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Systems: Paediatrics AB > Urology > Flashcards

Urology Flashcards

1
Q

How can paediatric urology problems present systemically?

A
  • Fever, vomiting
  • Failure to thrive
  • Anaemia
  • Hypertension
  • Renal failure
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2
Q

How can paediatric urology problems present locally?

A
  • Pain
  • Changes in urine
  • Abnormal voiding
  • Mass
  • Visible abnormalities
  • Incidental
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3
Q

How can paediatric urology problems present antenatally?

A
  • Seen on scan
  • Foetus will be asymptomatic
  • Permits immediate postnatal assessment
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4
Q

What is the epidemiology of inguinal hernias?

A
  • 2% boys
  • M:F 9:1
  • 99% direct
  • Increase with prematurity
  • <1 year 33% incarcerate
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5
Q

How do inguinal hernias present?

A

GROIN swelling

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6
Q

How are inguinal hernias managed in the <1 years?

A
  • URGENT referral by phone

- Repair: no place for observation

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7
Q

How are inguinal hernias managed in the >1 years?

A

Elective referral and repair

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8
Q

How are inguinal hernias treated in they are incarcerated?

A

Reduce and repair on same admission

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9
Q

How do hydroceles present?

A
  • SCORAL swelling
  • Painless
  • Increases with crying, straining and in the evening
  • Bluish colour
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10
Q

Who are hydroceles very common in?

A

New-borns

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11
Q

How are hydroceles managed?

A

Conservative until 5 years of age

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12
Q

What is cryptorchidism?

A

Any testis that cannot be manipulated into the bottom half of the scrotum

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13
Q

What are the types of cryptorchidism?

A
  • True cryptorchidism
  • Retractile
  • Ectopic
  • Ascending testes
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14
Q

Why are the testis located in the scrotum?

A

To keep the sperm cool for viability

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15
Q

What is the incidence of cryptorchidism?

A
  • 0.8-1%

- Much more common in babies under 2kg

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16
Q

What are the indications for ochidopexy?

A
  • Fertility preservation
  • Malignancy prevention
  • trauma
  • Torsion
  • Cosmetic
17
Q

What is orchidopexy?

A

Fixation of testis into the scrotum

18
Q

What is circumcision?

A

Removal of the foreskin

19
Q

What are the absolute indications for circumcision?

A

Balanitis xerotica obliterans

20
Q

What are the relative indications for circumcision?

A
  • Balanoprosthitis
  • Religious reasons
  • UTI
21
Q

What are the suggested advantages of circumcision?

A
  • UTI prevention
  • Malignancy prevention
  • Sexual enhancement (increased nerve endings in prepuce)
  • AIDS/STDs
  • Overall no medical benefit
22
Q

What are the disadvantages of circumcision?

A
  • Painful
  • Complications
  • Looks different
23
Q

What are the possible complications of circumcision?

A
  • Bleeding
  • Meatal stenosis
  • Fistula
  • Cosmetic
24
Q

What is the differential diagnosis for the acute scrotum?

A
  • Torsion testis
  • Torsion appendix testis
  • Epididymitis
  • Trauma, haematocele, incarcerated inguinal hernia

If in doubt, explore the scrotum

25
Q

How long are the testis viable in an acute scrotum?

A

6-8 hours

26
Q

Why are UTIs investigated?

A

Prevent renal scarring
-Reflux nephropathy and CKD

Prevent hypertension

27
Q

Who is investigated for UTI?

A

All 6/12, atypical and recurrent

28
Q

How is a UTI defined?

A

Pure growth of >10^5 with pyuria and systemic upset

Mixed growth bacteria with no pyuria or systemic upset is less significant

29
Q

How are UTIs assessed?

A

History and examination
-FH, bowel habit, voiding dysfunction

Ultrasound scan
-Number, size, position, shape, hydronephrosis

Renography
- MAG3 - drainage, function, reflux
DMSA- function, scarring

Micturating cystourethrogram (MCUG)

30
Q

How is VUR managed?

A

Conservative
-Voiding advice, constipation, fluids

Antibiotic prophylaxis

  • ? Until age 4
  • Trimethoprim (2mg/kg nocte)

STING
-Mild/moderate with symptoms

Ureteric reimplantation

31
Q

What is hypospadias?

A

Urethral meatus on the ventral aspect of the penis

32
Q

How is hypospadias classified?

A
  • Anterior 50%
  • Middle 30%
  • Posterior 20%
33
Q

What are the associated anomalies of hypospadias?

A
  • Upper tract abnormalities

- Intersex

34
Q

How is hypospadias investigated?

A
  • Clinical examination

- US if severe

35
Q

How is hypospadias managed?

A

DO NOT CIRCUMCISE

-One stage or 2 stage surgical procedure

Systems: Paediatrics AB (31 decks)

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