Urology Flashcards

1
Q

Newborn with prenatal ultrasound (US) positive for hydronephrosis (>10mm AP diameter of the renal pelvis. What is the next best step?

A

Renal US after 48h of life

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2
Q

What is the best test to confirm the diagnosis of urinary tract infection (UTI)

A

Urine culture

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3
Q

A one-year-old child presents with the first febrile UTI.What is the appropriate imaging study?

A

Renal-bladder US (RBUS)

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4
Q

What is the gold standard test for the diagnosis of anatomical details of the renal system and degree of reflux?

A

Voiding cystourethrography (VCUG). It should not be routinely performed in children after a first febrile UTI

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5
Q

What are the indications of VCUG?

A

Findings on RBUS that suggest the presence of high-grade vesicoureteral reflux or the recurrence of febrile UTIs

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6
Q

What is the main difference between cystitis and acute pyelonephritis?

A

Presence of fever and urine infection is highly suggestive of pyelonephritis

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7
Q

Prevalent cause of recurrent UTIs in children

A

Constipation

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8
Q

Child with an indwelling catheter and a urine dipstick analysis negative for nitrites

A

Enterococcal UTI

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9
Q

Empiric antibiotics in patients suspected of having an enterococcal UTI

A

Combination of ampicillin or amoxicillin and, third-generation cephalosporin or aminoglycoside

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10
Q

A 4-year-old boy with weak urine stream, failure to thrive, recurrent UTIs, enuresis. The renal US is positive for bilateral hydronephrosis. What is the best test to establish the diagnosis?

A

VCUG for the possibility of a posterior urethral valve

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11
Q

A 4-year-old female with a history of chronic constipation presenting with vaginal bleeding and urethral mass

A

Female urethral prolapse

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12
Q

A 6-year-old female with persistently damp underwear (day and night)

A

Ectopic ureter

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13
Q

A 7-year-old uncircumcised boy with penile pain, swollen foreskin O/E: head of the penis is enlarged and congested with a collar of edematous foreskin. A constricting band of retracted foreskin is noted past the head of the penis. What is the best treatment?

A

Emergent reduction of the foreskin to its anatomical position. May apply compression, sugar, pin-pricks to decrease the edema

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14
Q

What are the most common anatomical contraindications of circumcision?

A

Hypospadias with incomplete foreskin, epispadias, ambiguous genitalia

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15
Q

An uncircumcised 3-year-old boy presents with a nonpainful, white, mobile mass just distal to the corona of the boy’s penis

A

Reassurance (normal smegma)

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16
Q

Full-term male newborn presents with right undescended testis. The remainder of the physical examination is unremarkable. What is the next best step?

A

Referral to a surgeon if the testis remains undescended at 6months of age

17
Q

A 15-year-old boy presents with a painless, solid, firm, irregular mass in the left testicle

A

Testicular cancer until proven otherwise

18
Q

A 12-year-old boy presents with sudden onset of testicular pain, vomiting, the right testicle is swollen, tender, absent cremasteric reflex

A

Testicular torsion

19
Q

Patient presents with testicular torsion

A

Immediate urology consult (the testicular US should not delay the consultation)

20
Q

A 12-year-old boy presents with pain, tenderness, and swelling in the upper pole of the right testicle. O/E: bluish dot is visible through the scrotum

A

Torsion of the testicular appendage

21
Q

A 12-year-old boy presents with soft non-tender fullness within the left hemiscrotum, homogenous glow without internal shadows on transillumination; testes are palpable posteriorly

22
Q

An 18-year-old male presents with a left-sided mass that feels like a bag of worms; the left testicle is smaller than normal; the mass increases in size with Valsalva maneuver

A

Varicocele

23
Q

Adolescent male is complaining about a mobile nodule noted above the testis; the mass does not increase with Valsalva

A

Spermatocele

24
Q

A sexually active adolescent male presents with testicular pain that improves with testicular elevation; he has dysuria and fever. The cremasteric reflex is intact

A

Epididymitis

25
A 10-year-old boy with a sudden onset of right flank colicky abdominal pain, nausea, vomiting, frequent urination. Physical examination is normal. The urine test is positive for 20 RBCs. The renal US shows 3 mm stone in the right ureter
Pain medicine, aggressive hydration (most stones smaller than 5 mm pass spontaneously in children)
26
A 10-year-old boy presents with blood in urine and difficulty voiding after blunt trauma to the genital area. O/E: there is a drop of blood on the meatus
Urethral injury (best study is retrograde urethrography)