Urinary

Question 1

Cryptorchidism treatment

Answer 1

Orchidopexy before 2yrs

Refer to surgeons at 3m and should be seen before 6m

Question 2

Testicular torsion Rx

Answer 2

Surgical exploration within 6h

Question 3

What should parents be told about hypospadias?

Answer 3

Do not circumcise as foreskin used to repair if severe

Question 4

What is defined as secondary enuresis?

Answer 4

Was achieved before for 6m

Question 5

three reasons for enuresis

Answer 5

Inability to wake when bladder full

Bladder overactive

High nocturnal urine output

Question 6

When do most children achieve day and night continence?

Answer 6

3-4yrs

Question 7

What % have achieved day time continence by 4 yrs

Answer 7

95%

Question 8

What % have achieved day time continence by 2.5yrs

Answer 8

50%

Question 9

What % have achieved night time continence by 5yrs

Answer 9

95%

Question 10

What % have achieved night time continence by 10yrs

Answer 10

97-98%

Question 11

Boys or girls slower to achieve continence?

Answer 11

Boys

Question 12

What are some organic reasons for enuresis

Answer 12

Constipation

DM

UTI

Spina bifida

Ectopic ureter

Question 13

What investigations and examination done in enuresis

Answer 13

Ask about fluid intake, stress, access to toilet, diet

Examine abdo, genitalia, spine, neuro, growth

BP

Urine sample- glycosuria, protein, infection, osmolality

?Renal USS or AXR

Question 14

Management enuresis for >5yo

Answer 14

Star chart

Alarm

Question 15

What is second line management enuresis, or for older child

Answer 15

Drugs- desmopressin (ADH analogue)

Oxybutinin (anticholinergic)

TCA (imipramine)- last line

Question 16

management enuresis <5yo

Answer 16

Reassure as not all children have achieved yet. Advice easy access to toilet at night ?potty, empty bladder before bed, not too much fluid before bed

Question 17

If child >5 has daytime Sx management enuresis?

Answer 17

Refer

Question 18

Secondary enuresis where to manage?

Answer 18

If something can be done in PC e.g. constipation, UTI then there, otherwise refer to secondary care

Question 19

What syndrome predisposes children to infections, thrombosis and hyperlipidaemia, and presents with oedema

Answer 19

Nephrotic syndrome

Question 20

Age group nephrotic syn

Answer 20

2-5y

Question 21

Triad in nephrotic syn

Answer 21

Proteinuria (>1g/m2/24hr) leads to hypoalbuminuria (<25g/L) and oedema

Question 22

80% nephrotic synd caused by?

Answer 22

Minimal change glomerulonephritis

Question 23

90% nephrotic synd responds to

Answer 23

High dose oral steroids

Question 24

Should child UTI be investigated?

Answer 24

Yes for cause or renal damage

Question 25

80% childhood UTI caused by

Answer 25

E coli

Question 26

Predisposing factors to UTI

Answer 26

Incomplete emptying (infrequent or hurried voiding, constipation obstructing or neuropathic bladder) Vesicoureteric reflex Poor hygiene

Question 27

Preferred way of sampling urine

Answer 27

Clean catch, if not pad

Question 28

Management UTI

Answer 28

<3m refer to paeds >3m and upper- 7-10 days oral Abx or admit >3m and lower- 3 days Abx PO Recurrent- consider Abx prophylaxis

Question 29

What can occur 7-14 days following a group A beta-haemolytic Streptococcus infection?

Answer 29

Post-strep glomerulonephritis caused by immune complex (IgG, IgM and C3) deposition in the glomeruli

Question 30

4 important causes of glomerulonephritis

Answer 30

Post-strep HSP IgA nephropathy Alport syndrome

Question 31

Advice for vulvovaginitis

Answer 31

Loose clothes Not too much soap