All the following are causes of hematuria EXCEPT

Correct Answer: D

Rationale: In the context of pediatric genitourinary assessment, understanding the causes of hematuria is crucial for accurate diagnosis and management. In this case, the correct answer is D) hemoglobinuria. Hematuria refers to the presence of blood in the urine, and hemoglobinuria is the presence of hemoglobin in the urine. Hemoglobinuria can be caused by conditions such as hemolytic anemia, transfusion reactions, or certain infections, leading to the release of hemoglobin into the urine, not red blood cells as in hematuria. A) Acute cortical necrosis is a condition where there is ischemic necrosis of the renal cortex, leading to hematuria due to damage to the kidney's blood vessels. B) Urinary tract malformations can cause hematuria due to structural abnormalities in the urinary system, such as congenital anomalies or obstructive lesions. C) Trauma, including physical injury to the kidneys or urinary tract, can result in hematuria due to blood leakage from damaged tissues. Educationally, it is important for healthcare providers to differentiate between the various causes of hematuria in pediatric patients to provide appropriate treatment and follow-up care. Understanding the pathophysiology of each condition helps in making accurate clinical decisions and ensuring optimal outcomes for pediatric patients with genitourinary issues.

Correct Answer: B

Rationale: In evaluating a 3-year-old boy with minimal change nephrotic syndrome (MCNS) showing albumin +++ and RBC + on the genitourinary examination, the correct answer is B) 25%. In MCNS, the hallmark is massive proteinuria, leading to hypoalbuminemia, which can be detected by urine dipstick testing showing high levels of albumin. The presence of RBCs in the urine indicates hematuria, which can be seen in renal conditions like MCNS. Option A) 15% is incorrect as it does not account for the significant proteinuria seen in MCNS. Option C) 35% and D) 45% are both higher concentrations of albumin in the urine, which are not typically seen in MCNS. Educationally, understanding the significance of urine dipstick findings in pediatric patients with genitourinary issues like MCNS is crucial for accurate diagnosis and management. This knowledge helps healthcare providers interpret test results correctly and provide appropriate care for pediatric patients with renal conditions.

Correct Answer: D

Rationale: In pediatric patients with nephrotic syndrome and a history of thromboembolism, the correct choice of medication is Dipyridamole (Option D). Dipyridamole is a platelet aggregation inhibitor that works by preventing platelet adhesion and aggregation, reducing the risk of thrombus formation. This is crucial in a patient with a history of thromboembolism to prevent further clotting events. Warfarin (Option A) is not typically used in pediatric patients due to its narrow therapeutic window and the need for frequent monitoring, making it less favorable in this scenario. Lovenox (Option B) is a low molecular weight heparin that is also effective in preventing clotting but may not be the first choice in this case. Low-dose aspirin (Option C) is generally not recommended in pediatric patients with thromboembolism due to the risk of Reye's syndrome. In an educational context, understanding the rationale behind choosing Dipyridamole in this specific case enhances pharmacological knowledge in pediatric nephrology and thrombosis management. It underscores the importance of selecting appropriate medications based on the patient's condition, age, and previous medical history to optimize therapeutic outcomes and minimize risks.

Correct Answer: D

Rationale: In this case, the correct answer is D) Atypical HUS. Atypical hemolytic uremic syndrome (aHUS) is a rare but serious condition characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Unlike typical HUS, atypical HUS may present without the typical prodrome of diarrhea seen in infections like E.coli O157:H7 and Shigella. Option A) E.coli O157:H7 and B) Shigella are known causes of typical HUS, which is often preceded by gastrointestinal symptoms. Streptococcus pneumoniae, option C), is a common cause of bacterial pneumonia and meningitis but is not typically associated with HUS. Educationally, understanding the different etiologies of HUS is crucial for healthcare providers working with pediatric populations. Recognizing the atypical presentation of aHUS without diarrhea prodrome is essential for prompt diagnosis and management to prevent potentially severe complications like renal failure. Healthcare professionals must be aware of the diverse presentations of pediatric genitourinary conditions to provide optimal care.

Correct Answer: D

Rationale: In this case, the correct answer is D) insulin/dextrose. The baby boy developed anuria after undergoing intravenous pyelography (IVP) due to possible renal impairment following the procedure. Anuria can lead to metabolic acidosis, and insulin with dextrose is used to manage hyperkalemia, a potential consequence of renal impairment. A) Bicarbonate is not the correct choice in this scenario as anuria does not directly indicate a need for bicarbonate administration. B) Beta-agonists are not indicated for anuria or post-procedure renal impairment in this context. C) Diuretics would not be appropriate in a situation of anuria, as the patient is not producing urine and diuretics aim to increase urine output. Educationally, this question highlights the importance of understanding the pathophysiology of anuria and its management in pediatric patients. It emphasizes the need for healthcare providers to be familiar with appropriate interventions to address potential complications following procedures like IVP in infants, particularly when faced with acute renal issues. This case underscores the critical role of pharmacological knowledge in pediatric care and the significance of selecting the most appropriate treatment based on the patient's condition.