Uro and Gyne Flashcards
UTI is most common in children under what age?
1 year
UTIs are caused by 54-67% by this bacteria
Escherichia coli
2 basic forms of UTI
Pyelonephritis
Cystitis
most common serious bacterial infection in infants younger than 24 months of age who have fever without an obvious focus
Pyelonephritis
In uncircumcised males, bacteral pathogens that cause UTI arise from?
flora beneath the prepuce
Enumerate or give examples of risk factors for UTI
Female gender
Uncircumcised male
Vesicoureteral reflux
Toilet training
Voiding dysfunction
Obstructive uropathy
Urethral instrumentation
Sources of external iritation (tight clothing, pinworm infestation)
Constipation
Anatomic abnormality (labial adhesion)
Neuropathic bladder
Sexual activity
Pregnancy
This diagnostic test is necessary for confirmation and appropriate therapy in UTI
Urine culture
Urine culture result suggestive of UTI
> 50,000 CFU/mL of a single pathogen, urinalysis has pyuria or bacteriuria in a symptomatic child
True or false: repeat urine culture is necessary after the termination of treatment of UTI
False
Not routinely needed
typically become negative within 24 hour of initiation of antibiotic therapy
main consequences of chronic renal damage caused by pyelonephritis
Arterial hypertension
End stage renal insufficiency
what are the urologic conditions that can cause recurrent UTIs might benefit from long term antibiotic prophylaxis
Neuropathic bladder
Urinary tract stasis and obstruction
Severe VUR
Urinary calculi
VUR is most common among males. True or false?
False, 80% of the cases are female, average age of diagnosis is 2-3 yr of age
most common disorder of sexual differentiation in males
Cryptoorchidism/undescended testis
when does testicular descent occur?
7-8 months of gestation
during this month, once testis is still undescended, it will remain undescended
4 months of age
Potential consequences of cryptochordism
- poor testicular growth
- testicular malignancy
- associated hernia
- torsion of the cryptorchid testis
- psychological effects of an empty scrotum
peak age of developing a malignant testis tumor
15-45 yr
most common tumor developing in an undescended testis in an adolescent or adult
seminoma (65%)
when is the recommended time to treat surgically congenital undescended testis
9-15 months of age
differential diagnosis for painful scrotal swelling
testicular torsion or incarcerated inguinal hernia or epididymitis
most common cause of severe testicular pain in males >12 yr and older
Testicular (spermatic cord) torsion
Golden period of absent blood flow to the testis which will cause irreversible loss of spermatogenesis in torsion
4-6 hours
treatment for testicular torsion
surgical exploration and detorsion
most common cause of testicular pain in males 4-10 yr
torsion of the appendix testis
most common (and virtually the only) surgically correctable cause of infertility in males
Varicocele
presents as a painless paratesticular mass
varicocele
accumulation of fluid in the tunica vaginalis
hydrocele
hydrocele fluid disappears by what age?
1 year
90% of urinary stones contain what type of element as a major constituent
calcium
Factors that promote stone formation
Low urine volume
Low urine pH
Calcium
Na
Oxalate
Urate
give examples of inorganic and organic substances that inhibit stone formation
Citrate
Magnesium
Glycosaminoglycans
Osteopontin
most narrow segment of the ureter where calculus typically causes obstruction
ureterovesical junction
this medication is an alpha adrenergic blocker that can facilitate stone passage
Tamsulosin (0.4 mg)
- decreases ureteral pressure below the stone, decreases the frequency of the peristaltic contractions of the obstructed ureter
effective method of preventing stones
High fluid intake
— because lithiasis results from elevated concentrations of specific substances in the urine
most common gynecologic-based problem for prepubertal children
vulvovaginitis
most common dermatologic problem in infancy
diaper dermatitis
accumulation of mucus or nonsanguineous fluid in the vagina
hydrocolpos
accumulation of blood in the vagina
hematocolpos
accumulation of blood in the uterus
hematometra
accumulation of serous fluid in the fallopian tube
hydrosalpinx
two cervices, each associated with one uterine horn
didelphic uterus
one cervix associated with 2 uterine horns
bicornuate uterus
one cervix and one uterine horn
unicornuate uterus
— result of failure of one müllerian duct to descend
