Pediatric Urology/Renal

Question 1

what is the expectation for cryptorchidism

Answer 1

testicles should spontaneously descend by 4-6 months

Question 2

what would you do on PE for cryptorchidism

Answer 2

“milk” the testicle if youre having trouble finding it

Question 3

what are the indications for referral for cryptochidism

Answer 3

• bilaterally nonpalpable
• unilaterally nonpalpable after 6 months

Question 4

what is the treatment of cryptorchidism

Answer 4

surgery

Question 5

what are the complications of cryptorchidism

Answer 5

• infertility
• testicular torsion

Question 6

what are the s/s of acute cystitis in school aged kids

Answer 6

• irritative voiding
• suprapubic pain
• hematuria

Question 7

s/s of acute cystitis in preschool aged kids

Answer 7

• abd pain
• vomiting
• fever

Question 8

s/s of acute cystitis in infants

Answer 8

• fever
• hypothermia
• irritability
• FTT

Question 9

etiology of acute cystitis

Answer 9

E. colii

Question 10

how do you diagnose acute cystitis

Answer 10

• UA
• culture

Question 11

when should you hospitalize a patient with a UTI

Answer 11

• less than 2mo
• toxic appearance
• immunocompromised
• lack of urine output
• treatment failure

Question 12

what is the treatment of acute cystitis

Answer 12

• 3rd gen cephalosporin
• 10 days for febrile
• 3-5 days for no fever

Question 13

what are the indications for Renal/bladder US in a UTI patient

Answer 13

• younger than 2 with first febrile UTI
• recurrent UTIs
• family hx of renal issues

Question 14

what are the indications for a voiding cystourethrogram

Answer 14

• 2 or more febrile UTIs
• first febrile UTI
• any anomalies on renal US

Question 15

what is vesicoureteral reflux

Answer 15

backflow of urine from the bladder into the upper urinary tract

Question 16

what is the difference between primary and secondary vesicoureteral reflux

Answer 16

• primary: due to incompetent or inadequate closure of ureterovesical junction
• secondary: associated with anatomic or functional bladder obstruction

Question 17

how do you diagnose vesicoureteral reflux

Answer 17

voiding cystourethrogram

Question 18

How do you stage vesicoureteral reflux?

Answer 18

• 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

Question 19

How do you treat vesicoureteral reflux

Answer 19

• grade 1-2: watchful waiting
• grade 3-4: antibiotic prophylaxis
• grade 5: surgery

Question 20

what is enuresis

Answer 20

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

Question 21

what are the 2 types of enuresis

Answer 21

• diurnal-wetting in daytime
• nocturnal passage of urine during nighttime

Question 22

what are the etiologies of nocturnal enuresis

Answer 22

• ADH release at night
• anatomic abnormalities
• strong association with constipation
• lesions of spinal cord results in neurogenic bladder

Question 23

what is the treatment of enuresis

Answer 23

• alarm therapy
• behavioral modifications
• desmopressin

Question 24

what are the s/s of glomerulonephritis

Answer 24

• HTN
• edema
• protein in urine
• RBC casts

Question 25

what is immune complex deposition glomerulonephritis

Answer 25

* when antigen excess over antibody production occurs * antigen-antibody complexes lodge into basement membrane causing destruction

Question 26

what is pauci-immune glomerulonephritis

Answer 26

* cell mediated immune processes with no immune complexes or direct antibody binding

Question 27

what is anti-GBM associated acute glomerulonephritis

Answer 27

autoantibodies against the GBM

Question 28

what is goodpastures syndrome

Answer 28

Autoantibodies against alveolar and glomerular basement membrane proteins

Question 29

what is the treatment of glomerulonephritis

Answer 29

high dose steroids

Question 30

what is the difference between a communicating and non-communicating hydrocele

Answer 30

* communicating: patent processus vaginalis where fluid flows into the tunica vaginalis * noncommunicating: processus vaginalis is closed and fluid is trapped

Question 31

what are the s/s of a hydrocele

Answer 31

* transillumination * scrotal swelling

Question 32

what is the treatment for a hydrocele

Answer 32

supportive until 1-2 years and then surgery

Question 33

what is the etiology of hypospadias

Answer 33

disruption of the androgenic stimulation required for the development of the normal male genitalia

Question 34

what are the s/s of hypospadias

Answer 34

urethral meatus opens on the ventral side of the penis

Question 35

what is the management of hypospadias

Answer 35

delay circumcision and use skin to surgically repair

Question 36

what is the etiology of paraphimosis

Answer 36

foreskin is retracted and not replaced

Question 37

what are s/s or paraphimosis

Answer 37

* flaccid proximal to paraphimosis * swelling of glans * pain * dysuria

Question 38

what is the treatment of paraphimosis

Answer 38

* manual decompression * dorsal slit * puncture

Question 39

what is phimosis

Answer 39

foreskin is too scarred to retract

Question 40

what is the s/s of phimosis

Answer 40

* irritation * bleeding * dysuria * painful erection * ballooning

Question 41

what is the treatment of phimosis

Answer 41

* topical steroid cream * surgery (circumcision or dorsal slit)

Question 42

what is the etiology of testicular torsion

Answer 42

* bell clapper deformity * twisting of the spermatic cord

Question 43

what are the s/s of testicular torsion

Answer 43

* acute onset of severe scrotal pain * n/v * no cremasteric reflex * negative phren's sign` * erythematous, edematous and tender

Question 44

how do you diagnose testicular torsion

Answer 44

doppler US

Question 45

what is the treatment of testicular torsion

Answer 45

* manual detorsion * surgery