Nephrology and Urology – Set 6

What this deck covers

Nephrology and Urology – Set 6 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Scrotal pain building over 2 days
2. Glowing scrotal swelling since birth
3. Gravel and red urine at 7 years
4. How the bedtime tablet works
5. Hypertensive girl with flank masses
6. Wet by day and by night at 7
7. When to fix an opening below the glans
8. Wet again two weeks off treatment
9. Compressed newborn with a small chest
10. Toddler with stones in both kidneys
11. Sudden scrotal pain at 13
12. Scrotal fluid and early surgery
13. Left side missing at bath time
14. Buzzer for three months, still wet
15. Crying, with a new tender lump
16. Urgency and hard stools in a boy
17. Samples before the first dose
18. Urgency after 3 months of measures
19. Dry pregnancy, stiff lungs, no urine
20. Stone disease with days of vomiting
21. Woken by pain two hours ago
22. Ending the second course
23. Oxalate stones in the son of cousins
24. Bedwetting at 4 years old
25. When to operate on the right side
26. Newborn versus teenager, the mechanism
27. Fuller abdomen and easy bruising
28. Why a testis can twist in its sac
29. How long a twisted testis can wait
30. Father and grandmother have cysts
31. Blue spot at the upper pole
32. High in the scrotum on a cold morning
33. Big bright kidneys from fetal life
34. Sorting an 8-year-old’s enuresis
35. Fever, discharge and a sore scrotum
36. What a stone-forming girl should eat
37. When help for bedwetting should begin
38. Dark, hard scrotum at the first check
39. Plans for the healthy side
40. Rigors in a girl with cystic kidneys
41. Unequal kidneys in a young infant
42. Right side that cannot be felt at all
43. Second stone after six months of diet
44. Imaging first, a colleague suggests
45. Parents planning a circumcision
46. Still wet on two treatments at once
47. The worry with a tricyclic at home
48. Loin-to-groin colic in a girl of 10
49. Swollen epididymis at 6 years
50. Why a lifelong wet bed happens

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Testicular torsion, It reduces the urine made overnight, within days, After puberty is complete, Cystinuria with recurrent cystine stones, An ectopic testis: laparoscopy to find and place it, Oral oxybutynin from today, before anything else, Cranial ultrasound, Withdrawn gradually, not stopped suddenly, By 12 months, or 18 months at the latest, A bell-clapper deformity, A tumour of the upper pole of the testis, Wetting the bed on most nights of the week, From 10 years, if he was still wet, Acute pyelonephritis in a cystic kidney.

Clinical pearls from this deck

• The cremasteric reflex is the quickest bedside question to ask of a painful scrotum.
• In an infant, a scrotal swelling that glows and is not tender can be left to time.
• Gravel, red urine with normally shaped red cells and a stone-forming father all point to what the urine is carrying.
• A medicine that lowers night urine needs a limit on evening drinks.
• Flank masses with a firm liver and a large spleen put one disease in two organs.
• A child who curtsies or squats on her heel is holding back an unwanted bladder contraction.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all nephrology and urology case decks · pediatric reference values.