q14 - beth77

[ArchivalUser]

A 5-year-oldboy is brought to an inner city pediatric clinic because of daytime urinary incontinence. His mother is very frustrated because he has never been dry during the day and the kids at school constantly tease him. Further history taking reveals that he has had inconsistent medical care, but fails to reveal any psychologicalproblems. On physical examination,his blood pressure is 100/70 mm Hg. Both his weight and height are below the 5th percentile for his age. His bladder is enlarged and palpableabove the symphysis pubis. The remainder of the examinationis unremarkable. Which of the followingis the most likelycause of his problem?
Obstructive uropathy
Primary polydipsia
Reflux nephropathy
Sickle cell trait
Unstable bladder

[ArchivalUser]

obs. uro

[ArchivalUser]

Unstable bladder?

[ArchivalUser]

The correct answer is A. These findings suggest that this boy has bladder outlet obstruction. The most common cause of urethral obstruction in males is posterior urethral valves. It typicallyresults in urinary obstruction and vesicoureteralreflux. Its incidence is 1 in 5000-8000males. The degree of obstruction varies; therefore, the degree of renal failure also varies. It can range from mild hydronephrosis to renal dysplasia. Voidingcystourethrogram is the definitivediagnostic test.

[ArchivalUser]

Thanks, I thought Obstruction of the urinary tract will present as hydronephrosis or something. Thanks for correcting me.