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Adult Ped/Med: 5 > Pediatric Urology > Flashcards

Pediatric Urology Flashcards

1
Q

What are the three types of cryptochism?

A

undescended testicles, retractile testicles, and ascending testicles.

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2
Q

When are undescended testicles most common?

A

at birth, they are more common in premature or low weight births.

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3
Q

What is the recommended time to do surgery if they do not descend?

A

after 6 months but before 12-24 months.

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4
Q

boys and bilateral normal testis and boys with unilateral UDT have the (same or different) risks of fertility

A

the same (both have 90%). bilateral udt has 50%.

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5
Q

do retractile or ascending testis have associated cancer or fertility risks?

A

not shown

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6
Q

When is the best time in life to do a scrotal exam?

A

birth.

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7
Q

What is the most reliable way of diagnosing a UDT?

A

physical exam (current says you can use MRI or U/S also)

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8
Q

When should a PCP order a scrotal US for UDT?

A

never (according to lecture)

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9
Q

What might you expect to see for a non palpable testicle?

A

compensatory hypertropy > 1.8cm usually indicates the other testicle is dead. There may be a risk of cancer in the testiulcar nubbin, and a higher risk of torsion in a solitary testicle.

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10
Q

What is the mandatory procedure in a child with a non palpable testicle?

A

laparoscopy

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11
Q

What are the risks associated with hernias?

A

incarceration, strangulation and bowel necrosis

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12
Q

what is a hydrocele?

A

it is a fluid filled sac surrounding a testicle that results in swelling of the scrotum. it is common in newborns and most disappear without treatment. it is not painful most of the time.

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13
Q

what are the two types of hyrdoceles?

A

communication (sac open and fluid passes to and from abdominal cavity, higher risk of hernias. most resolve by 18 months) and non communicating (sac closes)

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14
Q

compare a febrile UTI vs a non febrile UTI

A

febrile: younger, temp >38.5, sick, back pain, anatomic problem, workup = renal us and VCUG
non febrile: older, no fever, dysfunctional elimination, normal anatomy, workup: KUB, voiding diary

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15
Q

what is the workup for a febrile UTI?

A

renal us and vcug

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16
Q

what is the workup for a non febrile UTI

A

KUB and voiding diary

17
Q

What is hydronephrosis?

A

dilation of the kidney, specifically the renal pelvis (where urine is produced)

18
Q

What can cause hydronephrosis?

A

anatomic abnormality, variant of normal, or an obstruction are most common

19
Q

how is hydronephrosis classified?

A

grade 0-4

20
Q

Which children require immediate evals of hydronephrosis after birth?

A

boy, history of oligodraminos, bilateral grade 2 hydro
girl, bilateral ureteroceles
boy, bilateral grade 2 or more hydro

21
Q

Who should get a VCUG for hydronephrosis?

A

grade 2 or more

22
Q

Who should get a Mag 3 for hydronephrosis?

A

grade 3 or 4

23
Q

Between incontinence and encopresis, which should be treated first?

A

encopresis because constipation could be the underlying cause to both

24
Q

What is psuedofecal incontinence?

A

due to constipation

25
Q

Treatment of encopresis involves?

A

desimpaction, maintenince (stool softener with schedule potty time), and this can last for 6 months

26
Q

Daytime urinary incontinence in older kids, you need to order what?

A

renal us to r/o neurogenic bladder, valves, or anatomic problems.

27
Q

How do you treat daytime incontinence?

A

constipation relief, and time voiding, or double voiding.

28
Q

what is mono symptomatic nocturnal enuresis?

A

the brain and the bladder are not communicating about when each needs to go.

29
Q

What is the treatment for monsymptomatic nocturnal enuresis?

A

general measures: pee before bed, limit fluids
medications: not very helpful
bedwetting alarm: only help about 1/2 the time.

30
Q

What is the recommend care of the uncircumcised penis from age 0 to age 8.

A

once the foreskin becomes retractable, teach children to retract their own foreskin during voiding and bathing.

31
Q

For labial adhesions, what are the treatment options?

A

observatiogn, estrogen cream or surgical lysis

32
Q

What is phimosis?

A

you cannot retract the foreskin all the way back. there is physiological and pathological

33
Q

What is the difference between physio and patho phimosis?

A

physio= ring is supple, patho= ring is thick and inflammed

34
Q

Distinguish between soft penile adhesions and the penile bridge?

A

soft= do not involve the circumcision, disappear on their own without treatment. penile = involve circumsicion, require lysis.

35
Q

This is indicated in a child with significant hypospadius, which results in outflow abnormalities and likely sexual dysfunction

A

referral to a surgeon

Adult Ped/Med: 5 (7 decks)

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