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Paediatric

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Renal System

Question
37 out of 61
 

A five year old male child presents with complaints off ever and abdominal distension He is having vomiting for the last five days. On examination there are 6-8 Pus Cell/hpf in urine. WBC count shows 78% neutrophils. What is the best line of management -(AIIMS Nov 2012)



A Send urine for culture and sensitivity and wait for results

B Send urine for culture and sensitivity and start I.V. antibiotics immediately

C Send urine for culture do an USG and start chloroquine

D Radio nucleotide studies

Ans. B

Send urine for culture and sensitivity and start I.V. antibiotics immediately

Clinical manifestations of UTI

Three basic forms of UTI are -

a. Pyelonephritis

o Abdominal pain or flank pain o Nausea and vomiting o Malaise

o Fever o Abdominal distension

b. Cystitis

o Dysuria o Frequency o Incontinence

o Urgency o Suprapubic pain o Malodorous urine

c. Asymptomatic bscteriuria

o Positive urine culture without any symptoms.

Coming back to question -

a. Fever, vomiting, abdominal distension with 6-8 pus cells/hPfin urine suggest the diagnosis of UTI, more specifically pyelonephritis.

b. The investigation which almost confirms the diagnosis of U.T.I is presence of 6-8 puscells / high power field.

c. "The presence of pyuria (>5 white blood cells/ high power field) is consistent with urinary tract infection."

d. Once U,T.I. is suspected, urine specimen is sent for culture and treatment started:

Don't wait for results of the culture.

Renal System Flashcard List

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