ABU Pediatric Urology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Wilms tumor

Most common pediatric renal malignancy, peak age 3-4 years, associated with WT1 mutations, WAGR, Beckwith-Wiedemann; treatment nephrectomy plus chemotherapy with or without radiation.

Neuroblastoma

Most common extracranial solid tumor in children, arises from neural crest, elevated urinary VMA/HVA, often calcified on imaging; treatment surgical resection with or without chemo/radiation.

Yolk sac tumor

Most common prepubertal testicular tumor, painless scrotal mass, elevated AFP; treatment radical inguinal orchiectomy, excellent prognosis.

Posterior urethral valves

Most common cause of lower urinary tract obstruction in boys; prenatal ultrasound shows keyhole sign and thickened bladder; treatment bladder drainage then valve ablation.

Vesicoureteral reflux grading

Graded I-V by VCUG; grade I-III often managed medically with antibiotic prophylaxis; grades IV-V may require ureteral reimplantation or endoscopic injection.

Hypospadias

Ventral urethral meatus, dorsal hooded foreskin, chordee; avoid circumcision; repair at 6-18 months; severity based on meatal location.

Bladder capacity formula

Normal bladder capacity in children: (age in years + 2) × 30 mL; expected voiding frequency 4-7 times/day; post-void residual <10% capacity.

Dysfunctional voiding

Pelvic floor contraction during voiding; staccato or interrupted stream; diagnosed by uroflow with EMG; treatment biofeedback and pelvic floor relaxation.

Neurogenic bladder

Due to spinal dysraphism, spinal cord injury, tethered cord; urodynamics assess compliance and leak point pressure; clean intermittent catheterization and anticholinergics protect kidneys.

Pediatric urolithiasis

Increasing incidence; most common composition calcium oxalate; risk factors: low fluid intake, metabolic abnormalities, anatomic anomalies, infection.

Cystinuria

Autosomal recessive; defective renal tubular reabsorption of cystine, ornithine, lysine, arginine; treatment hyperhydration, alkalinization, chelators (penicillamine, tiopronin).

ESWL in children

First-line for renal stones <1 cm in children; less effective for lower pole stones; complications: hematuria, colic, steinstrasse.

Renal trauma

Most common pediatric genitourinary injury; grading I-V by CT; hemodynamically stable patients managed nonoperatively; absolute indication for surgery: hemodynamic instability.

Urethral injury

Suspect with blood at meatus, perineal hematoma, inability to void; retrograde urethrogram for diagnosis; suprapubic catheter if unable to place urethral catheter; delayed repair for stricture.

Hypospadias repair goals

Straight penis, meatus at tip, normal voiding, acceptable cosmesis; techniques: tubularized incised plate (TIP), onlay graft; complications: fistula, stricture, diverticulum.

Febrile UTI

Common in children; may cause renal scarring; diagnosis by urinalysis and urine culture; neonates and infants often require parenteral antibiotics.

Acute pyelonephritis

Fever, flank pain, elevated inflammatory markers; imaging (ultrasound) to rule out abscess or obstruction; treatment IV antibiotics then oral.

Epididymitis

Scrotal pain and swelling; in children often due to urinary tract anomaly or sexual abuse; treat with antibiotics and scrotal support; differentiate from testicular torsion.

Schwartz formula

Estimates GFR in children: eGFR = 0.413 × height (cm) / serum creatinine (mg/dL); normal GFR >90 mL/min/1.73m2.

Pediatric hypertension

Defined as BP ≥95th percentile for age, sex, height; secondary causes common in young children (renal parenchymal disease, coarctation, endocrine); renal ultrasound and labs for evaluation.

Renal transplantation

Preferred treatment for end-stage renal disease in children; living donor preferred; complications: rejection, infection, hypertension, recurrence of primary disease.

Congenital adrenal hyperplasia

Most common cause of 46,XX DSD; 21-hydroxylase deficiency; virilization of female genitalia; treat with glucocorticoids and mineralocorticoids; feminizing genitoplasty in severe cases.

Androgen insensitivity syndrome

46,XY DSD; complete (CAIS) or partial (PAIS); complete: female phenotype, absent uterus, testes; partial: ambiguous genitalia; management individualized.

Testicular torsion

Acute scrotal pain; bell-clapper deformity; surgical emergency; detorsion and orchiopexy; salvage rate decreases after 6 hours.

Prenatal hydronephrosis

Most common fetal anomaly; defined as anterior-posterior renal pelvis diameter (APRPD) ≥4 mm in second trimester, ≥7 mm in third trimester; grading by Society for Fetal Urology (SFU).

Fetal urine analysis

Sodium, chloride, osmolarity; poor prognosis if sodium >100 mEq/L, osmolarity >200 mOsm/L; used to select candidates for intervention.

Vesicoamniotic shunt

Prenatal intervention for bladder outlet obstruction (e.g., posterior urethral valves) with oligohydramnios; diverts fetal urine to amniotic cavity to prevent pulmonary hypoplasia.

Renal ultrasound

First-line imaging for hydronephrosis, renal size, and bladder; no radiation; use for prenatal and postnatal evaluation.

VCUG

Gold standard for vesicoureteral reflux (VUR) and urethral anatomy; grading I-V; use for recurrent UTIs, hydronephrosis, and suspected posterior urethral valves.

Diuretic renogram

Assesses renal function and drainage; furosemide given to provoke diuresis; obstructive pattern: delayed drainage (T1/2 >20 min).

DMSA scan

Evaluates renal cortical scarring and differential function; gold standard for pyelonephritis and scarring; use in febrile UTI.

Urodynamics

Assesses bladder storage and emptying; indications: neurogenic bladder, dysfunctional voiding, posterior urethral valves; measures compliance, leak point pressure, detrusor overactivity.