Disorders Of The genitourinary System

Question 1

Pathological features of hypospadias
Hint:VEGHAs

Answer 1

Ventral curvature of penis/Chordee
Ventral opening of external meatus
Spatulated/flattened glands
Dorsal pre-putial hood
Bifid scrotum
Empty scrotal sac

Question 2

Classification of hypospadias

Answer 2

Glanula
Corona
Penile
Scrotal
Perineal

Question 3

Physical examination of hypospadias

Answer 3

Inspect the external genitalia
Inspect the scrotum
Inspect the perineum
Palpate the abdomen
Examine other systems-VATERL

Question 4

VATERL

Answer 4

Vagina
Anus
Trachea
Esophagus
Renal
Limbs

Question 5

What forms the collecting duct

Answer 5

Pronephros initially but later mesonephros

Question 6

Unilateral kidney incidence

Answer 6

1 in 550 births

Question 7

Bilateral kidney incidence

Answer 7

1 in 4000live births

Question 8

Unilateral renal agenesis

Answer 8

Incidental finding with compensatory hypertrophy of the contralateral kidney

Question 9

Unilateral renal agenesis components

Answer 9

VATERL
Ipsilateral ADRENAL AGENESIS
Blind ENDING Ureteric STUMP

Question 10

Pelvi- Ureteric Junction(PUJ) obstruction

Answer 10

Common abnormality of the ureter
More in boys than girls
Affects left more than right

Question 11

which urinary bladder disorder is assc with epispadia-

Answer 11

bladder exstrophy

Question 12

bladder exstrophy-

Answer 12

absence of ant abd wall and ant wall of urinary bladder

Question 13

condition assc with undesceneded testis and renal agenesis

Answer 13

Apenia

Question 14

micropenis results from-

Answer 14

hypogonadotropic hypogonadism

Question 15

PUV-

Answer 15

cong mucosal folds in post urethra

Question 16

common cause of bladder obs

Answer 16

PUV

Question 17

natural history of PUV-

Answer 17

Prog.renal failure -ESRD(40%)

Question 18

Prenatal diagnosis

Answer 18

Failure of bladder emptying
Thickened bladder wall
Hydronephrosis
Renal dysplasia
Oligohydromnios

Question 19

Post natal diagnosis of Puv-neonates

Answer 19

NEONATAL PERIOD
OBSTRETRIC HX OF OLIGOHYDRAMNIOS
PALPABLE MASSES
RESPIRATORY DISTRESS
LIMB DEFORMITIES
SMALL CHEST CAVITY
INDENTATION OF THE KNEES AND ELBOWS
POTTER’S FACIES
N.B Potter’s syndrome (dysmorphic facial features, fetal growth retardation, positional limb deformations, pulmonary hypoplasia).

Question 20

OLDER CHILD DIAGNOSIS -PUV

Answer 20

OLDER CHILD
VOIDING DYSFUNCTION PRESENTS AS URINARY INCONTINENCE,ENURESIS
POOR URINARY STREAM
POST VOID DRIBBLING
STRAINING AT MICTURATION
UTI
FAILURE TO THRIVE BECAUSE OF RENAL INSUFFICIENCY

Question 21

Penis and associated urethra develop from 3 structures:

Answer 21

Glans: Genital tubercle
Penile urethra: (genital) urethral folds
Scrotum: primitive genital swellings

Question 22

Hypospadias occurs due to

Answer 22

failure (arrest) of complete fusion of (genital) urethral folds.

Question 23

The most common site of

Answer 23

undescended testis is the superficial inguinal ring

Question 24

Affects about- of boys and about of premature babies-undescended testis

Answer 24

3-4%
30%

Question 25

Chordee: may be due to

Answer 25

Skin tethering Fibrous band adjacent to urethra Short urethra Corporal disproportion Not present in all patients

Question 26

Splayed and flattened glans (spade-like)

Answer 26

Sometimes appears rather large A cause of anxiety for mothers (sexual acceptability)

Question 27

Ectopic ureter-male termination

Answer 27

Terminate proximal to the external sphincter : 1)bladder neck or prostatic urethra, 2)seminal vesicle, 3)ejaculatory duct , 4)vas deferens 5) or the epididymis

Question 28

Female ureter ternination-ectopic ureter

Answer 28

Female- ureters may terminate at the bladder neck/urethra, vestibule, vagina or the uterus