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Nephrology and Urology > GU Problems > Flashcards

GU Problems Flashcards

1
Q

define hydrocele

A

an abnormal collection of fluid within the remnants of the processus vaginalis around the testes

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2
Q

describe a simple hydrocele

A

accumulation of fluid within the tunica vaginalis

in neonates is simply congenital but in adults, occurs due to trauma, torsion or tumour formation

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3
Q

describe a communicating hydrocele

A

persistence of the processus vaginalis to allow peritoneal fluid to communicate freely with scrotal portion of the processus

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4
Q

describe a non-communicating hydrocele

A

occurs due to imbalance between secretion and reabsorption of fluid

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5
Q

risk factors of hydroceles

A 
younger age 
FH of hydroceles 
connective tissue disorder
low birth weight 
trauma
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6
Q

clinical features of hydroceles

A

non-tender smooth enlargement of the scrotum

often transilluminates

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7
Q

investigations of hydroceles

A

US of scrotum

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8
Q

management of hydroceles in infants < 6mnths

A

watchful waiting as should self-resolve

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9
Q

indication for surgical management of hydroceles in infants

A

unresolved >12mnths
excessive discomfort
compromised scrotal skin
suspect underlying pathology

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10
Q

management of hydroceles in adolescents

A

reassurance and monitoring but if large and uncomfortable, consider surgery

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11
Q

management of hydroceles in asymptomatic adults

A

observation

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12
Q

management of hydroceles in symptomatic adults

A

aspiration and surgery

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13
Q

define testicular torsion

A

an event in which tissues around the testicles are not sufficiently attached, causing twisting around the spermatic cord which obstructs blood flow

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14
Q

describe intravaginal testicular torsion

A

torsion occurring secondary to lack of normal fixation of the posterior lateral aspect of the testes to tunica vaginalis

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15
Q

describe extravaginal testicular torsion

A

torsion of both the spermatic cord and tunica vaginalis together

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16
Q

clinical features of testicular torsion

A

sudden onset unilateral testicular pain causing swollen erythematous appearance
nausea and vomiting

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17
Q

signs of testicular torsion

A

high rising scrotum
unilateral absence of cremaster reflex
no pain relief on testicle elevation (-ve prehn’s sign)

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18
Q

management of testicular torsion

A

expedited surgical exploration and orchidoplexy

19
Q

define varicocele

A

a scrotal swelling consisting of an abnormal collection of dilated veins of the pampiniform plexus of spermatic cord

20
Q

describe subclinical and Grade I varicoceles

A

subclinical: detect only on Doppler US

Grade I: small and detected only on Valsalva manoeuvre

21
Q

describe Grade II and Grade III varicoceles

A

Grade II: moderate size and palpable without Valsalva

Grade III: large size and visible through scrotal skin

22
Q

clinical features of varicoceles

A

painless scrotal swelling
scrotum feels like “bag of worms”
feelings of scrotal heaviness

23
Q

investigations of varicoceles

A

colour Doppler studies
thermography
sperm counts

24
Q

management of subclinical or Grade I varicoceles in adolescent and adults

A

no treatment and annual examinations + sperm counts (in adults)

25
Q

management of Grade II and Grade III varicoceles in adolescent and adults

A

refer to urology

26
Q

common scrotum affected in varicocele cases

A

left

27
Q

define phimosis

A

inability of the foreskin to retract over the glans penis due to tightness of the foreskin

28
Q

clinical features of phimosis

A 
issues retracting foreskin 
painful erections 
poor urine stream 
ballooning of foreskin of micturition 
recurrent balanitis
29
Q

management of phimosis in patients < 2yrs

A

reassurance
advise against forceful retraction
advise good hygiene

30
Q

management of phimosis in patients >2yrs

A 
topical corticosteroid (e.g. Betamethasone) 
vertical incision
31
Q

define paraphimosis

A

an inability of retracted foreskin to return to its original anatomical location due to glans penis swelling

32
Q

clinical features of paraphimosis

A

unmoveable foreskin
swelling and pain of the penis
discolouration of the penis

33
Q

conservative management of paraphimosis

A

gradual manual reduction using topical or local anaesthetic

34
Q

surgical management of paraphimosis

A

dorsal slit reduction therapy

35
Q

last resort of phimosis and paraphimosis management

A

circumcision

36
Q

define cryptorchidism

A

an incomplete descent of one or both testes from the abdomen through the inguinal canal, causing absence from the scrotum

37
Q

risk factors of cryptorchidism

A 
FH of undescended testes 
low birth weight 
preterm delivery 
endocrine disorder 
maternal smoking
38
Q

clinical features of cryptorchidism

A

lack of testes or a testicle within the scrotum

39
Q

investigations of cryptorchidism

A

bloods (FBC, TFTs and serum testosterone)

pelvic and abdominal US

40
Q

management of bilateral cryptorchidism

A

urgent referral to paeds for endocrine and genetic testing

if still not present at 3mnths: referral for surgery by 6mnths

41
Q

management of unilateral cryptorchidism

A

review at 6-8wks

if still not present:
review at 3mnths

if still not present:
referral for surgery by 6mnths

42
Q

surgical method of choice in cases of cryptorchidism

A

orchidoplexy

43
Q

common complications of cryptorchidism

A

testicular torsion
infertility
testicular cancer

Nephrology and Urology (8 decks)

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