Urology Flashcards

1
Q

what is acute scrotum

A

acute onset of scrotal swelling, redness and pain

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2
Q

ddx of acute scrotum

A
  • testicular torsion
  • torsion appendix testis
  • epididymitis
  • haematocele
  • incarcerated inguinal hernia
  • trauma
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3
Q
  • what is a hernia
  • epidemiology
  • management
A
  • groin swelling

epidemiology:

  • increased risk in premature babies
  • commoner in males
  • 1/3 of presentations under 1 are incarcerated hernias

management:

  • if under 1–> emergency referral and repair
  • if > 1 –> elective referral & repair
  • if incarcerated hernia –> same day repair
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4
Q

main type of hernia to arise in children?

A

indirect

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5
Q

what are incarcerated hernias?

A

when some of the bowel gets trapped “incarcerated” in the hernia and causes obstruction etc –> child VERY unwell and if not treated promptly can lead to death

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6
Q
  • what is hydrocele
  • epidemiology
  • symptoms & signs
A
  • collection of fluid within tunica vaginalis that surrounds testes
  • very common in newborns
  • symptoms and signs:
    • blue-ish colour
    • painless but increase with crying / coughing
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7
Q

types of hydrocele?

A
  • simple
  • communicating
    • where tunica vaginalis is connected to peritoneal cavity
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8
Q

examination findings of hyrocele?

A

will transilluminate with light

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9
Q

management of hydrocele?

A

simple- conservative

communicating- surgery

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10
Q

DDx of scrotal/inguinal swelling in newborn?

A
  • undescended testes
  • hydrocele
  • testicular torsion
  • inguinal hernia
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11
Q

what is cryptorchidism?

A

this is when 1 or both testis have failed to descend from the abdomen to the scrotum

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12
Q

what are the risks associated with undescended testes in older children?

A

higher risk of

  • malignancy
  • infertility
  • testicular torsion
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13
Q

Mx of cryptorchidism?

A
  • conservative
    • most will descend in first 3-6months
  • if not, orchidopexy
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14
Q

what is circumcision and what are the indications for it

A
  • removal of the foreskin
  • indications
    • absolute indications
      • Balanitis Xerotica Obliterans
    • relative
      • ​phimosis
      • paraphimosis
      • religious
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15
Q

definition of UTI

A
  • bacteria > 105
  • pyuria
  • systemic symptoms
    • fever, vomiting etc
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16
Q

reasons and when to investigate UTI?

A
  • to prevent renal scarring / hypertension
  • always investigate in any case <6months old; recurrent; atypical presentation
17
Q

investigation of UTI?

A
  • USS
  • Micturating Cystourethrogram (MCUG)
    • to diagnose VUR
18
Q

Mx of UTI in < 3 months w fever?

A

IV Abx - ceftriaxone

oral Abx if > 3 months and otherwise well

19
Q

what Ix can you use to assess for damage from recurrent /atypical UTIs

A

DMSA scan

20
Q

management of Vesico Ureteric Reflux

A
  • conservative
    • voiding & fluids / avoid constipation
  • avoid excessively full bladder
  • prophylactic Abx
  • ureteric re-implantation
21
Q

what are hypospadias?

A

congenital condition when the urethral meatus is on the ventral aspect of the penis

22
Q

types of hypospadias?

A

anterior - most common

middle

posterior - least common

23
Q
  • associated anomalies with hypospadias
  • management
A
  • associated with abnormal genitalia + upper tract abnormalities
  • do not circumcise, reconstructive surgery