20 cards Flashcards
Features of inguinal hernias
If inguinoscrotal swelling; cannot ‘get above it’ on examination
Cough impulse may be present
May be reducible
Features of testicular tumors
Often discrete testicular nodule (may have associated hydrocele)
Symptoms of metastatic disease may be present
USS scrotum and serum AFP and β HCG required
Features of acute epididymo-orchitis
Often history of dysuria and urethral discharge
Swelling may be tender and eased by elevating testis
Most cases due to Chlamydia
Infections with other gram negative organisms may be associated with underlying structural abnormality
Features of epididymal cysts
Single or multiple cysts
May contain clear or opalescent fluid (spermatoceles)
Usually occur over 40 years of age
Painless
Lie above and behind testis
It is usually possible to ‘get above the lump’ on examinatio
Features of hydroceles
Non painful, soft fluctuant swelling
Often possible to ‘get above it’ on examination
Usually contain clear fluid
Will often transilluminate
May be presenting feature of testicular cancer in young men
Features of testicular torsion
Severe, sudden onset testicular pain
Risk factors include abnormal testicular lie
Typically affects adolescents and young males
On examination testis is tender and pain not eased by elevation
Urgent surgery is indicated, the contra lateral testis should also be fixed
Features of varicoceles
Varicosities of the pampiniform plexus
Typically occur on left (because testicular vein drains into renal vein)
May be presenting feature of renal cell carcinoma
Affected testis may be smaller and bilateral varicoceles may affect fertility
management of minimal change glomerulonephritis
Prednisolone - renal biopsy only if poor response to steroids
what do serum electrolytes showing a low bicarbonate and elevated chloride suggest.
Normal anion gap metabolic acidosis
WHich types of renal tubular acidosis is associated with reccurent nephrolithiasis
RTA type 1
WHen should metformin dose be reduced vs discontinued.
Reduced when egfr below 60, discontinue when below 30
most common presentation of renal cell carcinoma
Incidental finding
Late stage disease is usually: flank pain, hematuria, abdo mass
what is calciphylaxis?
AKA: calcific uremic ateriolopathy - occurs in patients with ESRD - painful, violaceous, reticular lesions with areas of necrosis.
Warfarin is a risk factor
how does a testicular hematoma present
following trauma \acute scrotal pain and swelling . can have a thickened cord
RIsk factors for squamous cell carcinoma of the bladder
Schistosoma haematobium exposure.
Chronic irritation from long term cathertisation and recurrent UTIS
Most common type of bladder cancer overall
Urothelial carcinoma
First line management for small (<2cm), in the upper and middle calyces, non emergent kidney stones
Extracorporeal shockwave lithotripsy
Features of kidney stones requiring emergent intervention include:
Evidence of infection
Impaired renal function
Uncontrolled pain
Only one kidney
Emergency management options for kidney stones
Ureteric stent and ureteroscopic extraction
How to manage renal stones in the lower calyces and those 1-2 cm in diameter
Urteroscopic lithotripsy
How to manage stones that are larger than 2 cm diameter
Percutaneous nephrolithiotomy
