In exercise-induced hematuria, one of the following is TRUE

Correct Answer: B

Rationale: In exercise-induced hematuria, the correct answer is B) no dysuria. This is because exercise-induced hematuria typically presents with blood in the urine without associated pain or discomfort during urination. This is a key distinguishing feature of this condition. Option A) stating that blood clots are rarely seen in urine is incorrect as clots can be present in exercise-induced hematuria, especially following intense physical activity. Option C) mentioning abnormal findings on cystoscopy is also incorrect as in exercise-induced hematuria, cystoscopy typically reveals normal bladder and urethral anatomy. Option D) resolution after 7 days is incorrect because exercise-induced hematuria usually resolves spontaneously within 48 to 72 hours after the cessation of strenuous exercise. In an educational context, understanding the characteristics and presentation of exercise-induced hematuria is crucial for healthcare providers, especially those working with pediatric populations. By knowing the typical features of this condition, healthcare professionals can make accurate diagnoses, provide appropriate reassurance to patients and parents, and recommend proper management strategies. This knowledge also helps in differentiating exercise-induced hematuria from other more serious urological conditions, ensuring timely and effective care for pediatric patients.

Correct Answer: C

Rationale: In pediatric nephrotic syndrome, steroid-resistant nephrotic syndrome is defined as the failure to achieve remission after 8 weeks of corticosteroid therapy (Option C). This is because nephrotic syndrome in children typically responds to corticosteroid therapy within the first 4-6 weeks of treatment. If remission is not achieved after 8 weeks, it suggests resistance to steroids. Option A (4 weeks) is too early to determine steroid resistance as some cases may take longer to respond adequately. Option B (6 weeks) is closer to the typical timeframe for response but may still not provide enough time for a full assessment of steroid resistance. Option D (10 weeks) is too long to wait for a response and may delay the implementation of alternative treatment strategies if resistance is indeed present. Educationally, understanding the timeframe for assessing steroid resistance in pediatric nephrotic syndrome is crucial for healthcare providers managing these patients. It helps in timely identification of cases that need alternative treatment options to improve outcomes and prevent complications associated with uncontrolled disease activity.

Correct Answer: D

Rationale: In this question, the correct answer is D) proximal RTA---gentamicin. Proximal renal tubular acidosis (RTA) is not typically associated with gentamicin use. Gentamicin is more commonly associated with nephrotoxicity and acute tubular necrosis rather than RTA. A) proximal RTA---trimethoprim: Trimethoprim is known to cause proximal RTA by inhibiting the secretion of organic acids in the proximal tubule. B) distal RTA---amphotericin B: Amphotericin B can cause distal RTA by impairing the distal tubular acid secretion. C) hyperkalemic RTA---cyclosporine: Cyclosporine can lead to hyperkalemic RTA due to its effects on renal tubular function. Educationally, understanding the relationship between specific medications and renal tubular acidosis in pediatric patients is crucial for pharmacology knowledge and clinical practice. It is essential for healthcare providers to be aware of potential adverse effects of medications on renal function in order to provide safe and effective care for pediatric patients with GU disorders.

Correct Answer: B

Rationale: The correct answer is B) nephrolithiasis. Medullary sponge kidney is a condition where there are cystic dilations in the collecting ducts within the renal medulla. These dilations can lead to the formation of kidney stones (nephrolithiasis). This condition predisposes individuals, including children, to the development of kidney stones due to the altered structure of the kidney tissue. Option A) cystic dilation of the proximal tubule is incorrect because medullary sponge kidney affects the collecting ducts, not the proximal tubules. Option C) proximal renal tubular acidosis is incorrect as this condition involves dysfunction of the proximal renal tubules in the reabsorption of bicarbonate. Option D) concentrated urine is not the defining characteristic of medullary sponge kidney; rather, it is the cystic dilations leading to nephrolithiasis. Educationally, understanding pediatric GU disorders, such as medullary sponge kidney, is crucial for healthcare professionals working with children. Recognizing the clinical presentations and complications of these conditions is essential for accurate diagnosis and management. By differentiating between various renal disorders, healthcare providers can offer appropriate treatment and preventive strategies to improve patient outcomes.

Correct Answer: D

Rationale: In pediatric GU disorders, grading vesicoureteral reflux (VUR) is crucial for proper management. Grade V reflux is the most severe form, characterized by complete obliteration of the ureterovesical angle with massive reflux into the renal pelvis (option D). This means that urine refluxes all the way back to the kidney, posing a high risk of renal damage and urinary tract infections. Option A is incorrect because mild dilatation of the ureter with minimal blunting of the ureterovesical junction is more indicative of lower-grade reflux. Option B is also incorrect as moderate dilatation with some tortuosity suggests a lower grade of reflux compared to Grade V. Option C is incorrect as severe dilatation of the ureter with marked tortuosity and calyceal distortion is typically seen in Grade IV reflux, which is less severe than Grade V. Understanding the grading system of VUR is essential for healthcare professionals caring for pediatric patients with urinary issues. Proper identification of the severity of reflux guides treatment decisions, such as whether to pursue surgical correction or opt for conservative management. Recognizing the characteristics of each grade helps in providing appropriate care and preventing long-term complications like renal scarring.