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Surgery II > congenital anomalies of the urinary tract > Flashcards

congenital anomalies of the urinary tract Flashcards

1
Q

what is vesicoureteric junction reflex?

A

retrograde flow of urine into upper urinary tract

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2
Q

which sex is more affected by VUR?

A

females

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3
Q

describe grade 1, 2 & 3of VUR.

A

grade 1: flow into non dilated ureter
grade 2: flow into non dilated pelvis and calyces
grade 3: mild to moderate dilation of the ureter and renal pelvis

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4
Q

describe grade 4&5 of VUR.

A

grade 4: moderate dilation and/or tortuosity of ureter
grade 5: severe dilation and toruosity of the ureter renal pelvis and calyces

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5
Q

what is the gold standard imaging for VUR?

A

micturition cystourethrography

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6
Q

what is diuretic renal scan DMSA used for?

A

visualizes scarring and assess renal function

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7
Q

what is the treatment for grades 1&2 VUR?

A

prophylactic antibiotics

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8
Q

what is the treatment for grades 3-5 VUR?

A

surgery–> uretherovesical reimplantation or endoscopic injections

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9
Q

when is surgery indicated for VUR?

A

patients with persistent reflux despite antibiotic trials

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10
Q

urethras duplication—->

A

frequent anomaly

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11
Q

what is the male to female ratio in duplication of the urinary system?

A

1:2

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12
Q

what is Weigert-Myer Law?

A

urethras orifice of upper renal segment drains inferiorly and medially to the orifice of the lower segment

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13
Q

which orifice is commonly obstructed in duplication of urinary system?

A

orifice draining the upper segment

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14
Q

which orifice commonly refluxes in duplication of urinary system?

A

orifice of the lower segment

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15
Q

how is duplication of urinary system discovered?

A

MRU

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16
Q

Define ectopic ureter?

A

ureter opening in another location and not in the bladder

17
Q

what is the percentage of ectopic bladder occurring with duplication of urinary system?

A

80%
20% with single system

18
Q

how does ectopic bladder present in females

A

incontenence

19
Q

what are the common site of ectopic bladder in females?

A

vestibule vagina urethera

20
Q

what are the common site of ectopic bladder in males?

A

posterior urethera
seminal vesicles

21
Q

define ureterocele

A

congenital cystic balloting of the terminal submucosal ureter

22
Q

what are the 2 types of ureterocele? and describe both.

A

simple–> in trigon
ectopic–> obstructor the bladder neck or prolapse from female urethera

23
Q

what is the incidence of undescended testis in full term boys?

A

3.4%-5.8%

24
Q

what is the cause of undescended testis?

A

unclear but androgens may have an important role

25
Q

what are the different location of undescended testis?

A

upper scrotum
superficial inguinal pouch
inguinal canal
abdomen

26
Q

in the majority of the patients where will the testis be palpable?

A

in 80% of patients testis will be palpable in the inguinal canal

27
Q

what are the different locations of ectopic testis?

A

perineal
retrovesicular
femoral
penile

28
Q

what are the complications of undescended testis?

A

sub fertility
increased risk of testicular cancer upto 10 times

29
Q

when is spontaneous descend of testis is rare?

A

after 1 year old

30
Q

what are the investigation for undescended testis?

A

examination is more accurate than imaging
imaging: US-CT-MRI (not accurate)

31
Q

what are the investigations for bilateral undescended testis?

A

chromosomal and endocrine studies

32
Q

what are the fertility percentages in patients who had surgery for uni/bilateral undescended testis?

A

unilateral: 90%
bilateral: 60%

33
Q

what are the surgeries for undescended testis?

A

orchidopexy–> for palpable in inguinal canal or below
orchidectomy–> for atrophic intra abdominal testis which is uncapable of spermatogenesis and has a high risk of malignancy

34
Q

what is the investigation for impalpable testis?

A

Laproscopy

35
Q

which 2 hormones are elevated in congenital adrenal hyperplasia?

A

17 hydroxyprogesterone
testosterone
low levels of cortisol

36
Q

describe genitalia in congenital adrenal hyperplasia?

A

virilization of external genitalia
normal internal genitalia

37
Q

what are the investigations for congenital adrenal hyperplasia?

A

karyotyping
hormone profile
no laproscopy

38
Q

what is the surgery for congenital adrenal hyperplasia?

A

early feminizing genitoplasty

Surgery II (4 decks)

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