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Peds > GU > Flashcards

GU Flashcards

1
Q

Inability to retract foreskin

A

phimosis

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2
Q

At what age can you physiologic ability to retract foreskin

A

Birth(4%)
10yo(50%)
12yo(99%)

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3
Q

Pathologic causes of retractable foreskin

A
  • Early forcible retraction

* Fibrosis secondary to infection

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4
Q

Sxs of phimosis

A
  • Inability to retract foreskin after previously being retractable
  • Painful erection
  • Bleeding/irritation
  • Dysuria
  • Recurrent infections
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5
Q

Tx phimosis

A
  • Stretching exercises
  • Topical corticosteroid
  • Circumcision
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6
Q

Phimosis pt educ

A
  • Dont retract 6mo
  • Clean w/ mild soap & water
  • Return foreskin to natural position
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7
Q

Retracted foreskin in uncircumcised male that can’t be returned to natural position

A

Paraphimosis (EMERGENT)

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8
Q

Pathophys of paraphymosis

A

Entrapment -> impaired venous flow -> engorgement -> arterial compromise

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9
Q

Causes of paraphimosis

A
  • Forcible retraction
  • Infection/inflammatin
  • GU procedure
  • Sexual activity/trauma
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10
Q

Sxs paraphimosis

A
  • Swelling
  • Pain
  • Irritability (infant)
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11
Q

Exam findings paraphimosis

A
  • Edema & tenderness of glans
  • Painful swelling of retracted foreskin
  • shaft unaffected
  • color change if ischemia present
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12
Q

Tx paraphimosis

A
  • Manual reduction

* Surgical intervention by urology

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13
Q

Surgical removal of foreskin

A

Circumcision

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14
Q

6 step circumcision procedure that leaves glans exposed during recovery

A

Gomco

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15
Q

3 step circumcision procedure that leaves plastic covering on glans during recovery

A

Plastibell (preferred by moms)

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16
Q

Congenital ventral displacement of urethra (looks like it is sucked back in)

A

Hypospadias

17
Q

When is hypospadias Dx made

A

New born exam

18
Q

Exam findings

A
  • Abn foreskin
  • Abn penile curvature (chord)
  • Second opening
19
Q

Further eval for hypospadias/chordee

A
  • Family Hx
  • Normal penile length (2.5-3.5cm)
  • Check for penile curvature
  • Look for disorders of sexual devt
20
Q

Tx Hypospadias/Chordee

A
  • Urology (surgical repair at 6mo)

* DONT CIRCUMCISE DURING NEW BORN PERIOD

21
Q

Testes not within scrotum and hasn’t spontaneously descended by 4mo

A

Cryptorchidism

22
Q

Cryptorchidism increases risk of

A
  • Testicular torsion
  • Subfertility (correct by 1yo)
  • Testicular cancer
23
Q

Cryptorchidism terminology

A
  • Absent (agenesis/atrophy)
  • Undescended (stopped short along path)
  • Retractile (overactive cremasteric reflex)
  • Ascending testes
  • Ectopic
24
Q

Clinical presentation of cryptorchidism

A

Absent uni/bilat testicle w/ flat scrotum

25
Q

Cryptorchidism exam

A
  • Check if unilat/bilat

* Check if testicle is palpable in canal (watch and wait)

26
Q

Cryporchidsm Tx

A
  • Spontaneous decent 6mo
  • Refer if;
  • non-palpable undescended testes
  • Ascending testes beyond infancy
  • Atrophic testis
  • Difficulty differentiating bt undescended, retractile, ectopic
27
Q

Twisting of spermatic cord due to poorly anchored testicle -> vascular compromise

A

Testicular torsion (EMERGENT)

28
Q

Peak incidence of testicular torsion

A

Neonatal period, puberty

29
Q

Neonatal testicular torsion

A

Extravaginal

30
Q

Testicular torsion Sxs

A
  • Abru and tept onset of severe scrotal pain (may radiate)
  • Constant pain
  • Nausea & vomiting
31
Q

Exam findings of testicular torsion

A
  • Edematous erythematous scrotum
  • Slightly elevated & tender
  • Absent cremasteric reflex
  • Negative Prehn’s sign (relief of pain when you elevate scrotum)
32
Q

Dx Testicular torsion

A
  • Hx and physical

* Doppler ultrasound (confirmatory test)

Peds (11 decks)

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