Urology Board Review (Peds)

Front 1

a female infant with unilateral renal agenesis must be monitored long-term for what?

Back 1

significant incidence of ipsilateral mullerian anomalies (uterine or vaginal anomalies)

Front 2

what is the orientation of the renal pelvis in most anomalous kidneys?

Back 2

anterior

Front 3

why does ectopic ureters not lead to incontinence in boys?

Back 3

in males, they insert into the lower GU tract above the external sphincter

Front 4

infant with R MCDK, what studies should be done to evaluate the L kidney?

Back 4

RUS to r/o hydro, and a VCUG since greater than 30% incidence of contralateral VUR

Front 5

early rupture of the cloacal membrane results in what anomalies?

Back 5

cloacal exstrophy, bladder exstrophy, epispadias

Front 6

why can horseshoe kidneys have UPJO?

Back 6

persistence of vessels that normally involute with renal ascent

Front 7

T/F: fused crossed renal ectopia is more common?

Back 7

True

Front 8

in cross-fused renal ectopia, where does the ureter of the crossed kidney usually enter the bladder?

Back 8

crosses midline and enters contralateral trigone

Front 9

one month old boy with L flank mass, what are the 2 likely dx?

Back 9

hydronephrosis and multicystic renal dysplasia; image with RUS

Front 10

12 yo male with terminal hematuria found to have a polyp in his post urethra arising from the verumontanum; what is it?

Back 10

benign fibroepitheliomatous polyp of congenital origin; similar polyps may be found in the ureter and renal pelvis

Front 11

15 yo boy with dysuria with cystic lesion in the bulbous urethra?

Back 11

Cowper's duct cyst

Front 12

what is lacuna magna?

Back 12

small diverticulum on the roof of the distal urethra in the fossa navicularis; can see dysuria and blood spotting

Front 13

3 yo boy with small, hydronephrotic L kidney and ureter. At cysto, no L UO seen. Where does the ureter insert?

Back 13

into the Wolffian system (SV, vas); represents failure of the ureteral bud to separate from it Wolffian duct origin

Front 14

what are fetal folds?

Back 14

persistent folds in the upper portion of the L ureter w/o hydro; they disappear with time

Front 15

what's the difference developmentally b/w MCRD and ADPCK?

Back 15

cysts in MCRD is failure of normal organogenesis leading to immature renal parenchyma and cystic dysplasia; in PCK, normal architecture of the nephron is destroyed by obstruction of the nephron and resulting cystic deformation

Front 16

when does the fetal kidney make urine?

Back 16

approx 9-12 wks

Front 17

what ureteral anomaly is found with MCRD?

Back 17

ureteral atresia

Front 18

What is a theory of Prune-Belly syndrome?

Back 18

anomalous development of the mesenchyme and a transient infravesical obstruction during early embryogenesis

Front 19

what is the state of the prostate in boys with PBS?

Back 19

hypoplastic prostate

Front 20

what is the incidence of cryptorchidism?

Back 20

about 30% in preemies, 3% in full term neonates, and less than 1% at a year of age

Front 21

what must you worry about with epididymitis in a prepubescent male?

Back 21

ectopic ureter draining into the vas deferens or SV; RUS is warranted

Front 22

describe the anatomy of cloacal exstrophy?

Back 22

midline segment of hindgut, frequently with a prolapsed ileum and one or more openings to at least one appendix; bladder is split into 2 by the hindgut; widely separated genital tubercles are seen as the hemi-scrotum and hemi-penis (or hemi-clitoris) on each side; the anus is imperforate

Front 23

vaginal atresia may be associated with what urinary tract anomaly most commonly?

Back 23

unilateral renal agenesis

Front 24

what is the embryological origin of the vagina?

Back 24

the upper portion of the vagina originates from the mullerian duct. the lower portion (distal to the hymen) originates from the UG sinus

Front 25

what are 3 theories of testicular descent?

Back 25

1. abdominal pressure forces testes down; 2. hormonal influence; 3. gubernaculum pulls into the scrotum

Front 26

the appendix testis is an embryological remnant of what structure?

Back 26

mullerian duct

Front 27

what is the embryologic origin of the appendix epididymis?

Back 27

wolffian duct

Front 28

what is the embryological explanation for uterus didelphys?

Back 28

failure of fusion of the caudal end of the mullerian ducts

Front 29

why do you see hemiscrotum with hemiphallus with cloacal exstrophy?

Back 29

if the cloacal membrane ruptures early, this acts as a wedge to keep the genital tubercles and folds widely separate

Front 30

when is nephron formation complete?

Back 30

about 36 wks

Front 31

at what postnatal age does GFR reach its peak?

Back 31

about 4 mos

Front 32

what are the anatomic correlates of the Mullerian tubercle in both male and female?

Back 32

the verumontanum and the hymen, respectively

Front 33

what is the mechanism by which the cloaca becomes divided into the urogenital sinus and rectum?

Back 33

the urorectal septum grows to meet the cloacal membrane, forming the perineal body as it fuses with it; it divides the cloacal membrane into an anterior urogenital membrane and a posterior anal membrane

Front 34

explain the embryological origins of the labia minora and labia majora.

Back 34

the labia minora are formed from the urethral folds, while the majora are derived from the genital swellings (homologue of the scrotum)

Front 35

explain the proposed etiology for exstrophy of the urinary bladder.

Back 35

early rupture of the cloacal membrane causes failure of mesenchymal migration into the area