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Board Exam Review > Urology > Flashcards

Urology Flashcards

1
Q

What are common s/s of a UTI?

Infants/neonates (11)

A
  1. Jaundice
  2. hypothemia
  3. FTT
  4. sepsis
  5. V/D, abdo distension
  6. lethargy
  7. malaise
  8. poor feeding
  9. fever
  10. malodor urine
  11. dribbling
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2
Q

What are common s/s of a UTI?

toddler/young children (7)

A
  1. malodor urine
  2. change in void
  3. abdo or flank pain
  4. enuresis
  5. V/D
  6. fever
  7. diaper rash
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3
Q

What are common s/s of a UTI?

school age/adolescent

A
  1. dysuria with freq
  2. urgency
  3. malodor
  4. enuresis
  5. abd or flank pain
  6. fever
  7. V/D
  8. malaise
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4
Q

UTI

  1. most common organism
  2. Dx
A
  1. most common organisms is E.coli with VUR as risk factor
    Vomiting and diarrhea = suspicious of pyelonephritis

Dx: >/= 50,000, or 50^3 on clean catch (mild s/s and older males and females)
>10,000 CFUs on straight cath (mod-severe s/s and infants/children)
>1,00 CFU on suprapubic aspiration

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5
Q

How is a UTI dx and tx?

F/u culture

A
  1. Use sterile cath in young children
  2. DX = nitrites, leukocytes = suspicious, culture must confirm dx
  3. TX: afebrile UTI >2m/o = TMP/SMX (bactrim) 6-10mg/kg/day of TMP and 30-60mg/kg/day of SMX BID
    * Alt: amox 30-50mg/kg/day TID x 10 days
    * other alt = augmentin, nitrofurantoin
  4. F/U culture: 48-72 hours after tx is started, pyridium can be given for >6 years for dysuria
  5. Pyelonephritis = hospitalize for IV antibiotics
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6
Q

What is hypospadias and what is the management?

A
  1. Congenital abnormality of the urethral meatus, can be located anywhere along the penis or perineum (usually on ventral side)
  2. TX = refer to urology for surgical repair
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7
Q

What is a hydrocele and what is tx/dx?

A
  1. Painless collection of serous fluid in the scrotal sac, can be communicating (fluid moves from abdomen to scrotum) or non-communicating (fluid only in scrotum so fluid doesn’t fluctuate)
  2. s/s = asymmetry of scrotum, unilateral swelling, translucent on transillumination, can be tense, blue, and non-reducible if non-communicating; smaller on awakening and larger as day progresses
  3. Dx= transillumination or abd u/s
    TX = non-communicating (no tx, fluid will reabsorb, refer if fluid persists); communicating (refer for surgical repair due to hernia risk)
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8
Q

What is cryptorchidism and what is the management?

define, s/s tx

A
  1. Testicle that does not reside/manipulate into the scrotum, can be gliding/ectopic or ascended, #1 GU disorder in males
  2. S/s = empty scrotum, testicle that moves in and out of scrotum
  3. TX = refer for surgical repair, esp if age >6mo, after 1 year requires immediate referral
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9
Q

What is phimosis?

s/s, tx

A

Foreskin too tight to be retracted

s/s = tight pinpoint opening to foreskin, thickened rolled foreskin (phimosis)

tx: cleanse and gently stretch foreskin during bathing, betamethasone cream (phimosis)

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10
Q

What is paraphimosis?

s/s, tx

A

Retracted foreskin that cannot be reduced

s/s: Edema blue color of glans (paraphimosis)

tx: ice, granulated sugar on penis, or wrapping in saline-soaked gauze and applying pressure for 5-10 minutes; surgical release if severe (paraphimosis)

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11
Q

What is a varicocele and what is the management?

define, s/s, dx, tx

A
  1. Benign enlargement/dilation of testicular veins, bag of worms, painless scrotal mass
  2. s/s = painless swelling, bag of worms texture
  3. DX = US to rule out malignancy
  4. TX = monitor, refer if large or painful
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12
Q

Describe testicular torsion

define, s/s, tx

A
  1. Twisting of the testis leads to ischemic injury; peaks at 7-12 years old and adolescents
  2. S/S unilateral pain that starts acutely and gradually worsens, ill-appearing, anxious, testes can be swollen/erythematous, absent cremasteric reflex on affected side
  3. TX = surgical emergency
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13
Q

What is epididymitis and what is the management?

define, s/s, prehn’s sign

A
  1. painful/acute inflammation of the epididymis often caused by N. gonorrhea, or chlamydia
  2. s/s = scrotal edema/erythema, epididymitis is hard, indurated, tender
  3. Prehn’s sign = elevation of testis relieves pain
  4. Possible urethral d/c
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14
Q

Epididymitis TX (5)

A
  1. bed rest, scrotal support, site baths, NSAIDS, antibiotic TX (ceftriaxone and doxycycline) alt = levofloxacin, refer if does not resolve
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15
Q

What is labial fusion and what is the management?

define, most common age, s/s, tx

A
  1. Fusion of the tissue between the labia minora
  2. Most common in girls 3mo-6year
  3. s/s thin, flat membrane found of varying length, degree of opening varies
  4. TX = observation (can resolve with puberty), A&d ointment with pressure, estrogen cream 1%
    Only need to separate if impedning vaginal/urine d/c, parental concern or d/c
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16
Q

What is vulvovaginitis and what is the management?

define, s/s, tx

A
  1. Inflammation with discharge from infection and or irritation, caused by non-specific, bacterial, fungal, FB or pinworms
  2. S/S = itching, irritation, d/c urinary complaints
  3. TX = depends on cause, antibiotic, antifungals, avoid exacerbating factors
17
Q

What is bacterial vaginosis and what is the management?
define, s/s, dx, tx

THE BOARDS LOOOOVE BV*

A
  1. Caused by Gardnerella vaginosis/anaerobic bacteria, can be sexually transmitted, replaces normal vaginal fauna
  2. s/s = foul odor, milky/white d/c, can be asymptomatic
  3. DX = pH >4.5, +whiff test = fish odor, +clue cells
  4. TX = metronidazole 500mg BID PO x 7 days or metronidazole gel x 5 days or clindamycin cream x 7 days
18
Q

Describe primary amenorrhea and possible causes

A
  1. Primary = absence of menarche by 15 years with normal puberty or by 13 years in girls without breasts or 14 years in boys without testicular enlargment
  2. Causes = delayed puberty, chronic illness, eating disorder, exercise, outflow obstruction, PCOS tumor, meds drugs
19
Q

Describe secondary amenorrhea and possible causes

A
  1. absence of menarche for 3 cycles or 6 mo

2. Causes = psych disorder, eating disorder, pituitary disease, pregnancy, exercise, PCOS, hypothyroid

20
Q

What are the s/s of pregnancy? (7)

A
  1. amenorrhea
  2. light short bleeding
  3. n/v
  4. urinary frequnecy
  5. breast pain
  6. abd fullness
  7. weight gain/loss
21
Q

Hegar sign

A

Cervical softening (2-3 mo preg)

22
Q

Goodell sign

A

sig softening of vaginal portion of the cervix from increased vascularization

23
Q

Chadwick sign

A

Blue cervix, vaginal, vulva

24
Q

pregnancy dx

A

serum HCG: post conception 48 hours

Urine HCG: 2-4 ays post conception

25
Q

What is turner syndrome (3)

A
  1. XO karyotype
  2. XO female with developmental cardiac, reproductive, genetic psych issues
  3. Female with unexplained growth or pubertal delay. Males can transmit gene. Many affected embryos don’t live to term
26
Q

s/s turner syndrome (15)

A
  1. edema of hands/feet
  2. nuchal folds (webbed neck)
  3. left sided card anomalies esp. coarc aorta or hypoplastic left heart
  4. low hairline
  5. high palate
  6. low ears
  7. small mandible
  8. COM
  9. short stature
  10. Increased FSH levels
  11. CUBITUS VALGUS
  12. nail hypoplasia
  13. multiple pigmented nevi
  14. short 4th metacarpal*
  15. no secondary sex characteristics
27
Q

Tests and TX for Turner syndrome?

A
  1. TESTS = cytogenic testing, renal u/s. hearing tests, echo, > 4 years = t4, TSH U/S for gonadal dysgenesis
  2. TX = endocrine, psych, special ED if needed, cardio, opthal, ENT, orthodontist, urology, screen for celiac
28
Q

Vulvovaginitis types of d/c related to cause (5)

A
  1. White/yellow: chemical, mechanical, chlamydia
  2. Pale, yellow/gray green: trichomoniasis
  3. White, thick, cheesy: candidiasis (yeast)
  4. Thin, white, frothy: bacterial vaginosis
  5. Brown, bloody, foul odor: foreign body
29
Q

pH of vaginal secretions (2)

A

<4.5: normal or candidiasis

>4.5: bacterial vaginosis or Trichomonas

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