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Paediatrics > Paediatric Urology > Flashcards

Paediatric Urology Flashcards

1
Q

What are some systemic presentations of paediatric urological problems?

A
  • fever, vomiting
  • failure to thrive
  • anaemia
  • hypertension
  • renal failure
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2
Q

What are some local symptoms of paediatric urological problems?

A
  • pain
  • changes in urine
  • abnormal voiding
  • mass in pelvis
  • visible abnormalities
  • incidental
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3
Q

What are antenatal presentations of paediatric urological problems?

A
  • asymptomatic

- permits immediate postnatal assessment

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4
Q

How does inguinal hernia present?

A

groin swelling out of deep inguinal ring

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5
Q

What do we mean when we say a hernia is ‘incarcerated’?

A

it cannot be reduced back to where it originated

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6
Q

How would hernia be managed if the child was less than a year old?

A

urgent referral and repair because the hernia is more likely to be incarcerated

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7
Q

How would hernia be managed if the child was more than a year old?

A

elective referral and repair

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8
Q

What is hydrocele and what generally causes it in children?

A
  • painless scrotal swelling

- fluid leaking through the processes vaginalis

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9
Q

What can worsen hydrocele?

A

increases with crying, straining and in the evening

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10
Q

How would hydrocele be managed?

A

conservative until 5 years of age

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11
Q

What is cryptorchidism?

A

any testis that cannot be manipulated into the bottom half of the scrotum

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12
Q

True cryptorchidism?

A

the testes have not descended at all

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13
Q

Retractile cryptorchidism.

A

can manipulate the testis to come down but will bounce back after a few seconds

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14
Q

Ectopic cryptorchidism.

A

testis descend into wrong place e.g. thigh

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15
Q

Ascending testis.

A
  • have been in scrotum at birth but not later on

- can be due to cord of testis not growing properly and so lifting them up

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16
Q

What is circumcision?

A

removal of foreskin

17
Q

What is an absolute indication for circumcision?

A

Balanitis Xerotica Obliterans - a scarring condition of the foreskin that can lead to urinary retention

18
Q

What are some relative indications for circumcision?

A
  • balanoprosthitis
  • religious
  • UTI
19
Q

What are disadvantages of circumcision?

A
  • painful

- complications such as bleeding, mental stenosis, fistula, cosmetic

20
Q

If a child presents with n acute scrotum (painful scrotum), what would you include in the differential diagnosis?

A
  • testicular torsion***
  • torsion appendix testis**
  • epididymitis*
  • trauma
  • haematocoele
  • incarecerated inguinal hernia
21
Q

In what age group is testicular torsion common?

A

12-14 year olds

22
Q

How much time do you have to save the testicle in testicular torsion?

A

6-8 hours from time of twist

23
Q

What is torsion appendix testis?

A

when an appendage to the testis (most likely a remnant from embryological development) gets twisted and causes pain

24
Q

What sign on examination might suggest testicular torsion?

A

transverse lie of testicle

25
Q

Why would you investigate UTI?

A
  • prevent renal scarring

- prevent hypertension

26
Q

Who would you investigate with a UTI?

A
  • atypical UTI
  • recurrent UTI
  • all children less than 6 months old with UTI
27
Q

What growth of bacteria defines a UTI?

A

pure growth bacteria >10 to power of 5

28
Q

What symptoms are there of UTI?

A
  • pyuria

- systemic upset e.g. fever, vomiting

29
Q

How would you assess a UTI?

A 
-history and examination
ask abut family history, bowel habit (constipation), voiding dysfunction
-US
number of kidneys? size, position, shape, hydronephrosis
-renography
MAG3
DMSA
-micturating cystourethrogram
30
Q

What is MAG3?

A

a type of demography that looks at the drainage, function and reflux in the kidney

31
Q

What is DMSA?

A

a type of demography looking at function, scarring of kidney (area of kidney not being perfused will show up)

32
Q

What is the purpose of a micturating cystourethrogram?

A

look for reflux in kidney

33
Q

How is kidney reflux graded? (vesicoureteric reflux VUR)

A

1-5
1- reflux does not extend past the ureters
2-reflux extends to the kidney
3-reflux extends to kidney with some dilatation
4-reflux extends to kidney with moderate dilatation
5-reflux extends to kidney with extensive dilatation

34
Q

How is vesicoureteric reflux managed?

A
  • conservative i.e. voiding advice, constipation, fluids
  • antibiotic prophylaxis for grade 3 and above (trimethoprim)
  • STING for mild/moderate with symptoms
  • ureteric reimplantation
35
Q

What are hypospadias?

A

when the urethral meatus is on the ventral aspect of the penis

36
Q

How are hypospadias classes and what is the most common?

A
  • anterior(most common-50%)
  • middle
  • posterior (at scrotum)
37
Q

What management is there for hypospadias?

A

one stage or 2 stage procedure to move urethral meatus to tip of penis

Paediatrics (25 decks)

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