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Peds 3 GU/Gyn
Nova Orlando
92
Health Care
Graduate
05/04/2011

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Cards

Term
what kind of derformity happens when there's an abnormal attachment of the testis within the scrotum
Definition
Bell and Clapper Deformity
Term
torsion of the appendix of the testis is most common at what age?
Definition
2-11yo
Term
MCC of testicular pain in boys > 12yo
Definition
testicular torsion
Term
acute testicular pain and swelling, cremasteric reflex is absent, 2-3mm tender mass in upper pole, blue dot sign present when seen through the scrotum
Definition
testicular torsion
Term
test of choice for testicular torsion
Definition
color doppler sonography (CDS)
Term
what does radionuclide imaging of a testicular torsion show if present > 5 hrs
Definition
positive hot-dot sign
Term
tests to order for recurrent UTI/hematuria
Definition
UA and culture, suprapubic aspiration,
all children < 6yo should undergo renal US or VCUG
Term
when should a VCUG always be done?
Definition
all children 2mo-2yo after the first UTI
Term
DDx for recurrent UTI
Definition
Cystitis, Pyelonephritis, Vesicouretal reflux
Term
incidence of UTI's in males and females, how does this change with age?
Definition
males = less common due to long urethra.
females = much more common due to short urethra.
As kids age male UTI's decrease and female UTI's increase
Term
Tx of UTI inpt vs outpt
Definition
outpt if > 2mo, tolerate PO fluids, and non-toxic.
in pt if < 2mo, can't tolerate PO, toxic appearing and dehydrated.
Term
abx for UTI
Definition
septra, amoxicillin, cephalosporins
ceftriaxone, gantrisin, cefotaxime, ampicillin, or gentamycin
Term
UTI prophylaxis
Definition
circumcision helps, abx, cranberry juice is recommneded only to prevent not tx.
Term
dysuruia, urgency, frequency, suprapubic tenderness/pain, fever, flank pain
Definition
UTI
Term
abrupt onset fever, chills, nausea, abd pain and tender swollen testicle
Definition
orchitis
Term
acute testicular pain and swelling, absence of cremesteric reflex
Definition
testicular torsion
Term
type of PCKD that is rare, often fatal in 1st month of life
Definition
ARPCKD
Term
50% of pts with ARPCKD die from?
Definition
pulmonary hypoplasia
Term
complications of ARPCKD
Definition
hepatic fibrosis
Term
rx criteria for ADPCKD
Definition
2 cysts in 1 kidney and 1 cyst in the other
Term
MC PCKD
Definition
AD = late onset
Term
tx of ADPCKD
Definition
supportive, HTN control, genetic counseling,
low protein diet not necessary
Term
MCC of proteinuria
Definition
DM
Term
abdominal discomfort, hematuria, UTI, HTN, abdominal mass, mild proteinuria, polyuria/nocturia
Definition
PCKD
Term
asx, abdominal swelling, fever, hematuria, reduced appetitie, HTN, constipation, stomach pain, nausea
Definition
Wilms Tumor
Term
gastroenteritis, weakness, lethargy, vomiting, diarrhea, anemia, uremia
Definition
Hemoltyic Uremic Syndrome
Term
other names for minimal change disease
Definition
Lipoid Nephrosis or Nil Disease
Term
MCC of nephrotic syndrome in kids < 10 yo
Definition
Minimal change disease
Term
causes of minimal change disease (3)
Definition
food allergies, meds, idiopathic
Term
who is minimal change disease increased in?
Definition
Asians, M:F ratio = 2:1
Term
proteinuria, and edema usually preceeded by a URI, bee sting, drug use, or malignancy
Definition
minimal change disease
Term
what is the tx of minimal change disease?
Definition
prednisolone, BP meds (ACEI), statins
Term
MC urethral pathology
Definition
hypospadias (meatus may be anywhere along the urethral groove)
Term
complication of cryptorchidism
Definition
increased risk of infertility and malignancy (specifically seminoma)
Term
girls = normal reproductive organs, abnormal menstrual periods, excessive hair growth, failure to menstruate.
boys = appear to enter puberty at 2-3 yrs of age, small testes
Definition
congential adrenal hyperplasia
Term
how does congenital adrenal hyperplasia effect height?
Definition
boys and girls will be tall as children but short as adults
Term
newborn manifestations of CAH
Definition
cardiac arrhythmias, dehydration, electrolyte changes, vomiting
Term
ambiguous genetalia from chromosomal abnormality, presence of both male and female sex organs
Definition
hermaphroditism
Term
painful swelling of the foreskin distal to the phimotic ring, occurs if the foreskin remains retracted too long
Definition
paraphimosis
Term
lack of testes on testicular exam
Definition
cryptorchidism
Term
edema in the periorbital and scrotal region
HTN
anti-glomerular basement membrane antibodies
UA = RBC's, protein
Definition
acute glomerulonephritis
Term
nausea/vomiting, fever
dysuria
low back pain, fatigue
hyperkalemia, metabolic acidosis
kidney failure, proteinuria
Definition
acute interstitial nephritis
Term
3 phases of tubular necrosis
Definition
oliguric, diuretic, recovery
Term
when is renal recovery unlikely with tubular necrosis?
Definition
if the period of oliguria/anuria lasts 3-6 wks
Term
peripheral edema
dyspnea due to pulmonary edema
ascites
UA = proteinuria
serum albumin is decreased, lipids = increased
Definition
nephrotic syndrome
Term
1st MC bacterial cause of UTI
2nd MC bacterial cause of UTI
Definition
1 = e coli
2 = klebsiella
Term
who has little risk of internal vaginal infections? why?
Definition
prepubertal girls due to an unestrogenized genital tract
Term
dysuria, vulvar pain and itching, vaginal discharge
Definition
vulvovaginitis
Term
who is urethral prolapse MC in?
Definition
AA girls and obese school aged girls
Term
what precipitates urethral prolapse?
Definition
valsalva
Term
tx of urethral prolapse
Definition
tx the underlying disease
estrogen cream of tropical abx cream
oral analgesics
Term
chronic derm disorder preceeded by itching and mild watery discharge, small pink/whjite flat topped papular lesions appear on both cutanous and mucosal surfaces
Definition
lichen sclerosis
Term
when does lichen sclerosis of the genital region resolve?
Definition
with puberty
Term
lichen sclerosis in the genital region may raise concern for
Definition
sexual abuse
Term
vulva is intensely hyperemeic and a thick, cheesy, white discharge covers the urethra, introitus, and hymenal area
Definition
candidal vaginitis
Term
acute vulvar pain, dysuria, and discharge with a sharply circumscribed area of inflammation and desquamation
Definition
streptococcal vulvovaginitis
Term
painless indurated chancre, base is smooth and margins are rolled
Definition
primary syphilis
Term
flu like symptoms with generalized papulosquamous eruption involving the palms and soles
Definition
secondary syphilis
Term
DDx of breast mass complaint
Definition
fibrocystic changes, fibroadenoma, breast cancer
Term
if the vaginal orifice has lacerations or bruising suspect
Definition
sexual abuse
Term
risk factors involved in infants born to adolescent mothers
Definition
increased risk for LBW due in part to increased risk of pregnancy induced HTN and pre-eclampsia.
Increased risk of vertically transmitted STDs.
Term
What risks are involved in children born to mothers who are substance abusers
Definition
tobacco --> increased risk of LBW.
FAS --> distinct pattern of facial abnormalities, growth deficiency, and evidence of CNS dysfunction.
Marijuana --> withdrawal like sxs if used > 6x/week.
cocaine and other stimulants --> vasoconstriction = placental insufficiency and LBW.
Term
normal findings of the vaginal orifice
Definition
annular, crescentic, fibriated
Term
when is a pelvic exam indicated?
Definition
sexually active, abnormal vaginal discharge, pain/dysuria, severe dysmenorrhea, amenorrhea, oligomenorrhea, polymenorrhea, sexual contact with someone suspected of having an STD, suspected sexual abuse
Term
know normal PE findings in a newborn, prepubertal, and peripubertal girl
Definition
Term
when is endocrinologic referral indicated?
Definition
virilization noted in a newborn especially when accompanied by hyperpigmmentation = urgent endo referral
Term
MC form of genital tract obstruction
Definition
labial adhesions
Term
smooth flat membrane with a line overlying the introitus, fused portion is less than 1cm in length, rarely covers the urethral opening but urine can get trapped behind the fusion
Definition
labial adhesion
Term
tx for labial adhesions
Definition
topical estrogen cream BID x 2 wks then at night x 1 wk. may also use A&D ointment or triple antibiotic.
Zinc-oxide based cream at night x a few months to prevent re-adhesion
Term
SE of estrogen cream
Definition
hyperpigmentation of labia and areolae, increased breast tissue, estrogen withdrawal bleed, sxs resolve after stop tx.
Term
2 complications of imperforate hymen
Definition
hydrocolpos if infant has copious vaginal fluids.
hematocolpos due to neonatal withdrawal bleed or trauma
Term
when is imperforate hymen most commonly seen?
Definition
8-12 wks of age
Term
tx of imperforate hymen
Definition
incision of membrane to allow drainage, excision of redundant tissue
Term
it is not uncommon for one breast bud to appear how long before the other?
Definition
6 months
Term
preature thelarce is
Definition
breast development before age 8
Term
delayed thelarce is
Definition
absence of any breast development by age 13
Term
how do you assess a breast mass in an adolescent?
Definition
US
Term
when does breast development usually start? complete?
Definition
8-14yo, lasts approximately 4 yrs and is usually complete by 18yo
Term
what should be ruled out with premature thelarce (3)
Definition
estrogen producing ovarian tumors, ingestion of estrogen containing compounds, true precocious puberty
Term
when do the ovaries descent into the pelvis?
Definition
during puberty
Term
what speculum is ideal for virginal adolescents?
Definition
Huffman
Term
when does ACOG recommend the first pap smear?
Definition
age 21 or within 3 yrs of vaginal intercourse, whichever is sooner
Term
virilization in a newborn should prompt what?
Definition
immediately laboratory eval and urgent endocrinology consult.
Term
who should undergo rectal bimanual exam? (4)
Definition
pts with precocious puberty, suspected abdominal masses, suspected vaginal foreign bodies, abdominal pain
Term
with what disease is vaginal pH elevated? decreased?
Definition
elevated = BC, trich
decreased = candidal
Term
ectropian (eversion) of the endocervical columnar epithelium onto the cervical surface is
Definition
common and normal in adolescents
Term
urethral prolapse is often mistaken for
Definition
vulvovaginitis or trauma
Term
how is the tx of labial adhesions and urethral prolapse similar?
Definition
both use topical estrogen creams and topical abx creams.
Term
only cervical cancer vaccine that protects against 4 types of HPV (2 cancer, 2 warts)
Definition
Gardasil
Term
small pink-white, flat topped papular lesions that appear on both cutaneous and mucosal surfaces, may coalesce to form larger plaque like lesions that may have scaly surfaces
Definition
lichen sclerosus
Term
know PE exams findings of vaginal infections, trauma, sexual abuse, and normal pts
Definition
Term
causes of false positive pregnancy tests (4)
Definition
hydatiform mole, malignancy, post abortion, LH surge/elevations
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