Trigger Urology

Question 1

shallow rugae are found when

Answer 1

preterm infant

Question 2

what characterizes male menarche

Answer 2

sperm in urine and nocturnal emissions

Question 3

during which tanner stages does penile enlargement occur

Answer 3

stages 2-5

Question 4

by late childhood a penis should be how big

Answer 4

4.85cm

Question 5

what circumcision technique risks amputation of the glans

yikes

Answer 5

Mogen technique

Question 6

what is the % retrctability of the foreskin in correlation to age

Answer 6

age 1 - 50% of boys can retract foreskin
age 3 - 90%
age 6-7 -92%
adolescence 99%

Question 7

6 weeks of topical betamethasone + stretching

Answer 7

phimosis tx

Question 8

what are the tx options for the various etiologies of balanoposthitis

Answer 8

Nonspecific - topial bacitracin/mupirocin
Irritant - topical low potency steroid cream
Candidial - topical antifungal or one dose PO fluconazole
bacterial - topial abx. if severe oral amoxicillin

Question 9

urethral folds failing to completely close can result in ……. in male children

Answer 9

hypospadias

Question 10

this penile abnormality must be fixed when a boy is 6-12 months old

Answer 10

hypospadias

Question 11

A baby is born with the urethral meatus displaced to the top side of his penis. this baby has…..

Answer 11

epispadias

top = dorsal and underneath side = ventral … right? if not plz tell me

Question 12

epispadias that is associated w urinary icontinence is typically found where on the penis

Answer 12

dorsally and proximally

Question 13

when should testicles spontaneously descend

Answer 13

4-6 months

Question 14

state why each of the following diagnostics is used in cryptorchidism

Answer 14

Question 15

how soon after discovery should retractile/ascending testes be treated w surgery

Answer 15

within 6 months

Question 16

this disorder incereases testicular cancer by 5-10x

Answer 16

cryptorchidism

Question 17

what are the drawbacks of treating cryptorchidism with hCG

Answer 17

• can retract after hCG discontinuiation
• can hasten puberty
• can cause testicular damage and sterility
• long term studies are lacking

Question 18

what does disorder of sex developement mean

Answer 18

external genitalia and gonadal/chromosomal sex are differnt

Question 19

when would you want to order 17-hydroxyprogesterone

Answer 19

adrenal steroid lab test to assess ambiguous genitalia

Question 20

a patent processus vaginalis wher fluid flows into the tunica vaginalis describes a …

Answer 20

communicating hydrocele

Question 21

are direct or indirect inguinal hernias more common? who do these MC occur in ?

Answer 21

indirect.

boys <10months

Question 22

what is the tx of an inguinal hernia

Answer 22

always refer to surgery for laproscopic repair.

Question 23

What is the timeline in relation to testicular torsion and viability

Answer 23

detrosion within 4-6 hrs = 100% viable
after 12 hrs = 20% viable
after 24 hrs = 0%

Question 24

a pt w a normal cremasteric reflex but a + prehn sign probs has what

Answer 24

acute epididymitis

Question 25

If a patient presenting with high-likelihood STD epididymitis, you must order (3) labs

Answer 25

couldnt remember this so had to put it here too

Question 26

Doppler US shows increased blood flow to one of the testicles

Answer 26

acute epididymitis

Question 27

what is the treatment for epididymitis that is caused by:
STD suspected
enteric organism
suspected UTI

Answer 27

STD = rocephin + doxy
Enteric = levofloxacin
UTI = cefdinir or bactrim

Question 28

tx for vulvovaginitis caused by:
candidiasis
bacteria
candidiasis in children who cant swallow pills

Answer 28

• candidiasis = 1 dose oral fluconazole
• bacteria = metro + clinda
• unable to swallow = topcial azole (12+), nystatin (<12)

Question 29

how do you treat uncomplicated vs complicated labial adhesions

Answer 29

uncomplicated = reassureance and self liomiting
complicated = topical estrogen

Question 30

tx for penile adhesions

Answer 30

gentle traction

if fails can use topical low potency steroids

Question 31

what is the treatment of a penile skin bridge

Answer 31

referred to ped urologist for lysis of adhesions via scalpel after topical anesthetic application

Question 32

why would you need a clean catch urine sample from a child

Answer 32

if they have a UTI and you need a culture

Question 33

what is diagnostic of UTI in children

Answer 33

Clean-void: 100k or more CFUs
Catheter: 50k or more CFUs

Question 34

how do you treat a UTI

Answer 34

• cefdinir, defpodoxime, ceftriaxone, cefotaxime
• cipro if pseudomonas
• 10 days if febrile
• 3-5 if afebrile and immunocompetent

Question 35

what are indications for a renal US in children w a UTI

Answer 35

Question 36

indications for a voiding cystourethrogram

Answer 36

• 2+ febrile UTIs
• 1 febrile UTI + abnormal renal US OR 102.2 temp AND a pathogen other than E. Coli or poor growth or hypertension

oml shes def gonna ask this

Question 37

how do you tx VUR

Answer 37

• grades 1-2: abx if not potty trained. if potty trained, watchful waiting
• grade 3: ABX daily, surgery if non-compliance w meds
• grade 4-5 surgery w prohpylactic abx

Question 37

what are the 5 styages of vesicouretal reflux

Answer 37

1. reflux into ureter
2. reflux into kindeys
3. reflux into kidneys, ureter dilation
4. reflux into kidneys, ureter dilation, mild blunting of renal calyces
5. into kidneys, ureter dilation, moderate/severe blunting of renal calyces

Question 38

in order to diagnose enuresis how often does it have to occur

Answer 38

2x week
3 consecutive months
a kid thats at least 5

Question 39

when do we use desmopressin in this lecture

Answer 39

treatment for monosymptomatic NE

Question 40

when do we use oxybutynin-ditropan in this lecture

Answer 40

daytime enuresis