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Y5 Paediatrics > Genitalia > Flashcards

Genitalia Flashcards

1
Q

What is pathophysiology for inguinal hernia?

A

patent processus vaginalis

intestine emerges from deep inguinal ring through inguinal canal (indirect)

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2
Q

Why are premature babies more likely to get inguinal hernia?

A

tissues are weaker and more friable

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3
Q

what is the presentation of an inguinal hernia?

A

lump in the groin (extends onto scrotum/labia)

asymptomatic

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4
Q

What is an incarcerated hernia?

A

hernia that cannot be reduced (irreducible)

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5
Q

what is a strangulated hernia

A

intestine in hernia becomes ischaemic

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6
Q

what is management of hernia

A

taxis (compression in line with inguinal canal) with good analgesia)
surgery (once oedema has settled and child is well)

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7
Q

what is a hydrocele

A

patent processus vaginalis that allows peritoneal fluid to track down the testes

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8
Q

What is the clinical difference between hydrocele and hernia

A

you can get above a hydrocele

hydrocele transilluminates

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9
Q

What is management of hydrocoele under 2 yrs

A

NOTHING

should resolve spontaneously

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10
Q

What is mx of hydrocele >2 years

A

surgical repair, laparoscopic exploration

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11
Q

what is a varicocoele

A

scrotal swelling due to dilated testicular veins

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12
Q

what side is varicocele most common on

A

LEFT

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13
Q

what is the clinical presentation of varicocele

A

feels like BAG OF WORMS

dull ache

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14
Q

how do you manage varicocele

A

conservative if asymptomatic

otherwise can use surgical ligation

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15
Q

what is bilateral undescended testes

A

cryptorchidism

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16
Q

why is bilateral impalpable testes a medical emergency

A

because the karyotype must be CHECKED to exclude disorders of sex development

17
Q

what are risk factors for testicular torsion

A

undescended / bell clapper testes

18
Q

what are differentials for testicular torsion

A

torsion of appendix testis

epididimo-orchitis

19
Q

what is a medical cause of circumcision

A

balanitis xerotica obliterates
recurrent balanoposthitis
prophylaxis of UTI
if access to urethra is required regularly e.g. spina bifidA CATHETERISATION

20
Q

what is phimosis

A

inability to retract foreskin/ ballooning of foreskin during micturition

21
Q

how do you manage phimosis over / under 2 yo?

A

UNDER 2: physiological, should resolve with time (do NOT forcibly retract as it can cause scar formation)

OVER 2 + recurrent balanoposthitis/UTI: consider surgery

22
Q

what is the only condition that can cause true phimosis

A

balanitis xerotica obliterans

23
Q

what is balanitis xerotica obliterans

A

progressive scarring that extends onto glans, meatus and urethra
IT IS AN INDICATION FOR CIRCUMCISION

24
Q

what is paraphimosis

A

retracted foreskin cannot be reduced

it is an EMERGENCY, as it may compromise blood supply to glans

25
Q

How do you manage paraphymosis

A

manipulation with topical analgesia
puncture technique (perforating foreskin at multiple points to allow leakage of fluid)
surgical reduction, the circumcision

26
Q

what is hypospadia

A

failure of develoipment of ventral tissues of pnis

27
Q

what are three key features of hypospadia

A

ventral urethral meatus
ventral curvature of shaft of penis
hooded appearance of foreskin

28
Q

how do you manage hypospadia

A

surgery of cosmetic / functional grounds

ideally boys will be able to pass urine in straight line while standing and have a straight erection

NO CIRCUMCISION BEFORE REPAIR, as skin is important for repair

29
Q

How do you manage testicular torsion

A

Admit immediately to urology/paeds surgery
IV fluids, NBM, antiemetics, analgesia
Surgery within 4-6 hours to salvage the testicle: orchidectomy vs orchidopexy + fix contralateral testicle to the posterior wall

30
Q

What is the medical term for underscended testes

A

cryptorchidism

31
Q

what do you do if neonate presemnts with bilat undescended testes (and impalpable)

A

refer URGENTLY (24j)to senior paediatrician for genetic /endocrine testes

32
Q

How do you manage unilat undescended testes

A

Birth: arrange review. at 6-8 weeks
6-8 weeks: arrange review in 3 months
3m:
- descended but retractile > review annually as risk of ascending testes
- one testis still undescended > refer to paeds for surgey BEFORE 6 MONTHS

33
Q

What surgery is done for undescended palpable testes

A

Orchidopexy (placement of testis in scrotum)

34
Q

Why must an orchidopexy be carried out

A

Cosmetic
Reduced risk of trauma and torsion
Fertility
Malignancy (increased risk if undescended)

35
Q

What surgery is done for undescended NONPALPABLE tetes

A

laparoscopic inguinal surgical exploration

36
Q

How do you manage labial adhesions

A

Topical steroids / oestrogens to lyse the adhesions

Y5 Paediatrics (30 decks)

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