d/t scarring, which leads to renin-angiotensin system activation -> increased blood volume
  26. How many grades of VUR are there?
    5 grades
  27. T or F: With VUR, grades 1-4 may resolve spontaneously with growth/development
    False: 1-3
  28. How does endoscopic injection help with VUR management?
    Endoscopic injection of bulking maerial (deflux injctable gel) builds a protective wall inside the ureter to prevent black flow of urine. 
  29. What surgery can be done for harder cases of VUR?
    • Ureteral reimplantation is a surgery to fix the tubes that connect the bladder to the kidneys. 
    • The surgery changes the position of the tubes at the point where they join the bladder to stop urine from backing up into the kidneys.
  30. How many weeks in gestation do the testes usually descend? If not then or at birth, how long may it take up to?
    • 32-36 weeks gestation
    • If not at birth, then within a few weeks or up to 6 months
  31. What is an orchiopexy done for?
    It is a surgery to move an undescended (cryptorchid) testicle into the scrotum and permanently fix it there. Orchiopexy typically also describes the surgery used to resolve testicular torsion.
  32. Is this congenital anomaly of the penis hypospadias or epispadias?

    The urethral opening may be anywhere along the ventral side of the penis. It occurs 1/250 male births.
    Hypospadias
  33. Is this congenital anomaly of the penis hypospadias or epispadias?

    The urethral opening may be anywhere along the dorsal side of the penis. It occurs 1 in 121,000 live male births.
    Epispadias
  34. What is this anomaly in the GU tract?

    Collection of fluid in the scrotum




    D.
  35. What is this anomaly of the GU tract?

    Inability to retract the foreskin (beyond age 3)




    C.
  36. What is this anomaly of the GU tract?

    Rotation of the testicles that interrupts blood supply




    B.
  37. This anomaly of the GU tract is when the bladder is on the OUTSIDE of the body.
    Bladder extrophy
  38. In majority of infants with hydroceles (collection of fluid in scrotum), it will resolve in ___ months
    12
  39. If hydrocele with an infant doesn't solve by ___ months, it should be surgically repaired.
    12-18 months
  40. What is the tx for a fused labia?
    Topical estrogen cream for 2-3 weeks or until skin thins and labia seperate
  41. T or F: Fused labia rarely require surgical intervention
    True
  42. What is  ACUTE GLOMERULONEPHRITIS ? At what age range can it usually be seen in?
    An active inflammation in the glomeruli. It can usually be seen in ages 5-12.
  43. T or F: GAS infection is rarely seen in ages >3 years old.
    False: <3 years old
  44. Tests for a 7 year old child show high serum albumin, altered electrolytes, and reduced urine output can all indicate this
    Acute poststreptococcal Glomerulonephritis
  45. How Will you control BP with  Acute Glomerulonephritis ?
    • - administer meds to control HTN
    •  - restrict Na+ and Water
  46. A patient with which kidney disorder shows sgns of these:

    Severe proteinuria, hypoalbuminemia and severe edema.

    Why do these occur?
    Nephrotic syndrome: occurs because there has been an insult to the glomerular basement membrane
  47. What are causes of acquired nephrotic syndrome?
    systematic dz such as Lupus, heatitis, heavy metal poisoning, cancer
  48. How can these drugs help with Nephrotic syndrome?

    1. Prednisone
    2. Diuretics
    3. ACE inhibtor
    • 1. used to reduce remission
    • 2. Diuretics to reduce edema
    • 3. reduce proteinuria
  49. List tx for acute renal failure (5)
    • 1. Correct fluid and electrolyte imbalance
    • 2. strict I/O
    • 3. correct acid-base balance
    • 4. Nutrition consult
    • 5. dialysis
  50. What can these s/s indicate?

    acid base imbalance
    poor feeding/vomiting
    decreased appetite
    lethargy
    seizure
    Acute Renal Faiure
  51. Progress into ESRD is when glomerular filtration rate decreases to ___%
    10%
  52. List tx of ESRD
    • Modify diet
    • correct acid/base and electrolytes
    • hemodialysis
    • peritoneal dialysis
    • transplant
  53. List these 4 main renal failure manifestations
    • 1. Hypervolemia
    • 2. azotemia/urmia (a medical condition characterized by abnormally high levels of nitrogen-containing compounds (such as urea, creatinine)
    • 3. Build up of toxic substances
    • 4. Malnutritoin secondary to increased metabolic demands
  54. T or F: Children with renal failure will have a low serum potassium level, requiring intervention
    False: will have high serum K+ requiring intervention when the level reaches 6 mEq/L
  55. T or F: K+ will be restricted with renal failure
    True
  56. Why does acidosis occur with ESRD
    Results from poor renal acid excretion
  57. What are indications of dialysis in ARF? (acute renal failure)
    • severe fluid overload
    • pulmonary edema or CHF
    • severe HTN
    • metabolic acidosis
    • Hyperkalemia
    • blood urea nitrogen level higher than 120mg/dL
  58. What blood urea nitrogen level would indicate dialysis in Acute renal failure?
    >120mg/dL
  59. Nephrotoxins, Lupus, HUS, AGN, and pyeonephritis can all cause what?
    • Acute Renal Failure
    • AGN (Acute Glmoerulonephritis): active inflammation in the glomeruli
    • Pyelonephritis: potentially organ-and/or life-threatening infection that causes scarring of kidney
    • HUS (Hemolytic Uremic Syndrome): condition that affects blood and vessels, including vessels in kidneys
  60. 1. What can these s/s indicate:
    Fluid and electrolyte imbalance
    Increased BUN and Cr
    Acid-base imbalance
    Pallor
    HUS (GI symptoms)

    2. List tx
    • 1. Acute Renal Failure
    • 2. correct fluid and lytes, strict I/O, correct acid/base, Dialysis
  61. Fill in:
    Irreversible loss of kidney function can progress into __a__ when the glomerular filtration rate decreases to __b__%.

    This will require __c_ and eventually transplantation.
    • a. ESRD
    • b. 10%
    • c. dialysis
  62. Congenital anomalies (obstruction, VUR, renal dysplasia), AGN, pyelnoephritis, HUS.

    These diseases in children can all cause what? 

    (hint: it occurs in approx. 18/1 million children)
    CRF and ESRD
  63. What are the hypervolemic manifestations of renal failure?
    • Anasarca (extreme generalized edema)
    • HTN
    • Resp. and Heart failure
    • Hyponatremia (dilutional)
  64. 1. Will children with renal failure have a low or high potassium level?

    2. What level of K will require intervention?

    3. Will acidosis or alkalosis occur?
    • 1. High
    • 2. 6 mEq/L
    • 3. Acidosis from poor renal acid excretion
  65. T or F: Indications for dialysis in Acute renal failure is Metabolic acidosis and Hyperkalemia are not responsive to medications
    True
  66. Which form of dialysis is this:
    occurs through a surgically placed vascular access, such as a double-lumen central line

    a. Hemodialysis
    b. Peritoneal dialysis
    a.
  67. Which form of dialysis is this:
    A catheter is placed surgically and remains permanently in the abdomen.

    a. Hemodialysis
    b. Peritoneal Dialysis
    b.
  68. T or F: Hemodialysis is done 4-5 times a day. It can also be done overnight with a machine called a "cycler."
    False: Peritoneal dialysis
  69. T or F: Hemodialysis is typically done at a center 3 days a week, for 3-5 hours, and closely monitored by trained professionals.
    True
Author
edeleon
ID
335133
Card Set
GU dysfunction
Description
Exam 4 Lecture notes
Updated