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Prep4USMLE Forum » USMLE Step 2 CK Forum » Pediatrics Forum

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9 Posts

nadiabarati

10/09/06 - 12:53 PM

The mother of a newborn is concerned because he has not had a wet diaper during the first
24
hours of his life. The boy is the third child for this 26-year-old mother and 29-year-old father.
His siblings have no significant history. Prenatal care was appropriate and the mother says
that the infant's kidneys were "a little bit swollen" on prenatal ultrasound. There was no birth
trauma and no abnormalities were seen on initial examination at birth. Currently the infant
appears comfortable and there is no fever. Significant findings on physical examination
include
a palpable mass in the suprapubic area, consistent with a distended bladder. The remainder
of
the genitourinary examination is normal. Which of the following is the most appropriate next
step in the management of this infant?
A. Obtain a renal-bladder ultrasound
B. Order a retrograde urethrogram (RUG)
C. Perform voiding cystourethrogram (VCUG)
D. Place a urethral catheter to drain the bladder
E. Send the patient for surgery

ssrpk
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10/09/06 - 04:31 PM

i think if the obstruction were svere enough, then it wud caused oligomenorrhea and the whole bit!

now i am confused between b and d

i guess i'l go with D

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robin082006
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10/09/06 - 09:08 PM

I go with A

Before doing any intervention the problem is confirmed firstly.

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MHP
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10/09/06 - 09:30 PM

Sure A

kity
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10/14/06 - 03:19 AM

its not an emergency so we could do the investigation to know the cause for proper Mx

I will go with A

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kity
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10/14/06 - 03:20 AM

hey nadiabharti

whats the ans ??

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tolito
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10/17/06 - 03:36 PM

B.

the child has posterior urethral valve. an mcu is best but in this case where child is not voiding at all we cannot get that. next best will be the retrograde urethrogram whicxh should demonstrate the valve.

the bladder can also be drained at this procedure.

nadiabarati, what is the answer?

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krsna
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10/21/06 - 10:29 AM

i think i'll go with D

jvo_md
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11/08/06 - 02:39 PM

I'll go with A - renal-bladder US

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