20/06 Flashcards
tx of acute bacterial prostatitis
14 days quinolone eg ciprofloxacin
muddy brown casts in the urine
acute tubular necrosis
acute vs chronic urinary retention
painful vs painless
BPH mx
alpha 1 antagonists eg tamsulosin
5 alpha reductase inhibitors eg finasteride
both
TURP
alpha 1 antagonists eg tamsulosin SEs
dizziness
postural hypotension
dry mouth
depression
5 alpha reductase inhibitors eg finasteride SEs
erectile dysfunction
reduced libido
ejaculation problems
gynaecomastia
what is indicated if the patient has a significantly enlarged prostate and is considered to be at high risk of progression
5 alpha reductase inhibitors eg finasteride but takes 6 months to work
lump separate from the body of the testicle
found posterior to the testicle
epididymal cyst
ED normal libido
organic cause
ED decreased libido
psychogenic cause
oung man who has always had difficulty achieving an erection
refer to urology
which hydroceles are common in newborns
communicating -> usually resolves within first few months
Chronic upper urinary tract obstruction
ureteric stent or a pyeloplasty
urethral injury invx
ascending urethrogram
mx urethral injury
suprapubic catheter placed surgically
voiding symptoms
conservative measures: pelvic floor muscle training, bladder training, prudent fluid intake and containment products
alpha blocker if mod-severe
5alpha reductase if high risk of progression
voiding + storage - antimuscarinic
Predominately overactive bladder
moderate fluid intake and bladder retraining
antimuscarinic eg oxybutynin, tolteridone
mirabegron
nocturia
moderating fluid intake at night
furosemide 40mg in late afternoon
desmopressin
priapism invx
Cavernosal blood gas analysis to differentiate between ischaemic and non-ischaemic
mx priapism
> 4 hrs - aspiration of blood from the cavernosa
injection of phenylnephrine
surgery
prostate cancer hormonal tx
LHRH analogues and anti androgens
prostate cancer low risk
active surveillance
prostate cancer INVX
multiparamic MRI
prostate cancer tx
radical prostatectomy
radiotherapy: external beam and brachytherapy
anti-androgen therapy prostate cancer
GnRH agonists e.g. Goserelin (causes tumour flare)
most common renal cell cancer
clear cell
calcium oxalate stones
Hypercalciuria
radio opaque
cystine stones
inherited AR disorder
radio dense
uric acid
low urinary pH
malignancy
children with inborn errors of metabolism
radiolucent
calcium phosphate
renal tubular acidosis
radio-opaque (the most)
struvite
formed from magnesium, ammonium and phosphate
assoc with chronic infections
slightly radio-opaque
alkaline urine
Stone burden of less than 2cm in aggregate
lithotripsy
Stone burden of less than 2cm in pregnant females
uterescopy
Complex renal calculi and staghorn calculi
Percutaneous nephrolithotomy
Ureteric calculi less than 5mm
manage expectantly
cremasteric reflex is lost
elevation of the testis does not ease the pain (Prehn’s sign)
testicular torsion
ank spond xray findings
subchondral erosions
sclerosis
squaring of lumbar vertebrae
most likely inherited cancer
gastric
acute interstitial nephritis cause
drugs
penicillin
rifampicin
NSAIDs
allopurinol
furosemide
sterile pyuria
white cell casts
acute interstitial nephritis
exceptions to bilaterally small kidneys in ckd
autosomal dominant polycystic kidney disease
diabetic nephropathy (early stages)
amyloidosis
HIV-associated nephropathy
feature suggesting CKD > AKI
hypocalcaemia
definition oliguria
urine output of less than 0.5 ml/kg/hour
creatinine AKI criteria
a rise in serum creatinine of 26 or greater within 48 hours
a 50% or greater rise in serum creatinine known or presumed to have occurred within the past 7 days
imaging in AKI
renal USS
removal of potassium from the body
- Calcium resonium (orally or enema)
- Loop diuretics
- Dialysis