223- Peds urology

Question 1

ultrasound findings in multicystic dysplastic kidney. Treatment?

Answer 1

“bunch of grapes”. Resolves on its own but look at contralateral kidney for VUR and UPJO

Question 2

Antenatal hydronephrosis: most common treatment? Does it mean obstruction? Where is the most common obstruction? What are the most common causes of this obstruction?

Answer 2

most resolves on its own.
Not always obstruction
Ureteropelvic jxn
adynamic ureteral segment or crossing vessel, high insertion on kidney

Question 3

Why are UPJ ad UVj most common sites of obstruction

Answer 3

ureter re-canalizes starting in the middle

Question 4

Vesicureteral reflux: what can it cause? what do we do to treat? how does it usually present? What is the cause? how do you diagnose/

Answer 4

renal scarring. Presents with UTI in kids and we give prophylactic antibiotics to prevent future UTIs and scarring.

Caused by shortened intravesicular ureter and muscular deficiency resulting in lateral displacement of ureteral orifice

Diagnose with voiding cystourethrogram (VCUG)

Question 5

Wiegert-meyer rule

Answer 5

for ureteral duplication. The ureter associated with lower pole of kidney inserts more laterally and refluxes. The ureter of upper pole of kidney inserts medially and will obstruct

Question 6

Posterior urethral valves: what does it cause? what is the problem? what does ultrasound show?

Answer 6

bladder outlet obstruction can lead to ESRF

congenital obstructing membrane in posterior urethra

bilateral hydronephrosis, thick bladder, dilated posterior urethra, oligohydramnios (possibly leading to Potter’s syndrome)

Question 7

what do you think of when you see hypospadius with undescended testis?

Answer 7

disorder of sexual development

Question 8

Until when do you give the testes to descend on their own before you intervene? complication of undescended teste?

Answer 8

6 months post birth

Infertility and increased risk of seminoma

Question 9

what do you call a testicle that can be manipulated into scrotum and remains there for a time? how about one that was in the testicle but isnt anymore

Answer 9

retractile, ascended

Question 10

etiology of pediatric hernia and hydrocele? what’s the difference between the two? which would you operate on?

Answer 10

patent processus vaginalus
hydrocele= fluid only
hernia=abdominal contents

Operate on hernia or if hydrocele is communicating (fluctuates throughout the day) or if it lasts longer than 18 months