Med Study GU – Flashcards
Unlock all answers in this set
Unlock answersquestion
MCC of hydronephrosis in infants and kids
answer
UPJ obstruction
question
ureterocoeles mc in who and presentation?
answer
females assoc with duplex system - drain into the upper pole of the kidney can cause obstruction or reflux MC presentation = febrile UTI
question
megaureter and tx
answer
defin >7mm may cause reflux or obstrution most just observe no tx only tx if decline in renal function!
question
mcc urinary obstruction in male infants
answer
PUV
question
mcc obstructive uropathy leading to renal failure in childhood
answer
PUV
question
how are PUV diagnosed
answer
most in utero with on US showing bilateral hydronephrosis
question
what's Prune belly and what anom does it include? Do they have normal renal function?
answer
congen absence of abdominal wall m includes cyrptorchidism dilated prostatic urethra bladder and ureters can have severe presentation with obstruction->oligohydraminos and then pulmon hypolasia MC NORMAL renal function
question
tx prune belly
answer
orchioplexy with abdominoplasty early on! ppx abx for uti
question
as hypospadias becomes more proximal increases risk of?
answer
ventral shortening and development of chordee
question
what's the typical pt presenting with urethral prolapse?
answer
AA girls between 4-10 yo those with constipation, trauma, GU or vag infx tx with reduction of the prolapse, sitz baths
question
do you need a special w/u after dx hypospadius?
answer
No! no imaging to look at upper GU system usually isolated event need to do surgery pre age 2 yo
question
what is chordee and what is it assoc with?
answer
ventral curvature of the penis assoc with HYPOSPADIUS
question
phimosis defin and tx
answer
foreskin that can't be retracted mcc = iatrogenic injury by forcible retraction (normal until 4, most should be easily retracted by age5) tx= topical steriod and gentle periodic retraction
question
Posthitis
answer
preputial inflammation and cellulitis if goes to glans = BALANITIS treat with topical and or oRAL abx and steroid cream with local hygiene
question
paraphimosis and tx
answer
entrapment of the phimotic prepuce proximal to the coronal margin reduction = emergent! need sedation and local anesthesia
question
how do you dx meatal stenosis? do you need to evaluate the upper GU system?
answer
need to observe voiding (look for straining and assess angle and strength of stream) it does NOT create upper GU probs
question
what syndromes are microphallus assoc with?
answer
central causes: Kallmann syndrome Prader-Willi panhypopit
question
microphallus tx
answer
testosterone can be benefitial
question
at what age should you do more of a workup for urinary incontinence>
answer
not until >5 yo
question
cause of urinary incontinence if child has normal intentional voiding but constant urine leakage
answer
ectopic ureter
question
cause of urinary incontinence if child voids without prior awareness
answer
sensory defect
question
cause of urinary incontinence in child "bouncing up and down on the soles of their feet"
answer
destrusor instability
question
cause of urinary incontinence when accident when coughing, sneezing, lifting, giggling etc
answer
stress incontinence
question
evaluation for child (>5 yo) with daytime incontinence
answer
UA, urine cx must do a Renal & bladder U/S for child with daytime enuresis (could do urodynamics for child is suspect neuropathic cause, rare)
question
important hx to get in child with nocturnal enuresis
answer
+family hx! (strong genetic predisposition AND always consider ABUSE of any kind
question
when do you do a further workup with labs and imaging for nocturnal enuresis
answer
no imaging done typically (though some get if kid >10 yo)
question
Treatment of nocturnal enuresis
answer
"potty alarms" - good for younger kids meds: oral desmopressim (DDAVP) oxybu BEHAVIORAL training
question
loss of cremaster reflex, horizontal high lying testes
answer
intravaginal testicular TORSION immed surgery (skip US unless dx is unclear) need to fix contralateral test because its also at risk!
question
neonate with painless, swollen discolored hemiscrotum
answer
neonatal testicular torsion due to extravaginal torsion neonatally or prenatally testes usually can't be saved
question
MCC acute scrotal pain in boys 3 to 13
answer
testicular appendage torsion! blue dot sign early on later stages can look just like testicular torsion (if so do doppler US to dx) tx = NONE resolves spon
question
MC genital problem in newborn males
answer
cryptorchidism
question
by what age should testes descend for males?
answer
1 year
question
tx for retractile testes
answer
none almost all eventually end up in the scrotum
question
undescended testes have increased risk of what Ca?
answer
Seminoma (this is why you fix them!)
question
management of hydroceles
answer
if last past 1 year of age need to surgically repair
question
repair inguinal hernias when?
answer
at time of dx
question
varicoceles occur on which side
answer
LEFT
question
baby with PUV surgically corrected and now normal lytes, UOP how long until he develops renal failure?
answer
most by 5 years old!
question
child with first UTI who should you get a renal US (with a VCUG initially) for?
answer
newborns (younger the age more likely it is to be anom) males symptoms of pyelo
question
best emperic abx for pyleo
answer
bactrim or 3rd gen cephlasporin
question
tx epididymitis
answer
(cremaster in tact, testicle low lying) white cells in the urine! tx = for GC and Cglamydia with IM CTX and PO Doxy
question
(for the boards: foreskin is fully retractable by age 3) is foreskin that doesn't retract in a boy younger than 3 need any intervention?
answer
NO
question
T/ F evaluate for testicular CA with BILATERAL US, even if mass is unilatr
answer
true
question
condyloma accuminata assoc with
answer
veneral warts HPV
question
a child with new onset condyloma acuminata after age ___ = due to child abuse
answer
after age 3 = child abuse younger than that can be perinatally acquired (through birth canal)
question
ovarian cyst management
answer
smaller than 6cm = f/u US >6 cm or causing sxs of signif discomfort = lap cyst aspiration
question
Fitz hugh curtis
answer
RUQ pain in sex active female manifest of GC/Chlamydial infx peri-hepatitis (normal LFTs)
question
children on peritoneal dialysis freq get what as a complication?
answer
abdominal hernias due to increased intraperitoneal pressure
question
what do you do for labial adhesions?
answer
resolve spon ->reassurance if no sxs it sxs (dysuria or secondary bact infx then tx with estrogen cream
question
green vaginal discharge
answer
neisseria gonorrhea (but a beta hemolytic strep infx can also present similarly
question
soft vaginal mass, fluctuant in vaginal wall tender non-erythematous no vaginal discharge or bleeding
answer
bartholin gland cysts
question
how are sebaceous cysts different from bartholin gland cysts
answer
sebaceous cysts are flesh colored bumps that arise form the skin
question
undescended testes when to tx
answer
orchiopexy by age 1
question
what syndrome: micropenis poor feeding hypotonia
answer
prader willi
question
what syndrome? micropenis hypoglycemia septo-optic dysplasia anosmia
answer
Kallman syndrome
question
name 4 syndromes assoc with hypospadious
answer
slob silver russell syndrome laurence moon biedl syndrome optiz syndrome beckwith wiedemann syndrome
question
how do distinguish diff between epididymitis and orchitis
answer
orchitis = no dysuria
question
how do you test for orchitis secondary to mumps
answer
mumps serology
question
discharge that reveals gram negative intracellular diplococci
answer
gonococcal urethritis
question
work up for a testicular mass
answer
bilateral US LDH, B-HCG and alpha feto protein
question
risk factors for testicular cancer
answer
cryptochidism previous testicular cancer family hx klinefelters syndrome
question
flesh colored verrucous lesions non tender but bleed with minor trauma
answer
condyloma acuminata genital warts by HPV
question
condyloma lata
answer
secondary syphilus white gray papules that have coalesced in the genital flat
question
in undescended testes bringing the teste down may improve fertility but it does not lower risk of malignancy, true or false?
answer
true
question
criteria for dx PID
answer
adenexal tenderness cervical motion tenderness lower abd pain
question
what is pediculosis pubis
answer
crabs will be described as red, crusted suprapubic macules blue gray dots (macula cerulea)
question
teen female with RUQ pain, N/V "only med she's; taking is OCPs" what test to do?
answer
GC/Chylamdia for fitz hugh curtis
question
what's the best test to do for herpes
answer
viral culture for HSV
