Urology Flashcards
what imaging modality is useful to assess for vesicourethral reflux?
MAG 3 venogram
what imaging modality is useful to assess for renal scarring and function?
DMSA venogram
what is the management for VUR?
conservative with voiding advice, constipationa dn fluids
antibiotic prophylaxis - trimethoprim
STING procedure
ureteric reimplantation
what are the clinical features diagnostic of pyelonephritis?
pure growth bacteria > 10(5)
pyuria
systemic upset- vomiting, fever
how would you differentiate between pyelonephritis and cystitis clinically?
cystitis has mixed growth bacteria but no systemic upset (vomiting, fever), no pyuria
what imaging modalities are useful in the diagnosis of a child with a UTI?
USS of kidneys
DMSA
MAG 3
micturating cystourethrogram
when would you investigate a child who has a UTI?
< 6 months old
recurrent
atypical
what is the main cause of UTI in children?
vesicoureteric reflux
what are the complications with VUR?
renal scarring
reflux nephropathy chronic kidney disease in adult hood
prevent hypertension
what are the differential diagnoses of an acute scrotum?
testicular torsion
torsion appendix testis
epididymitis
less commonly;
- trauma, haematocele, incarcerated inguinal hernia
how long do you have to recover testes if they are torted before they become necrotic?
6-8 hours
what is the age prevalence of testicular torsion?
communion neonate
less common in infant - primary school age
increasing incidence academy-adulthood
what is the age prevalence of torsion appendix testis?
increasing in prevalence from 2 years - adulthood
rare in neonates/infants
what is the age prevalence of epididymitis?
common in neonates and adults
very rare in children/adolescents
a 6 month old boy with an acute scrotum. what is the most likely cause?
torsion testes
a 5 year old boy with an acute scrotum. what is the most likely cause?
testicular appendix testis
a 15 year old boy with an acute scrotum. what is the most likely cause?
torsion testis
what is the mnagaemnrt of a hydrocele?
conservative until 5yrs of age
what is the presentation of a hydrocele and in what age group is it commonly found in?
very common in newborns scrotal swelling painless made worse with crying, straining, at evening bluish colour
what is the management for an inguinal hernia in a 10 month old boy?
urgent surgical referral for repair
what is the management for an inguinal hernia in a 5 year old boy?
elective referral for repair
what is the main complication from an inguinal hernia?
incarceration
what increases a babies risk of an inguinal hernia?
prematurity
what are the 4 types of cryptorchidism?
true cryptorchidism
retractile
ectopic
ascending testis
what are the indications for oschideopexy in cryptorchidism?
fertility
malignancy
trauma - mobile if in scrotum so less damaged by trauma
torsion - less likely to twist if they are mobile
cosmetic
what are the indiction of circumcision?
balanitis xerotica obliterans (BXO)
balanoprosthitis
religious
UTI (reduces risk esp if they have disrupted urinary tract)
what is hypospadias?
urethral meatus on the ventral aspect of the penis
what is the most common position of the hypospadias?
anterior (50%)
middle (30%)
posterior (20%)
what anomalies are associated with hypospadias?
upper tract anomalies
ambiguous genitalia
what is the treatment for cryptorchidism?
surgery
if retracted cryptorchidism management = conservative
