OnlineMedEd: Pediatrics - "Urology"

Question 1

List the anatomic abnormalities that can occur in the urethra, bladder, ureters, and kidneys.

Answer 1

• Urethra: posterior urethral valve; hypospadias; epispadias
• Bladder: vesicoureteral junction abnormalities
• Ureter: ureteropelvic junction abnormality
• Kidneys: Wilms’ tumor

Question 2

What should you do to manage microscopic hematuria?

Answer 2

Watch and wait. If it doesn’t go away –which most times it does –then it may indicate a congenital defect.

Question 3

An ultrasound can detect what urologic abnormalities?

Answer 3

Hydronephrosis (which could be from an obstruction or from ureteral reflux)

Question 4

What is a VCUG?

Answer 4

Voiding cystourethrogram

Injecting dye into the bladder and then having the child void. If an x-ray shows dye in the ureters, then you know there’s reflux.

Question 5

What is the pathology of posterior urethral valve?

Answer 5

Redundant tissue causes urinary retention.

Question 6

_____________ presents with no urinary output, oligohydramnios, and a distended bladder at birth.

Answer 6

Posterior urethral valve

Question 7

What is the usual way PUV is diagnosed?

Answer 7

1) US shows hydronephrosis in a kid with oliguria
2) VCUG shows no reflux
3) Catheterization shows significant residual volume

Question 8

You should never do a circumcision on a child with _____________.

Answer 8

hypospadias or epispadias (the extra tissue is used to make a urethra)

Question 9

How can you differentiate between ureteropelvic junction obstruction and ureterovesicular junction obstruction?

Answer 9

UPJO presents with hydronephrosis and a normal ureter. UVJO presents with hydronephrosis and ureterocele.

Question 10

Often UVJO and UPJO can go be asymptomatic for a long time. What is a common presentation later in life?

Answer 10

Adolescents discover it from binge drinking. The volume of beer and the diuresis of alcohol can induce a simulated obstruction in the ureters due to high volume passing through a narrowed lumen.

Question 11

In ectopic ureter, the ___________ end implants incorrectly.

Answer 11

distal

Question 12

Why are women more likely to have symptoms in ectopic ureter?

Answer 12

The distal end can implant in the vagina or distal to the urethral sphincter. This anomaly will present with constant leakage of urine in a young child who has never been dry.

Question 13

True or false: ectopic ureters present with hydronephrosis.

Answer 13

False. The constant leak prevents this from happening.

Question 14

Those with VUR will usually get diagnosed _____________.

Answer 14

on prenatal US showing hydronephrosis

Question 15

Recurrent pyelonephritis in a child is suggestive of _______________.

Answer 15

VUR