Pediatrics/Congenital

Question 1

The age and the appearance of a child with a Wilms’ tumour is most frequently as follows:

A. A 3-year old who looks very ill
B. A 7-year old who looks very ill
C. A 3-year old who does not look ill
D. A 7-year old who does not look ill

Answer 1

C. A 3-year old who does not look ill

Question 2

What is the most common cause of bladder outflow obstrucion in males during the neonaltal and infancy period?

A. Vesico-ureteral reflux
B. Posterior urethral valves
C. Urethral congenital stricture
D. Hypospadis

Answer 2

B. Posterior urethral valves

Question 3

The urachus involutes to become:

A. The appendix testes
B. The veru montanum
C. The lateral umbilical folds
D. The median umbilical ligament

Answer 3

D. The median umbilical ligament

Question 4

At what age should surgery be carried out for boys with undescended testes?

A. At birth
B. Around 6 months of age
C. Around 12 months of age
D At 2 years of age

Answer 4

C. Around 12 months of age

Question 5

Complete double urethers are seen when:

A. Two metanephric blastema develop
B. Two ureteric buds arise from the mesonephric duct
C. A single ureteric bud divides into two parts
D. Two mesonephric ducts arise from urogenital sinus

Answer 5

B. Two ureteric buds arise from the mesonephric duct

Question 6

Which of the following possible abnormalities is most commonly found in a complete duplex system?

A. VUR in both ureters
B. Obstruction in both ureters
C. VUR in the lower pole moiety
D. Veisco-ureteral reflux (VUR) in the upper pole moiety

Answer 6

C. VUR in the lower pole moiety

Question 7

Which radiopharmaceutical is the agent of choice for demonstrating renal scarring in childhood?

A. 99m Tc-DPTA
B. 99m Tc-DMSA
C. 99m Tc-MAG3
D. 99m Tc Gluconate

Answer 7

B. 99m Tc-DMSA

Question 8

A 10-month-old otherwise normal boy underwent a pyeloplasty. In the immediate postoperative phase the amount of fluid for intravenous maintenance is:

A. 25 ml/kg/24hr
B. 50 ml/kg/24hr
C. 100 ml/kg/24hr
D. 200 ml/kg/24hr

Answer 8

C. 100 ml/kg/24hr

Question 9

After having one child with hypospadias, what is the relative risk for a couple of giving birth to another child with hypospadias?

A. Approxiamately 1%
B. Approxiamately 17%
C. Approxiamately 42%
D. Approxiamately 62%

Answer 9

B. Approxiamately 17%

Question 10

Which gene does NOT play a role in the development of hypospadias?

A. Wilm’s tumor gene 1 (WT1)
B. Sonic hedgehehog gene (SHH)
C. Homeox gene a13 (HOXa13)
D. Fibroblast growth factor 8 (FGF8)

Answer 10

A. Wilm’s tumor gene 1 (WT1)

Question 11

In a 13-year-old girl with urinary incontinence since birth the diaper test shows a continuous leakage of urine with low volume. What is the most likely diagnosis?

A. Lazy bladder
B. Ectopic ureter
C. Vaginal pooling
D. Urge syndrome

Answer 11

B. Ectopic ureter

Question 12

The most accurate diagnosis in acute scrotum in children is provided by:

A. CT-scan
B. Doppler-ultrasound
C. operative exploration
D. Testicular nuclear scan

Answer 12

C. operative exploration

Question 13

What is the main cause of nocturnal enuresis in children?

A. An imbalance of urine production and bladder capacity
B. An insufficient nocturnal ADH secretion
C. A problem of high arousal combined with either a high night-time urine production or a night-time OAB (or both)
D. A delay in maturity of the pontine micturition center in combination with an insufficient nocturnal ADH secretion

Answer 13

C. A problem of high arousal combined with either a high night-time urine production or a night-time OAB (or both)

Question 14

Which patients should be categorised as “high”-risk for vesicoureteral reflux (VUR) and be advised open surgery (ureteral reimplantation) rather than endoscopic surgery or antibiotic prophylaxis?

A. Toilet-trained boys and girls with low-grade VUR and lower urinary tract and bowel symptoms
B. Small, not toilet-trained boys and girls with bilateral high-grade (4-5) VUR and unilateral renal damage
C. Small, not toilet-trained boys and girls with bilateral high-grade (4-5) VUR and bilateral renal damage
D. Toilet-trained boys and girls with high-grade reflux, recurrent UTI, unilateral renal damage and unilateral high-grade (4-5) VUR

Answer 14

D. Toilet-trained boys and girls with high-grade reflux, recurrent UTI, unilateral renal damage and unilateral high-grade (4-5) VUR

Question 15

A patient experienced an anaphylactic reaction to chlorhexidine. What may be unsafe to use during a future cystoscopy?

A. Antibiotics
B. Sterile water
C. Local /topical anaesthetic
D. Water soluble iodine based skin preparation

Answer 15

C. Local /topical anaesthetic