Pediatric Urology/Renal Flashcards
what is the expectation for cryptorchidism
testicles should spontaneously descend by 4-6 months
what would you do on PE for cryptorchidism
“milk” the testicle if youre having trouble finding it
what are the indications for referral for cryptochidism
- bilaterally nonpalpable
- unilaterally nonpalpable after 6 months
what is the treatment of cryptorchidism
surgery
what are the complications of cryptorchidism
- infertility
- testicular torsion
what are the s/s of acute cystitis in school aged kids
- irritative voiding
- suprapubic pain
- hematuria
s/s of acute cystitis in preschool aged kids
- abd pain
- vomiting
- fever
s/s of acute cystitis in infants
- fever
- hypothermia
- irritability
- FTT
etiology of acute cystitis
E. colii
how do you diagnose acute cystitis
- UA
- culture
when should you hospitalize a patient with a UTI
- less than 2mo
- toxic appearance
- immunocompromised
- lack of urine output
- treatment failure
what is the treatment of acute cystitis
- 3rd gen cephalosporin
- 10 days for febrile
- 3-5 days for no fever
what are the indications for Renal/bladder US in a UTI patient
- younger than 2 with first febrile UTI
- recurrent UTIs
- family hx of renal issues
what are the indications for a voiding cystourethrogram
- 2 or more febrile UTIs
- first febrile UTI
- any anomalies on renal US
what is vesicoureteral reflux
backflow of urine from the bladder into the upper urinary tract
what is the difference between primary and secondary vesicoureteral reflux
- primary: due to incompetent or inadequate closure of ureterovesical junction
- secondary: associated with anatomic or functional bladder obstruction
how do you diagnose vesicoureteral reflux
voiding cystourethrogram
How do you stage vesicoureteral reflux?
- grade 1: into ureter
- grade 2: into kidneys
- grade 3: into kidneys, dilation of ureter
- grade 4: into kidneys, dilation of ureter, mild blunting of renal calyces
- grade 5: into kidneys, dilation of ureter, moderate to severe blunting of renal calyces
How do you treat vesicoureteral reflux
- grade 1-2: watchful waiting
- grade 3-4: antibiotic prophylaxis
- grade 5: surgery
what is enuresis
voiding in bed or on clothing that occurs at least twice per week for at least 3 consecutive months in a child who is at least 5 years old
what are the 2 types of enuresis
- diurnal-wetting in daytime
- nocturnal passage of urine during nighttime
what are the etiologies of nocturnal enuresis
- ADH release at night
- anatomic abnormalities
- strong association with constipation
- lesions of spinal cord results in neurogenic bladder
what is the treatment of enuresis
- alarm therapy
- behavioral modifications
- desmopressin
what are the s/s of glomerulonephritis
- HTN
- edema
- protein in urine
- RBC casts
what is immune complex deposition glomerulonephritis
- when antigen excess over antibody production occurs
- antigen-antibody complexes lodge into basement membrane causing destruction
what is pauci-immune glomerulonephritis
- cell mediated immune processes with no immune complexes or direct antibody binding
what is anti-GBM associated acute glomerulonephritis
autoantibodies against the GBM
what is goodpastures syndrome
Autoantibodies against alveolar and glomerular basement membrane proteins
what is the treatment of glomerulonephritis
high dose steroids
what is the difference between a communicating and non-communicating hydrocele
- communicating: patent processus vaginalis where fluid flows into the tunica vaginalis
- noncommunicating: processus vaginalis is closed and fluid is trapped
what are the s/s of a hydrocele
- transillumination
- scrotal swelling
what is the treatment for a hydrocele
supportive until 1-2 years and then surgery
what is the etiology of hypospadias
disruption of the androgenic stimulation required for the development of the normal male genitalia
what are the s/s of hypospadias
urethral meatus opens on the ventral side of the penis
what is the management of hypospadias
delay circumcision and use skin to surgically repair
what is the etiology of paraphimosis
foreskin is retracted and not replaced
what are s/s or paraphimosis
- flaccid proximal to paraphimosis
- swelling of glans
- pain
- dysuria
what is the treatment of paraphimosis
- manual decompression
- dorsal slit
- puncture
what is phimosis
foreskin is too scarred to retract
what is the s/s of phimosis
- irritation
- bleeding
- dysuria
- painful erection
- ballooning
what is the treatment of phimosis
- topical steroid cream
- surgery (circumcision or dorsal slit)
what is the etiology of testicular torsion
- bell clapper deformity
- twisting of the spermatic cord
what are the s/s of testicular torsion
- acute onset of severe scrotal pain
- n/v
- no cremasteric reflex
- negative phren’s sign`
- erythematous, edematous and tender
how do you diagnose testicular torsion
doppler US
what is the treatment of testicular torsion
- manual detorsion
- surgery
