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Pediatrics Exam 2 > GU > Flashcards

GU Flashcards

1
Q

What is the most common form of Ambiguous genitalia?

A

46 XX DSD - Pseudohermaphroditism - Female inside and out but doesn’t look right

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2
Q

What is the common cause of Female Pseudohermaphroditism:

A

Congenital adrenal hyperplasia - enzyme def. cannot make cortisol and aldosterone from cholesterol - High levels of androgens

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3
Q

A baby with CAH and ambiguous genitalia can present to the ER in:

A

Shock - after birth (low aldosterone –> increased sodium resorption in the renal = hyponatremia and hyperkalemia)

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4
Q

What is the most common enzyme deficiency for CAH?

A

21-hydroxylase deficiency

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5
Q

What do you treat the CAH ambiguous genitalia with?

A

CAH-cortisol + mineralocorticoid (then testosterone or estrogen at puberty)

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6
Q

What is hypospadias, when is it corrected?

A

Ventral placement of urethra; corrected 4-18 months

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7
Q

What is commonly associated with hypospadias?

A
  • Ventral curvature (chorded)

- Undescended testes (9-30%)

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8
Q

How do you want to look for Crytochidism?

A

US but surgery is better - could be done before US

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9
Q

When is an orchiopexy done to get the undescended testicle and bring it down?

A

4-6 months

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10
Q

What are three complications of Cryptochidism?

A

Infertility, testicular cancer, torsion

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11
Q

What are the THREE acute issues with the testicle?

A
  • Testicular torsion
  • Torsion of the appendix testis
  • Incarcerated hernia
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12
Q

Most common surgical procedure in kids:

A

Hernia/hydrocele repair

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13
Q

What is the formation of a hydrocele?

A

Fluid within the tunica vaginalis - can be communicating or non-communciating

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14
Q

How do you differentiate between the hernia and the hydrocele?

A

US

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15
Q

A hydrocele does not need to be repaired unless:

A

It has persisted for over 1 year

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16
Q

When is the peak incidence for testicular torsion? Most common age!

A
  • Perinatal
  • Puberty

7-12 is the most common

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17
Q

Bell Clapper deformity:

A

When the tunica vaginalis is attached to the spermatic cord up top

18
Q

If there is still a positive cremasteric reflex, what can you be dealing with?

A
  • Appendix wrong

- Nothing wrong

19
Q

A blue dot on the pole of the testes can indicated:

A

Appendix testicular torsion

20
Q

If you have a testicular torsion, how long do you have to get to the operating room?

A

6-8 hours to save the testes

21
Q

If you know it is testicular torsion you can proceed to the:

A

OR (US is not needed first)

22
Q

Treatment for the torsion of the appendix testes and when should the pain resolve?

A
  • ICE and NSAIDS (tight/whiteies)

- Pain resolves in 5-10 d

23
Q

In early infancy, who are UTIs more common in:

A

Boys - uncircumcised (4-8x more)

24
Q

After three months, UTIs are more common in:

A

Girls

25
Q

A baby with a fever, check a:

A

UA!!!!!

26
Q

What bacteria accounts for 80-90% of first UTI infections?

A

E. coli

27
Q

What is the anatomical abnormality with Vesicoureteral reflux?

A

Uterovesical junction abnormality

28
Q

VUR patients are at higher risks for ___ d/t ___ but it should ___

A

UTIS due to urine left in the bladder; should spontaneously resolve

29
Q

You can rule out a UTI only if bag urine on an infant is:

A

Negative - positive test does not rule in

30
Q

If an infant is under two months and the child is vomiting with a UTI, how do you treat?

A

IV ABX and admission to hospital - 3rd gen cephalosporin

31
Q

If a child is over 2 months and not vomiting but has a fever you treat with:

A

Oral ABX for 10 days - 3rd gen cephalosporin

32
Q

If a child is over 2 months and not vomiting and does not have a fever, you treat with:

A

Oral ABX for 5 days - 3rd gen cephalosporin

33
Q

What do you image with on a child’s first and second febrile UTI:

A

First: Renal and bladder ultrasound
Second: Voiding Cystourethrogram

34
Q

What is the most common complaint of prepubescent girls?

A

Vulvovaginitis

35
Q

What is the bacterial cause of vulvovaginitis 20% of the time?

A

Group A Hemolytic strep

36
Q

When is leukorrhea common in girls?

A

6-12 months before their period; after tanner stage III is hit

37
Q

What type of discharge is seen with Group A strep infection in the vagina?

A

Serosanguinous

38
Q

For UTI management, what guidance can you give for baths?

A

Warm sitz; BID, pretzel legged, no washcloth

39
Q

You can treat vaginal labial adhesions with:

A

Topical estrogen if it is painful or deflects the stream of urine

40
Q

When do you see labial adhesions?

A

Young children and 2 years - Poor perineal hygiene with inflammation

Pediatrics Exam 2 (7 decks)

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