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CS4: Exam 2 > 23/24: Urologic Diseases - Fang > Flashcards

23/24: Urologic Diseases - Fang Flashcards

1
Q

define microscopic hematuria

A

greater than 3 RBC/HPG on two of three urine samples

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2
Q

nephrologic/glomerular hematuria

A

significant proteinuria
dysmorphic RBC
red cell casts

warrants nephrology evaluation

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3
Q

______ of pts evaluated will be diagnosed with a urologic malignancy

A

10-20%

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4
Q

gold standard for stones imaging

A

CT scan of abdomen and pelvis without oral or IV contrast **

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5
Q

gross or microscopic hematuria present in ____ urinary stones

A

90%

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6
Q

*** indications for urgent intervention with urinary stones

A

obstructed upper tract with infection

impending renal deterioration

pain refractory to analgesics

intractable n/v

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7
Q

medical expulsion therapy

A

alpha blockers
calcium channel blockers
NSAIDS

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8
Q

oral stone dissolution

A

uric acid stones only
urinary alkalinization
potassium citrate, sodium bicarbonate

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9
Q

_____- of ureteral stones will pass w/i 4 wk onset of symptoms

A

2/3

if stone not passed w/i 4 wks intervention is needed

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10
Q

only ______ stones can be treated by shock wave

A

opaque

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11
Q

prevention =

A

adequate hydration

dietary modifications including low animal prtn, low sodium, low oxalate diets and citrate therapy

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12
Q

renal cysts present in ___ of ppl over 50

A

50%

typically asymptomatic - no tx unless very lg and causing pain

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13
Q

benign solid renal tumor containing proliferation of blood vessels, smooth m. and adipose tissue that is frequently associated with tuberous sclerosis

A

angiomyolipoma

typically an incidental finding

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14
Q

tx threshold for angiomyolipoma

A

observation less than 4 cm

symptomatic , greater than 4 cm or atypical appearance tx with selective embolization, or nephrectomy

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15
Q

presence of even a small amount of fat w/i a renal lesion on CT scan virtually excludes the diagnosis of renal cell carcinoma and is considered diagnostic of…

A

AML angiomyolipoma

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16
Q

benign tumor derived from distal tubules

A

oncocytoma

hard to differentiate from renal cell carcinoma - tx as if malignant

17
Q

only generally accepted environmental risk factor for RCC

A

tobacco use

majority of cases are idiopathic

18
Q

RCC tumor histotypes
clear cell RCC
papillary RCC
chromophobe RCC

A

loss of VHL
activation of MET
loss of multiple chromosomes - best prognosis

19
Q

approx ___ RCC have metastatic dz at presentation

A

1/3

metastasize to:
retroperitoneal lymph nodes
lung
liver
bone
brain
20
Q

systemic immunotherapy for advanced RCC

A

interleukin 2

very toxic and requires hospitalization

21
Q

risk factors for UTIs

A 
poor fluid intake/ chronic dehydration
infrequent voiding
incomplete bladder emptying
chronic constipation
postmenopausal vaginal atrophy
staghorn calculi
22
Q

ascending infection caused by…

hematogenous infection caused by …

A

e. coli

staphylococcus

23
Q

empiric tx UTIs

A

SMP-TMX or fluoroquinolones

24
Q

urge vs. stress urinary incontinence

A

involuntary urine leak accompanied by or immediately preceded by strong desire to urinate - occurs when bladder pressure overcomes sphincter mechanism

involuntary urine leak with any sudden increase in abdominal pressure:cough, sneeze, lifting, straining, exercie

25
Q

frequency and urgency to urinate with or without UUI

A

OAB overactive bladder

26
Q

mainstay tx for UUi/OAB

A

anticholinergics

inhibit involuntary detrusor m. contraction

27
Q

stress urinary incontinence tx

A

pelvic floor strengthening exercises
formal pelvic floor PT
pessary placement
surgery (midurethral sling placement*)

28
Q

risk factor bladder dz

A

smoking

29
Q

sites of metastasis for bladder cancer

A

pelvic lymph nodes
lung
liver
bone

30
Q

stimulates prostate differentiation and growth

A

DHT

made from free testosterone by 5 apha reductase

31
Q

decision to treat BPH…

A

determined by pt’s level of bother and wilingness/ability to comply with therapy or presence of complications

tx with alpha antagonists first**

32
Q

strongest risk factor for prostate cancer

A

age

33
Q

s/s prostate cancer

A

later only due to metastasis

metastasis to…
pelvic lymph node
bone
lung

34
Q

greater than ___ of suspicious palpable lesions are proven to be cancer

A

50% on DRE

imaging does not improve cancer detection over DRE alone and is not recommended for screening

35
Q

true or false: DRE is diagnostic for prostate cancer, PSA is indication to proceed with biopsy.

A

false neither are diagnostic, both are indications to proceed with biopsy

CS4: Exam 2 (15 decks)

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