Urology

Question 1

what imaging modality is useful to assess for vesicourethral reflux?

Answer 1

MAG 3 venogram

Question 2

what imaging modality is useful to assess for renal scarring and function?

Answer 2

DMSA venogram

Question 3

what is the management for VUR?

Answer 3

conservative with voiding advice, constipationa dn fluids
antibiotic prophylaxis - trimethoprim
STING procedure
ureteric reimplantation

Question 4

what are the clinical features diagnostic of pyelonephritis?

Answer 4

pure growth bacteria > 10(5)
pyuria
systemic upset- vomiting, fever

Question 5

how would you differentiate between pyelonephritis and cystitis clinically?

Answer 5

cystitis has mixed growth bacteria but no systemic upset (vomiting, fever), no pyuria

Question 6

what imaging modalities are useful in the diagnosis of a child with a UTI?

Answer 6

USS of kidneys
DMSA
MAG 3
micturating cystourethrogram

Question 7

when would you investigate a child who has a UTI?

Answer 7

< 6 months old
recurrent
atypical

Question 8

what is the main cause of UTI in children?

Answer 8

vesicoureteric reflux

Question 9

what are the complications with VUR?

Answer 9

renal scarring
reflux nephropathy chronic kidney disease in adult hood
prevent hypertension

Question 10

what are the differential diagnoses of an acute scrotum?

Answer 10

testicular torsion
torsion appendix testis
epididymitis

less commonly;
- trauma, haematocele, incarcerated inguinal hernia

Question 11

how long do you have to recover testes if they are torted before they become necrotic?

Answer 11

6-8 hours

Question 12

what is the age prevalence of testicular torsion?

Answer 12

communion neonate
less common in infant - primary school age
increasing incidence academy-adulthood

Question 13

what is the age prevalence of torsion appendix testis?

Answer 13

increasing in prevalence from 2 years - adulthood

rare in neonates/infants

Question 14

what is the age prevalence of epididymitis?

Answer 14

common in neonates and adults

very rare in children/adolescents

Question 15

a 6 month old boy with an acute scrotum. what is the most likely cause?

Answer 15

torsion testes

Question 16

a 5 year old boy with an acute scrotum. what is the most likely cause?

Answer 16

testicular appendix testis

Question 17

a 15 year old boy with an acute scrotum. what is the most likely cause?

Answer 17

torsion testis

Question 18

what is the mnagaemnrt of a hydrocele?

Answer 18

conservative until 5yrs of age

Question 19

what is the presentation of a hydrocele and in what age group is it commonly found in?

Answer 19

very common in newborns 
scrotal swelling 
painless
made worse with crying, straining, at evening 
bluish colour

Question 20

what is the management for an inguinal hernia in a 10 month old boy?

Answer 20

urgent surgical referral for repair

Question 21

what is the management for an inguinal hernia in a 5 year old boy?

Answer 21

elective referral for repair

Question 22

what is the main complication from an inguinal hernia?

Answer 22

incarceration

Question 23

what increases a babies risk of an inguinal hernia?

Answer 23

prematurity

Question 24

what are the 4 types of cryptorchidism?

Answer 24

true cryptorchidism
retractile
ectopic
ascending testis

Question 25

what are the indications for oschideopexy in cryptorchidism?

Answer 25

fertility
malignancy
trauma - mobile if in scrotum so less damaged by trauma
torsion - less likely to twist if they are mobile
cosmetic

Question 26

what are the indiction of circumcision?

Answer 26

balanitis xerotica obliterans (BXO)

balanoprosthitis
religious
UTI (reduces risk esp if they have disrupted urinary tract)

Question 27

what is hypospadias?

Answer 27

urethral meatus on the ventral aspect of the penis

Question 28

what is the most common position of the hypospadias?

Answer 28

anterior (50%)
middle (30%)
posterior (20%)

Question 29

what anomalies are associated with hypospadias?

Answer 29

upper tract anomalies

ambiguous genitalia

Question 30

what is the treatment for cryptorchidism?

Answer 30

surgery

if retracted cryptorchidism management = conservative