Urology

Question 1

Common cause of urinary retention on females
Mass protruding from urethral meat is
Round filling defect on IVP

Answer 1

Ureterocele

Question 2

Palpable mass in newborn male
Weak urinary stream
Hydronephrosis
Distended bladder

Next step

Answer 2

Posterior urethral valves

Pass urine catheter
VCUG
Immediate urologic consultation

Question 3

Bilateral hydronephrosis/PUV
Undescended testicles
Poor anterior abdominal wall musculature

Answer 3

Prune belly (eagle Barrett) syndrome

Question 4

Female urinary incontinence
Negative work up

Answer 4

Ectopic urethral opening

Question 5

most common UTI organism

Answer 5

E coli

Question 6

Timing of VCUG with febrile UTI

Answer 6

After 2nd febrile UTI
Or if renal/bladder US from first febrile UTI is abnormal

Question 7

Bulge either in suprapubic or scrotal area
Increased in size with crying or straining

Answer 7

Inguinal hernia

Question 8

Painless swelling on scrotum
Transilluminates

Management

Answer 8

Hydrocele

If unresolved by age 2, surgical correction

Question 9

Left scrotum painless swelling
Heavy sensation
Bag of worms
Swelling decreases when patient lies down

Answer 9

Varicocele

Surgery when affected testicular volume is less than unaffected testicle

Question 10

Management of Undescended testicle

Answer 10

Urology consul by 3-6 mo
Orchiopexy y by 12-18 mo

Question 11

Associated syndromes with hypospadias

Answer 11

Silver russel syndrome
Laurence moon biedl syndrome
Pouts syndrome
Beckwith wiedemann syndrome

Question 12

Management for hypospadias

Answer 12

Surgical Correction by 6-12 mo

NO circumcision

Question 13

Micropenis
Poor feeding
Hypotonia

Answer 13

Prader willi syndrome

Question 14

Penile length for endocrine/genetic consult

Answer 14

< 2.5cm

Question 15

Unilateral scrotal pain
Dysuria
Fever
Cremasteric reflex present
+Phrehn sign (alleviation of pain with scrotal elevation)

Answer 15

Epididymitis

Question 16

Management of epididymitis

Answer 16

If sexually active, Ceftriaxone and doxycycline

If not sexually active, cephalexin or Bactrim

Question 17

Sudden severe scrotal pain
Cremasteric reflex absent
Pain not alleviated with scrotal elevation

Answer 17

Testicular torsion

Higher risk in cases of bell clapper deformity

Question 18

Focal tenderness of superior testis
Classic blue dot sign

Answer 18

Torsion of appendix testis

Question 19

Pain
Edema
Marked tenderness of scrotum/testis

Answer 19

Orchitis

Question 20

Inability to retract foreskin
> 3 yo

Management

Answer 20

Phimosis

Topical steroid cream
Gentle retraction
Good hygiene
Circumcision if no improvement

Question 21

Foreskin that cannot be brought back to normal position after retracted

Management

Answer 21

Paraphimosis

Surgical emergency

Question 22

Common bacteria for urethritis

Management

Answer 22

Gonorrhea
Chlamydia

IM ceftriaxone + PO doxycycline x 7 days

Question 23

Silk glove sign

Answer 23

Inguinal hernia