Children With Renal Abnormalities

Question 1

Mayer-rokitansky syndrome?

Answer 1

Absent kidney can cause:

Abnormalities of vagina, uterus, Fallopian tubes associated most commonly with absent kidney

Question 2

Vesicoureteral reflux happens how?

Answer 2

Ureteric bud arises laterally so submucosal tunnel absent or shot hence reflux

Question 3

A child with UTI and enlarged ureters can cause?

Answer 3

Pyelonephritis

Question 4

Hydronephrosis?

Answer 4

Dilated collecting system- renal pelvis and calluses bigger than normal. Could be due to obstruction

Question 5

Which scan is good for showing obstruction/drainage in kidney?

Answer 5

MAG3- nuclear scan

Question 6

Posteriorurethral valve PUV (only in neonatal/baby boys) causes?

Answer 6

Bladder obstruction and so back pressure on kidneys

They are diagnosed antenatal

Obstructive membranes in the urethra

Question 7

Hypospadia?

Answer 7

Opening of urethra not at tip of penis, underneath usually

Question 8

How does kidney develop?

Answer 8

Uterine bud moves towards metanephric blastema, triggering growth of kidney

Question 9

Testing for UTI

Answer 9

Suprapubic aspiration
Dipstick for nitrites
High index of suspicion
Difficulties in obtaining mid stream urine
Urine culture
Pyuria- increased white blood cells in urine

Question 10

What is the commonest cause of UTI?

Answer 10

VUR

Question 11

Treatment for VUR?

Answer 11

Uroprophylaxis

But a needle and add a small balloon to narrow opening

Question 12

How to look for hydronephrosis?

Answer 12

Ultrasound, nuclear scan

Question 13

Infection is very uncommon in…?

Answer 13

Hydronephrosis

Question 14

Mega ureter is associated with a?

Answer 14

Urterocele- swelling at bottom of one of the ureters.

Question 15

How does inguinal hernias form?

Answer 15

Normally the processus vaginalis obliterates, but contents (intestines) comes through opening remains

Question 16

Hydrocele?

Answer 16

Fluid coming through opening of processus vaginalis

Question 17

What is undescended testis UDT?

Answer 17

Testis cannot be brought to bottom of scrotum without undue tension of spermatic cord

Question 18

Incidence of UDT?

Answer 18

3%

Question 19

Testicular artery arises from?

Answer 19

Abdominal aorta

Question 20

Fowler stephens technique?

Answer 20

Ligation and clipping of main testicular vessels in situ in abdomen. Then orchidopexy, moving undescended testis into scrotum to fix permanently there

Question 21

Descent of testis happens in?

Answer 21

Third trimester

Question 22

Where does the kidney formation begin?

Answer 22

Uterus bud abnormally branching before it reaches metanephric blastema

Question 23

What is the commonest surgical cause of UTI?

Answer 23

VUR

Question 24

How to look for reflux nephropathy?

Answer 24

DMSA

Radioisotope

Question 25

Management of VUR?

Answer 25

Many will stop refluxing after age 5

Question 26

Treatment of VUR?

Answer 26

STING, suburetral Teflon injection, gel to prevent back flow of urine

Or balloon to close the ureter slightly

Question 27

How to investigate hydronephrosis?

Answer 27

Ultrasound scan nuclear scan

Question 28

What is a uterocele?

Answer 28

Ballooning of ureter inside bladder, usually happens in a megaureter