Urology/Renal Flashcards
What is Cryptorchidism
Undescended Testes
By when should the testes descend
Usually by 3 months, but for sure by 1 year
What if the testes are not descended by 1 year
Refer to Urology
What is a hydrocele
A collection of fluid in the scrotum due to the patency of the Processus Vaginalis
How do you tx hydrocele
Usually close by 18months
What is Phimosis
The Inability to retract the foreskin over the glans penis
Sx of phimosis
Erythema with tenderness, purulent drainage
Tx for Phimosis
If asymptomatic, leave it alone
If dysuria, painful erection, or recurrent UTI refer for circumcision
What is Paraphimosis
The entrapment of the foreskin behind glans penis
What causes paraphyimosis
Frequent catheterizations without reducing the foreskin
Forcibly retracting a phimosis
Vigorous sexual activity
Sx of paraphymosis
Pain, edema, tenderness, erythema of glans and foreskin
Tx of paraphymosis
Reduce emergently, first with manual reduction, squeeze glans for a few minutes to shrink
Urology referral if manual fails
What happens in testicular torsion
Testes abnormally twists on spermatic cord and compromises the arterial supply and venous drainage
Sx of testicular torsion
Sudden onset of severe unilateral pain and scrotal swelling
Edema
Negative Prehn Sign (no relief with elevation of testicle)
What is the time limit to salvage the testes with testicular torsion
5 hours
What is Enuresis
Primary is when someone wets the bed or their clothes and has never been potty trained
Secondary is when someone has learned bladder control but regresses to wetting the bed
Dx of Enuresis
Repeated urination into clothes or bed at least 2x/week for 3 months in a child who is over 5 yrs old
Tx of Enuresis
Limit fluids before bed, wake the child at night to toilet
Bedwetting alarms are standard of care
Never scold the child
Desmopressin Acetate to decrease urine production
What is Hypospadias
Abnormal placement of urethra where meatus is proximal and ventral to its normal, anterior position
Tx for Hypospadias
Nothing. No circumcision.
Renal US to r/u ascending pathology
What defines Nephrotic Syndrome
Proteinuria, Hypoalbuminemia, Edema and Hyperlipidemia
What are the 3 categories for Nephrotic syndrome
Minimal Change Disease
Focal Segmental Glomerulosclerosis
Mesangial Nephropathy
Tx for Nephrotic Syndrome
Corticosteroids to reduce proteinuria
Usually Prednisone for 6 weeks and tapered
If no remission, consult nephrology