congenital anomalies of the urinary tract

Question 1

what is vesicoureteric junction reflex?

Answer 1

retrograde flow of urine into upper urinary tract

Question 2

which sex is more affected by VUR?

Answer 2

females

Question 3

describe grade 1, 2 & 3of VUR.

Answer 3

grade 1: flow into non dilated ureter
grade 2: flow into non dilated pelvis and calyces
grade 3: mild to moderate dilation of the ureter and renal pelvis

Question 4

describe grade 4&5 of VUR.

Answer 4

grade 4: moderate dilation and/or tortuosity of ureter
grade 5: severe dilation and toruosity of the ureter renal pelvis and calyces

Question 5

what is the gold standard imaging for VUR?

Answer 5

micturition cystourethrography

Question 6

what is diuretic renal scan DMSA used for?

Answer 6

visualizes scarring and assess renal function

Question 7

what is the treatment for grades 1&2 VUR?

Answer 7

prophylactic antibiotics

Question 8

what is the treatment for grades 3-5 VUR?

Answer 8

surgery–> uretherovesical reimplantation or endoscopic injections

Question 9

when is surgery indicated for VUR?

Answer 9

patients with persistent reflux despite antibiotic trials

Question 10

urethras duplication—->

Answer 10

frequent anomaly

Question 11

what is the male to female ratio in duplication of the urinary system?

Answer 11

1:2

Question 12

what is Weigert-Myer Law?

Answer 12

urethras orifice of upper renal segment drains inferiorly and medially to the orifice of the lower segment

Question 13

which orifice is commonly obstructed in duplication of urinary system?

Answer 13

orifice draining the upper segment

Question 14

which orifice commonly refluxes in duplication of urinary system?

Answer 14

orifice of the lower segment

Question 15

how is duplication of urinary system discovered?

Answer 15

MRU

Question 16

Define ectopic ureter?

Answer 16

ureter opening in another location and not in the bladder

Question 17

what is the percentage of ectopic bladder occurring with duplication of urinary system?

Answer 17

80%
20% with single system

Question 18

how does ectopic bladder present in females

Answer 18

incontenence

Question 19

what are the common site of ectopic bladder in females?

Answer 19

vestibule vagina urethera

Question 20

what are the common site of ectopic bladder in males?

Answer 20

posterior urethera
seminal vesicles

Question 21

define ureterocele

Answer 21

congenital cystic balloting of the terminal submucosal ureter

Question 22

what are the 2 types of ureterocele? and describe both.

Answer 22

simple–> in trigon
ectopic–> obstructor the bladder neck or prolapse from female urethera

Question 23

what is the incidence of undescended testis in full term boys?

Answer 23

3.4%-5.8%

Question 24

what is the cause of undescended testis?

Answer 24

unclear but androgens may have an important role

Question 25

what are the different location of undescended testis?

Answer 25

upper scrotum superficial inguinal pouch inguinal canal abdomen

Question 26

in the majority of the patients where will the testis be palpable?

Answer 26

in 80% of patients testis will be palpable in the inguinal canal

Question 27

what are the different locations of ectopic testis?

Answer 27

perineal retrovesicular femoral penile

Question 28

what are the complications of undescended testis?

Answer 28

sub fertility increased risk of testicular cancer upto 10 times

Question 29

when is spontaneous descend of testis is rare?

Answer 29

after 1 year old

Question 30

what are the investigation for undescended testis?

Answer 30

examination is more accurate than imaging imaging: US-CT-MRI (not accurate)

Question 31

what are the investigations for bilateral undescended testis?

Answer 31

chromosomal and endocrine studies

Question 32

what are the fertility percentages in patients who had surgery for uni/bilateral undescended testis?

Answer 32

unilateral: 90% bilateral: 60%

Question 33

what are the surgeries for undescended testis?

Answer 33

orchidopexy--> for palpable in inguinal canal or below orchidectomy--> for atrophic intra abdominal testis which is uncapable of spermatogenesis and has a high risk of malignancy

Question 34

what is the investigation for impalpable testis?

Answer 34

Laproscopy

Question 35

which 2 hormones are elevated in congenital adrenal hyperplasia?

Answer 35

17 hydroxyprogesterone testosterone low levels of cortisol

Question 36

describe genitalia in congenital adrenal hyperplasia?

Answer 36

virilization of external genitalia normal internal genitalia

Question 37

what are the investigations for congenital adrenal hyperplasia?

Answer 37

karyotyping hormone profile no laproscopy

Question 38

what is the surgery for congenital adrenal hyperplasia?

Answer 38

early feminizing genitoplasty