Urology and Renal

Question 1

biochemistry of Bartter’s syndrome

Answer 1

low K+
low Cl-
high urinary calcium (stones)
metabolic alkalosis

Question 2

Ix of ?impalpable testes

Answer 2

re-examine at 5 months
go straight to laparoscopy at 5 months

(USS is not sensitive)

Question 3

management of retractile testes

Answer 3

annual f/u and exam until after puberty

(risk of ascending testes)

Question 4

who gets an IP USS KUB for UTI

Answer 4

septic
poor urine flow
abdominal/bladder mass
raised Cr
failure to respond to suitable abx within 48 hrs
non E coli infection

Question 5

VUR abx prophylaxis

Answer 5

grade 1-2 with recurrent UTI/not toilet trained
grade 3 + all

Question 6

eGFR for dialysis

Answer 6

10 (15 if diabetic)

Question 7

Who gets an USS KUB within 6 weeks for UTI

Answer 7

<6/12 and first
>6/12 and recurrent

Question 8

Who gets a DMSA in 4-6/12 for UTI

Answer 8

any age and recurrent
<3y and atypical

Question 9

Who gets an MCUG for UTI

Answer 9

<6/12 and recurrent or atypical
abnormal USS
FH of VUR

Question 10

treatment of BXO

Answer 10

1) 1% hydrocortisone for 7-14 days +/- PO abx or clotrimazole cream
2) circumcision with urethral calibration if chronic

Question 11

aetiology and causes of secondary VUR

Answer 11

(increased voiding pressure)

posterior urethral valve
neurogenic bladder e.g. spina bifida
ureterocele
ectopic ureter

Question 12

Features of posterior urethral valves

Answer 12

boys only
bladder hypertrophy and hydronephrosis
poor stream and UTIs
oligohydramnios
USS and MCUG
ablation via cystoscopy
RENAL FAILURE

Question 13

signs of an upper UTI in young children

Answer 13

fever 38 or more
bacteruria

Question 14

management of an upper UTI

Answer 14

<3/12 IV abx
>3/12 PO abx

Question 15

complement levels in PSGN

Answer 15

low C3
normal C4

Question 16

immunoglobulin in HSP

Answer 16

IgA

Question 17

which molecules does haemodialysis work best for

Answer 17

low molecular weight
not highly protein bound

Question 18

when to avoid using a reward system for nocturnal enuresis

Answer 18

if the child has no dry nights

Question 19

blue dot sign suggests…

Answer 19

torsion of the hydatis cyst of the testis

Question 20

cause of absolute incontinence and dribbling

Answer 20

ectopic ureter and duplex kidney

Question 21

causes of renal stones in children

Answer 21

Bartter’s syndrome
CF
cystinuria
tumour lysis syndrome
crohn’s

Question 22

Abx for MCUG

Answer 22

3 days with MCUG on day 2