Inguino-scrotal Flashcards Preview

MD 3 - Paeds > Inguino-scrotal > Flashcards

Flashcards in Inguino-scrotal Deck (39):
1

common organisms that cause epididymoorchitis

N. gonorrhoea
Chlaymdia trachomatis

2

what is epispadias

urethral opening is on top of the penis/above the clitoris

3

complications of phimosis and paraphimosis

urinary obstruction
ballooning of the foreskin on micturition

4

treatment of balanitis

topical or systemic antibiotics

5

clinical presentation of testicular torsion in a baby

hard, painless, scrotal mass

6

clinical presentation of torsion of the testicular appendage

- gradual onset of testicular pain
(no nausea)

7

complications of hypospadias

difficulty direction urinary stream
infertility
poor sexual function

8

treatment of testicular torsion

surgery

9

what signs on examination points towards a varicocele

- feels like a bag of worms
- asymmetry - testes hanging at different positions
- no transillumination
- increases in size during Valsalva
- decreases in size if supine

10

what causes a hydrocele

peritoneal fluid tracks down a narrow but patent processus vaginalis into the scrotum causing swelling

11

3 complications of cryptorchidism

reduced fertility
increased malignancy risk
increased risk of testicular torsion

12

typical clinical presentation of testicular torsion in a pubescent

sudden onset testicular pain and swelling
+/- nausea and vomiting
(pain may be in the iliac fossa)

13

treatment of paraphimosis

external compression of the glans --> reduce the swelling --> push back through the constriction

14

which testicle is more likely to have a varicocele? L or R

left

15

what percentage of live births of boys have undescended testes

2%

16

risk factors for epididymoorchitis

- UTI
- instrumentation/catheterization
- reflux
- other abnormalities of the urinary tract
- immunocompromise

17

greatest risk factor for torsion of the testes

Bell-clapper deformity

18

difference between direct and indirect inguinal hernias

direct - through the external ring due to abdominal wall weakness
indirect - through the internal inguinal ring

19

when does descent of the testes usually start in utero

by 28 weeks

20

history presentation of a varicocele

asymptomatic or may have scrotal pain or heaviness

21

what signs on examination do you see for testicular torsion

- discolouration of the scrotum
- exquisitely tender testes
- swollen testis, riding high
- absent cremasteric reflex

22

what signs of examination tell you that a scrotal swelling is a hydrocele and not an inguinal hernia

- transilluminates
- can get above it
- no impulse on crying/straining
- does not empty with compression

23

3 components of hypospadias

- proximal meatus on the undersurface of the penis
- dorsal hood
- chordee

24

what is the common cause of balanitis

infected urine pools under the foreskin due to phimosis

25

what causes acquired undescended testis

result of the failure of elongation of the spermatic cord with age caused by the persistence of a fibrous remanent of the processes vaginalis

26

what signs on examination do you see for torsion of the testicular appendage

- focal tenderness at upper pole of testes, but testis itself can be palpated without pain
- blue dot sign

27

principles of management of epididymoorchitis

scrotal support, bed rest, ice
analgesia
alkalinisation of urine
antibiotics - ceftriaxone and doxycycine

28

what is a bell-clapper deformity

when the tunica vaginalis joins high on the spermatic cord, leaving the testis free to rotate

29

what is smegma

a collection of shed skin cells and skin secretions under the foreskin of a penis in young boys due to adherence of the foreskin to the glans in early childhood (up to 5)

30

most common age for torsion of the testicular appendage

under 11 years

31

what causes a varicocele

Dilation of the pampiniform venous plexus and the internal spermatic vein within the scrotum due to incompetent valves in the testicular veins

32

difference between phimosis and paraphimosis

- phimosis - inability to RETRACT foreskin over glans penis
- foreskin is caught behind the glans leading to oedema and the ability to REDUCE the foreskin

33

when should you do surgery for a varicocele

if there is:
- pain
- testicular atrophy/delayed growth of ipsilateral testes

34

treatment of phimosis

- mild-moderate = application of steroid ointment to the tight shiny part of the foreskin
- severe = circumcision

35

clinical presentation of a hydrocele

PAINLESS cystic swelling around the testis in the scrotum

36

pathophysiology of paraphimosis

when a tight foreskin is forcibly retracted --> forms a constricting ring around the coronal groove of the glans --> venous engorgement --> painful swelling of the glans --> unable to reduce foreskin over the swelling

37

clinical presentation of epididymoorchitis

- sudden onset bilateral scrotal pain and swelling
- fever
- purulent discharge
- secondary reactive hydrocoele

38

detail the urgency of surgery for inguinal hernias

more urgent the younger the child

39

typical age group for torsion of the testes

- babies
- >13 years (most commonly between the ages of 13-16)