GU Flashcards
work up for prenatal hydronephrosis?
VCUG and US in 1st month (on day 1 UOP very low, so may look normal)
Most common cause of prenatally diagnosed hydronephrosis
UPJ obstrx
major risk for undescended testes?
infertility.
Risk of ca 5x, but still very rare
infertility is 10% in unilat, 40% bilat
Test for ? rectractile testis?
HCG stim test (used to be used for tx), can re-examine (not urgent), but should follow because they can ascend too
when to do surg for undesc testes? Success best for what location of testes?
6-12 mos, 90% success if inguinal. Less if abdominal
approach if can’t palpate testis
Treatment?
check baseline gonadotropins and can do HCG stim test
if they are missing, gonadotropins high and stim test neg…
IF they are there… NEED laparoscopy
blue dot hard tender nodule and big swollen testicle in young boy with incr pain over 1-3 days
torsion of appendix testes, tends to resolve over 7-10 days with NSAIDs
TReatment of phimosis
steroid cream, sometimes prepuciotomy or circ
inflammation of prepuce and glans and how to treat?
balanoposthitis
respond to topical steroids or topical or enteral abx…
what is paraphimosis?
looks like swelling and circ in kid NOT circed. Usu iatrogenic (left retracted, then swelling distally)
when to repair hypospadias?
6-12 mos
treatment of overactive bladder med? dose?
oxybutinin
0.5mg/kg/day div TID
or 0.5mg/kg single dose XL
*ANticholinergic
Drug/Treatments you can use for bedwetting?
Desmopressin prn up to 3 tabs QHS +/- oxybutinin if failure
imipramine continuously but s/e. 25-75mg (last resort)
Collection of fluid in uterus/retained menstrual blood
Hydrometrocolpos from imperforate hymen
Type of hypospadias that does not require intervention
distal
4 syndromes assoc w/ hypospadias
SLOB Silver Russel Laurence Mood Biedl Opitz Beckwith Wiedemann
Size of micropenis and two syndromes to consider if micropenis
micropenis <2.5cm (1 in)
Kallman
Prader Willi
unilateral pain, dysuria, fever, no testicular mass but low lying testicle, no urethral d/c
dx? test? tx?
epididymitis
maintained cremaster
WBC in urine
IM CTX, PO Doxy
when should foreskin be fully retractile
after age 3
flesh colored verrucous lesions that are non tender but bleed easily
conduloma acuminata (Venereal warts) - HPV
whitish-grey papules coalesced in genital area, flat with systemic sx including fever
condyloma lata, 2ary syphilis
red, crusted suprapubic macules, blue grey dots (maculae cerulea)
pediculosis pubis: crabs
size of ovarian cyst that requires intervention
> 6cm
