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Paediatrics > Paediatric Urology > Flashcards

Paediatric Urology Flashcards

1
Q

Presentations of Paediatric Urological problems: systemic

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

Presentations of Paediatric Urological problems: local

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

Presentations of Paediatric Urological problems: Antenatal

A
  • asymptomatic

- permits immediate postnatal assessment

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4
Q

lump in left groin, ale, gone next morning, baby is happy.. diagnosis?

A

inguinal hernia

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5
Q

Features of an inguinal hernia?

  • who is at most risk of them?
A

GROIN
- boys

  • prematurity
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6
Q

management of inguinal hernias? <1 year

A

< 1 year
URGENT referral
repair - no place for observation

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7
Q

management of inguinal hernias? >1 year

A

elective referral and repair

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8
Q
  • 9 month old boy
  • mum noticed lump in left SCROTAL swelling at bath time. -bluish colour
  • gone next morning
    baby happy and feeding
  • Diagnosis?
A

hydrocele

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9
Q

what is hydrocele?

when are they worse?

A

SCROTAL swelling
very common in newborns

  • increases with crying, straining, evening
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10
Q

management of hydrocele?

A

conservative until 5 yrs of age

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11
Q
  • 9 month old boy
  • mum noticed scrotum empty at bath time
  • normal neonatal discharge examination
  • baby happy and feeding

diagnosis?

A

Possible undescended testes

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12
Q

Incidence of Cryptorchidism - who is at risk?

A

premature babies

- testes don’t descend until the 3rd trimester

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13
Q

Indications for Orchidopexy?

A
  • for fertility
  • reduces risk of malignancy
  • trauma
  • torsion
  • cosmetic
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14
Q

4 year old boy with non retractile foreskin
- recurrent balanitis
o/e “pinhole meatus”

diagnosis?

A

Normal non retractile foreskin

  • pull it forward, not tight or obstructing
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15
Q
  • 14 year old boy with non retractile foreskin”
  • “struggling to pass urine”
  • o/e “scarred foreskin, narrow meatus”

diagnosis?

A

BXO – Balinitis Xerotica Obliterans

-scarring condition

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16
Q

intervention and treatment of BXO

A

dermovate - topically

  • ultrapotent steroid
  • Circumcision
17
Q

balanoprosthitis is recurrent?

A

infection of the foreskin and shaft

- needs antibiotics

18
Q

Circumcision – suggested advantages

A
  • reduces risk of UTI
  • penile cancer is rare
  • reduces AIDS/std’s
19
Q

Circumcision - disadvantages

A
  • painful
  • complications
  • bleeding
  • meatal stenosis
  • fistula
  • cosmetic
20
Q

14 year old boy with 4 hour history of right sided testicular pain”
o/e scrotum red, ASYMMETRY, acutely tender to touch

Diagnosis?

A

Testicular torsion

21
Q

14 year old boy with 4 hour history of right sided testicular pain”
o/e scrotum red, NO Asymmetry, blue spot seen, tender to touch

diagnosis???

A

Torsion Appendix Testis

22
Q

Acute scrotum, differentials?

A
  • torsion testis,
  • torsion appendix testis,
  • RARELY epididymitis
  • trauma, haematocele, incarcerated inguinal hernia
23
Q

what does renal scarring cause?

A
  • reflux nephropathy and chronic renal failure

- hypertension

24
Q

UTI - when/who to investigate?

A

<6 months

  • atypical symptoms /bug or history
  • recurrent UTUI
25
Q

what is the definition of UTI?? + symptoms

A
  • pure growth bacteria > 10’5
  • pyuria
  • systemic upset (fever, vomiting)
  • pus cells in samples?
26
Q

assessment of UTI - history and examination

A

FH, bowel habit ,voiding dysfunction?

27
Q

assessment of UTI - investigations

further? - when is this indicated?

A

ultrasound scan
(number, size, position, shape, hydronephrosis)

micturating cystourethrogram (MCUG) >1 year old

renogram
MAG3 - drainage, function, reflux
DMSA - function, scarring
(younger patients)

28
Q

gold standard test to pick up reflux (UTI)?

A

micturating cystourethrogram (MCUG)

29
Q

management of VUR? -CONSERVATIVE

A

voiding advice, constipation, fluids

30
Q

management of VUR? -antibiotic prophylaxis

A

keep it on until toilet trained?

Trimethoprim (2mg/kg nocte)

31
Q

management of VUR? - operation

  • if it is high grade what can you do
A

STING

ureteric reimplantation
- take ureter out, fix it, close the bladder

32
Q

what is Hypospadias?

3 types?

A

urethral opening on the underside of the penis

  • Anterior (50%)
  • Middle (30%) - operation
  • Posterior (20%) - most severe form
33
Q

Hypospadias associated anomalies?

A
  • upper tract

- (ambiguous genitalia) -is it defo a boy or girl?

34
Q

Hypospadias - investigations

A

US, Karyotype only if severe

35
Q

Hypospadias - management

A

one stage or 2 stages procedure

Paediatrics (49 decks)

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