Urology/Renal

Question 1

What is Cryptorchidism

Answer 1

Undescended Testes

Question 2

By when should the testes descend

Answer 2

Usually by 3 months, but for sure by 1 year

Question 3

What if the testes are not descended by 1 year

Answer 3

Refer to Urology

Question 4

What is a hydrocele

Answer 4

A collection of fluid in the scrotum due to the patency of the Processus Vaginalis

Question 5

How do you tx hydrocele

Answer 5

Usually close by 18months

Question 6

What is Phimosis

Answer 6

The Inability to retract the foreskin over the glans penis

Question 7

Sx of phimosis

Answer 7

Erythema with tenderness, purulent drainage

Question 8

Tx for Phimosis

Answer 8

If asymptomatic, leave it alone

If dysuria, painful erection, or recurrent UTI refer for circumcision

Question 9

What is Paraphimosis

Answer 9

The entrapment of the foreskin behind glans penis

Question 10

What causes paraphyimosis

Answer 10

Frequent catheterizations without reducing the foreskin
Forcibly retracting a phimosis
Vigorous sexual activity

Question 11

Sx of paraphymosis

Answer 11

Pain, edema, tenderness, erythema of glans and foreskin

Question 12

Tx of paraphymosis

Answer 12

Reduce emergently, first with manual reduction, squeeze glans for a few minutes to shrink
Urology referral if manual fails

Question 13

What happens in testicular torsion

Answer 13

Testes abnormally twists on spermatic cord and compromises the arterial supply and venous drainage

Question 14

Sx of testicular torsion

Answer 14

Sudden onset of severe unilateral pain and scrotal swelling
Edema
Negative Prehn Sign (no relief with elevation of testicle)

Question 15

What is the time limit to salvage the testes with testicular torsion

Answer 15

5 hours

Question 16

What is Enuresis

Answer 16

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

Question 17

Dx of Enuresis

Answer 17

Repeated urination into clothes or bed at least 2x/week for 3 months in a child who is over 5 yrs old

Question 18

Tx of Enuresis

Answer 18

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

Question 19

What is Hypospadias

Answer 19

Abnormal placement of urethra where meatus is proximal and ventral to its normal, anterior position

Question 20

Tx for Hypospadias

Answer 20

Nothing. No circumcision.

Renal US to r/u ascending pathology

Question 21

What defines Nephrotic Syndrome

Answer 21

Proteinuria, Hypoalbuminemia, Edema and Hyperlipidemia

Question 22

What are the 3 categories for Nephrotic syndrome

Answer 22

Minimal Change Disease
Focal Segmental Glomerulosclerosis
Mesangial Nephropathy

Question 23

Tx for Nephrotic Syndrome

Answer 23

Corticosteroids to reduce proteinuria
Usually Prednisone for 6 weeks and tapered
If no remission, consult nephrology