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Royal Super 4th Year Brain > Urology > Flashcards

Urology Flashcards

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1
Q

What is the first investigation to do for congenital urinary obstruction?

A

US

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2
Q

What are the x2 functional assessments that can be done in the setting of urinary obstruction?

A
  • DMSA

- MAG3 (gold standard)

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3
Q

What is the most common cause of congenital urinary obstruction?

A

UPJ

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4
Q

What x2 investigations do you do for PUV?

A
  • US

- Voiding cystourethrography

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5
Q

What x2 complications from intra-uterine environment for neonates with PUV?

A
  • pulmonary hypoplasia

- renal insufficiency

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6
Q

What is the concern for paraphimosis?

A

emergency because can lead to gangrene

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7
Q

Best timing for hypospadias correction

A

6-18 months

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8
Q

How to treat phimosis?

A
  • Betamethasone cream 0.1% BID x2 weeks on then off x4 cycles, need to retract foreskin
  • Circumcision
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9
Q

What APD measurement of the kidney would be consider “high grade” for congenital hydronephrosis?

A

> 15 mm

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10
Q

Most common cause of urinary obstruction in children

A

UPJ

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11
Q

What x2 things can VCUG detect?

A
  • PUV (in males only)

- VUR

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12
Q

What is the important indication for renal scans that other imaging modalities cannot provide?

A

Differential renal function

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13
Q

Difference between DMSA vs MAG3

A
  • Both provide functional information
  • DMSA = renal scarring
  • MAG3 = filtration + drainage
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14
Q

All grades of congenital hydronephrosis carry a 10-15% risk of what?

A

VUR

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15
Q

4 most common causes of high grade congenital hydronephrosis

A
  • UPJ obstruction
  • UVJ obstruction
  • VUR
  • PUV
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16
Q

What is the APD measurement in low grade congenital hydronephrosis?

A

<10mm

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17
Q

When should you do the first post-natal RBUS for (a) low grade vs (b) high grade congenital hydronephrosis?

A

(a) first 1-3 months

(b) first 2 weeks

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18
Q

Most common cause of acquired hydronephrosis

A

UPJ obstruction

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19
Q

Investigations for acquired hydronephrosis

A
  • RBUS

- Diuretic renal scan (MAG3)

20
Q

Typical presentation of acquired hydronephrosis

A
  • Recurrent abdo pain + flank pain
  • Recurrent pyelo
  • Emesis/pain following increased fluid intake
21
Q

Clues on prenatal US to suggest PUV

A
  • Male
  • Oligohydramnios
  • Bilateral hydronephrosis
  • Distended, thick-walled bladder
  • Keyhole sign
22
Q

Post-natal management if PUV

A
  • Stabilize respiratory
  • Decompress bladder
  • Check Cr
  • Urgent RBUS + confirmatory VCUG
  • Consult nephro + urology
23
Q

What is the most common non-infectious cause of daytime urinary incontinence?

A

Overactive bladder

24
Q

What are x2 scary things you want to make sure are not present in setting of overactive bladder?

A
  • Signs of spinal dysraphism / sacral agenesis (aka caudal regression syndrome)
  • Bladder outlet from scarred phimosis or meatal stenosis
25
Q

Signs + symptoms of overactive bladder

A
  • No neurological anomales
  • Frequency (>8 times per day)
  • Urgency
  • Urge incontinence
  • Urine holding postures
  • Small functional bladder capacity
  • Commonly associated with recurrent cystitis
  • Associated with constipation
26
Q

First and second line treatment of overactive bladder

A

1) Timed voiding, treat constipation + UTIs

2) Anti-cholinergics

27
Q

Types of ureteric duplication + associated risks

A
  • Complete = ureters do not merge –> associated with UVJ obstruction + VUR
  • Partial = ureters merge before entering the bladder
28
Q

When to refer a patient with a duplex kidney?

A

If febrile UTI + UVJO + VUR

29
Q

Most common example of a renal fusion anomaly

A

Horseshoe kidney

30
Q

Conservative tx for renal stones

A
  • Fluids
  • Analgesics
  • Alpha blockers (tamsulosin)
31
Q

Prevention of Ca oxalate stones

A
  • Increase fluids
  • Normal dairy intake
  • Decrease salt intake
  • Add citrus to diet
32
Q

First x2 steps in work of patient with ?renal stones

A
  • RBUS

- If confirmatory needed: CT KUB

33
Q

Types of hydrocele - characteristics of each

A
  • Communicating = congenital defect, risk of indirect hernia
  • Non-communicating = could be part of resolution of communicating, can be reactive (secondary to infection, tumor, inflammation, trauma)
34
Q

When should you refer a communicating hydrocele?

A

If no resolution by 18 months

35
Q

At what age would you consider referral for circumcision for non-retractile foreskin (aka physiological phimosis)?

A

> 10 years old

36
Q

What to think about if non-retractile foreskin with thick/blanched skin?

A

Lichen sclerosis

37
Q

Complication of circumcision that can be prevented by application of petroleum jelly

A

Meatal stenosis

38
Q

What are x2 possible benefits of circumcision?

A
  • Decreased STI transmission

- Decreased rate of penile cancer

39
Q

What is the best management plan for VUR I-III which is identified following a single febrile UTI?

A

Observation alone

40
Q

Dx if daytime urinary incontinence with leaks with increased abdo pressure

A

Stress incontinence

41
Q

Dx if daytime urinary incontinence - with continuous leaking/dribbling

A

Ectopic ureter

42
Q

Most common renal “solid” abdo mass for fetuses, neonates, and infants?

A

Congenital mesoblastic nephroma

43
Q

50% risk of Wilms Tumor with what x2 syndromes?

A
  • WAGR

- Denys Drash Syndromes

44
Q

If you see blueberry muffin rashs what malignancy would this make you think of?

A

-Neuroblastoma skin mets

45
Q

What do you think of with a midline mass in a newborn?

A

PUV

46
Q

Best treatment for buried penis

A

Weight loss

Royal Super 4th Year Brain (25 decks)

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