Trigger Urology Flashcards
shallow rugae are found when
preterm infant
what characterizes male menarche
sperm in urine and nocturnal emissions
during which tanner stages does penile enlargement occur
stages 2-5
by late childhood a penis should be how big
4.85cm
what circumcision technique risks amputation of the glans
yikes
Mogen technique
what is the % retrctability of the foreskin in correlation to age
age 1 - 50% of boys can retract foreskin
age 3 - 90%
age 6-7 -92%
adolescence 99%
6 weeks of topical betamethasone + stretching
phimosis tx
what are the tx options for the various etiologies of balanoposthitis
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
urethral folds failing to completely close can result in ……. in male children
hypospadias
this penile abnormality must be fixed when a boy is 6-12 months old
hypospadias
A baby is born with the urethral meatus displaced to the top side of his penis. this baby has…..
epispadias
top = dorsal and underneath side = ventral … right? if not plz tell me
epispadias that is associated w urinary icontinence is typically found where on the penis
dorsally and proximally
when should testicles spontaneously descend
4-6 months
state why each of the following diagnostics is used in cryptorchidism
how soon after discovery should retractile/ascending testes be treated w surgery
within 6 months
this disorder incereases testicular cancer by 5-10x
cryptorchidism
what are the drawbacks of treating cryptorchidism with hCG
- can retract after hCG discontinuiation
- can hasten puberty
- can cause testicular damage and sterility
- long term studies are lacking
what does disorder of sex developement mean
external genitalia and gonadal/chromosomal sex are differnt
when would you want to order 17-hydroxyprogesterone
adrenal steroid lab test to assess ambiguous genitalia
a patent processus vaginalis wher fluid flows into the tunica vaginalis describes a …
communicating hydrocele
are direct or indirect inguinal hernias more common? who do these MC occur in ?
indirect.
boys <10months
what is the tx of an inguinal hernia
always refer to surgery for laproscopic repair.
What is the timeline in relation to testicular torsion and viability
detrosion within 4-6 hrs = 100% viable
after 12 hrs = 20% viable
after 24 hrs = 0%
a pt w a normal cremasteric reflex but a + prehn sign probs has what
acute epididymitis
If a patient presenting with high-likelihood STD epididymitis, you must order (3) labs
couldnt remember this so had to put it here too
Doppler US shows increased blood flow to one of the testicles
acute epididymitis
what is the treatment for epididymitis that is caused by:
STD suspected
enteric organism
suspected UTI
STD = rocephin + doxy
Enteric = levofloxacin
UTI = cefdinir or bactrim
tx for vulvovaginitis caused by:
candidiasis
bacteria
candidiasis in children who cant swallow pills
- candidiasis = 1 dose oral fluconazole
- bacteria = metro + clinda
- unable to swallow = topcial azole (12+), nystatin (<12)
how do you treat uncomplicated vs complicated labial adhesions
uncomplicated = reassureance and self liomiting
complicated = topical estrogen
tx for penile adhesions
gentle traction
if fails can use topical low potency steroids
what is the treatment of a penile skin bridge
referred to ped urologist for lysis of adhesions via scalpel after topical anesthetic application
why would you need a clean catch urine sample from a child
if they have a UTI and you need a culture
what is diagnostic of UTI in children
Clean-void: 100k or more CFUs
Catheter: 50k or more CFUs
how do you treat a UTI
- cefdinir, defpodoxime, ceftriaxone, cefotaxime
- cipro if pseudomonas
- 10 days if febrile
- 3-5 if afebrile and immunocompetent
what are indications for a renal US in children w a UTI
indications for a voiding cystourethrogram
- 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
how do you tx VUR
- 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
what are the 5 styages of vesicouretal reflux
- reflux into ureter
- reflux into kindeys
- reflux into kidneys, ureter dilation
- reflux into kidneys, ureter dilation, mild blunting of renal calyces
- into kidneys, ureter dilation, moderate/severe blunting of renal calyces
in order to diagnose enuresis how often does it have to occur
2x week
3 consecutive months
a kid thats at least 5
when do we use desmopressin in this lecture
treatment for monosymptomatic NE
when do we use oxybutynin-ditropan in this lecture
daytime enuresis
