Exam Content

Level 2 Lifelong Learning - Pediatric Subspecialty

The Pediatric Qualifying and Life Long Learning Exam will consist of 125 questions:

The various sections involved in the exam, content and the percentage of questions on that content are listed below.

  1. Core General - all basic science questions must have clinical relevance - 35% of exam
    1. Anatomy
    2. Core Competency
    3. Radiation Safety
    4. Patient Safety include (DVT, antibiotic prophylaxis opioid addiction questions)
    5. Ultrasound Techniques
    6. Radiation Safety
    7. Ethics
    8. Basic Stats
    9. Fluid and Electrolyte management in children
    10. Infection & Inflammatory processes involving GU Tract
      1. UTI- Dx and management
      2. Rx and significance of reinfection vs relapsing UTI
      3. Pyelonephritis – Dx and management
      4. Xanthogranulomatous pyelonephritis
      5. Kidney Abscess
    11. Kidney scarring - Dx & complications
    12. Henoch- Schonlein - Urologic manifestations
    13. Crohns Disease – Urologic manifestations
    14. Lichen Sclerosis- Dx and treatment
    15. Epididymitis Dx and Rx
    16. Funguria Dx & Treatment
    17. Balanoposthitis – Dx, Rx
    18. Phimosis- Rx
    19. Pediatric Vulvovaginitis
    20. Vaginal adhesions - Rx
    21. Sexual Transmitted Disease in adolescence
      1. HPV vaccine
      2. Ethics of Rx ( see core- competency)
    22. Antibiotic prophylaxis
    23. Trauma
    24. Transplant (pre Tx-evaluations and Post Tx-urologic complications)
  2. Congenital Anomalies and Embryological defects - 25% of exam
    Note: Excludes obstructive disorders e.g. UPJ, PUV, primary obstructive megaureter, ureterocele see topic below
    1. Cloacal anomalies- common UG sinus
    2. Congenital adrenal Hyperplasia
    3. Cryptorchidism (anorchia)
    4. Disorders of Sexual Differentiation
    5. Ectopic Ureters
    6. Epispadias-Exstrophy Complex
    7. Epididymal and Vasal anomalies
    8. Vasal agenesis- cystic fibrosis
    9. Gender dysmorphia
    10. Hydrocele
    11. Hydroculpos (Mullerian Duct abnormalities)
    12. Hypospadias
    13. Enlarged prostatic utricle
    14. Imperforate Anus – associated GU anomalies
    15. Prune Belly Syndrome
    16. Congenital megalourethra
    17. Testicular torsion (neonatal and Intravaginal)
    18. Renal Agenesis
    19. Renal Fusion anomalies
      1. Horse shoe kidneys cross fused ectopy
    20. Renal cystic disease of childhood
      1. Multicystic dysplastic kidneys
      2. Autosomal recessive kidney disease
      3. Autosomal dominant kidney disease
    21. Urachal Abnormalities
    22. Varicoceles
    23. Vesicoureteral reflux
  3. Pediatric Obstructive Uropathy - 15% of exam
    1. Antenatal Hydronephosis
      1. Differential Dx and Management
    2. Posterior and anterior urethral valves Dx and Management
      1. Vesicostomy when to do
    3. Primary Obstructing Megaureter Dx and Management
    4. UPJ obstruction Dx and Management
    5. Ureteroceles
      1. Duplex
      2. Single system
    6. Physiologic alterations from obstruction
      1. Post-obstructive diuresis Dx and Rx
    7. Nephrogenic Diabetes Insipidus
  4. Neurogenic Bladder and Voiding Dysfunction - 15% of exam
    1. Dx –UDS assessment of Neurogenic bladder
    2. Etiologies of Neurogenic bladder in children
      1. Cerebral palsy
        1. Dx and Management
      2. Spina bifida
        1. Dx and Management
      3. Spinal cord injuries
        1. Dx and Management
      4. Tethered Cord
        1. Dx and Management
    3. Pharmacologic and Surgical Rx Neurogenic bladder (Not augments – see below)
      1. Antimuscuranics
      2. Onobotulinum Toxin
    4. Bladder and Bowel dysfunction
      1. Dx and Management
    5. Neural Stimulation
      1. Sacral Nerve stimulation
      2. Percutaneous Tibial nerve stimulation
    6. Management of Neurogenic Bowel
      1. Bowel Irrigations
      2. ACE indications and complications
  5. Pediatric Neoplasms and Urinary augmentation and diversion - 5% of exam
    1. Neoplasms
      1. Renal
        1. Mesoblastic Nephroma
        2. Wilms tumors Dx and Management
          1. Congenital anomalies associated with Wilms Tumors e.g. Deny Drash, Aniridia, Hemihypertrophy
        3. Clear Cell Sarcoma of the kidney: Dx and management
        4. Rhabdoid tumor of kidney: dx and management
        5. Tuberous sclerosis- angiomyolipoma
        6. Von Hippel Landau
        7. Renal cell carcinoma of childhood
      2. Testicular tumors of childhood and adolescence: Dx and Management
        1. Yolk sacTeratomaNSGC tumors in post pubertal pt stromal tumors ( Leydig cell tumors)Adrenal rest in congenital adrenal hyperplasiaEpidermoid cysts
      3. Rhabdomyosarcoma: Dx and Management
        1. Rhabdomyosarcoma: Dx and Management
        2. spermatic cord
        3. vagina (sarcoma botyroides)
      4. NO NEUROBLASTOMAS!!!
    2. Urinary Diversions , Augmentations. BNR, AUS & Slings
      1. Indications and segments used for bladder augmentation
      2. Complications of augmentations
        1. Rupture
        2. Electrolyte and vitamin abnormalities
        3. Bladder stones management and prevention
        4. Renal Preservation
      3. Assessment of post augment urinary incontinence
      4. Complications and management of continent stomas
      5. Bladder Neck reconstruction or slings with or without augmentation
      6. Vesicostomy management of complications
      7. Indication and complications of urinary conduits.
      8. Artificial Urinary Sphincter- Indications and complications
    3. Endourology, Nephrology and Laparoscopic - robotic complications - 5% of exam
      1. Nephrolithiasis
        1. Percutaneous nephrolithotomy – indications and technique
        2. ECSWL – indications
        3. Ureteroscopy indications and technique
        4. Recommended follow-up after stone removal
        5. Metabolic work-up for stone disease
        6. Dx and Rx based on metabolic work up
        7. Heredity (genetic) causes for nephrolithiasis
        8. Urinary Crystal identification
      2. Nephrology
        1. Microscopic hematuria (workup)
        2. Gross hematuria of Neonate
        3. Hypercalciuria of infancy
        4. Proteinuria ( Dx and significance)
        5. Identification of glomerulonephritis
        6. Casts - Crenated RBC
        7. Post infectious GMN
        8. Renal Vein thrombosis
        9. Renal Artery Thrombosis
      3. Complications of Endourology and Laparoscopy-Robotics
        1. Ureteral stricture post ureteroscopy Dx and Rx
        2. Ureteral perforation: Dx and Rx
        3. PCN complications
          1. Bleed
          2. Bowel perforation
          3. Urinoma
      4. ECSWL - complications
      5. Robotic complications
        1. Diminished blood flow
        2. Reduced urine output
        3. Air embolism
        4. Complications of trocar placement
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