Enuresis and Bladder Dysfunction in Children – 18 Board-Style Cases

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What this deck covers

Enuresis, Bladder Dysfunction and General Nephrology in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

  1. Wet at night, dry all day
  2. The trip is in three weeks
  3. A seizure after the party
  4. The bowel behind the bladder
  5. Dry for years, wet again
  6. Urgent, frequent, and emptying fine
  7. A dimple and a clumsy gait
  8. Wet just after the toilet
  9. Protein on the school dipstick
  10. Puffy, with a clean urine
  11. Contrast in a nephrotic child
  12. What is safe on steroids
  13. One kidney and a rugby pitch
  14. Whether she needs a biopsy
  15. Three insults at once
  16. The child who needs nothing
  17. Which of the four to refer
  18. When to stop the alarm

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A urinary tract infection, needing antibiotics, An anticholinergic such as oxybutynin, A febrile convulsion unrelated to the drug, Start desmopressin for the night wetting, Check a blood glucose, Desmopressin at night, A bladder diary and reassurance for the family, An ectopic ureter, Refer urgently for a renal biopsy, The absence of blood in the urine, Give N-acetylcysteine, All vaccines can be given as normal, Allow any sport with no discussion needed, Yes, because she is under five years of age.

Clinical pearls from this deck

  • Enuresis is not diagnosed before five years, and it is never the child’s fault.
  • An alarm cures slowly; desmopressin works tonight. Match the treatment to what the family needs.
  • The fluid restriction is the whole safety net for desmopressin; without it the drug causes seizures.
  • Treat the bowel before the bladder; it is the commonest reason bladder treatment fails.
  • Secondary enuresis is a symptom, not a diagnosis; check the glucose before anything else.
  • Check the post-void residual before any anticholinergic, or you will make the emptying worse.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all nephrology case decks · pediatric reference values.

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