4th Year Additions

Question 1

what is idiopathic hydronephrosis?

Answer 1

result of narrowing of PUJ

Question 2

management of idiopathic hydronephrosis

Answer 2

pyeloplasty
nephrostomy
antegrade ureteric stent

Question 3

what is vesicoureteral reflux?

Answer 3

urine refluxing from the bladder back into the ureters

Question 4

foley catheter in obstruction

Answer 4

coude tip

Question 5

referral of abnormal DRE

Answer 5

2 week wait

Question 6

what is orchitis?

Answer 6

inflammation of the testicle

Question 7

parotid gland swelling + orchitis

Answer 7

mumps (also causes pancreatitis)

Question 8

presentation of epidiymo-orchitis

Answer 8

pain
dragging/ heavy sensation
swelling
urethral discharge
systemic symptoms

Question 9

management of epidiymo-orchitis

Answer 9

ofloxacin if non-STI

surgery= orchiopexy or orchidectomy

Question 10

diagnosis of epidiymo-orchitis

Answer 10

USS whirlpool sign

Question 11

causes of testicular lumps

Answer 11

hydrocele
varicocele
epididymal cyst
testicular cancer
epidiymo-orchitis
inguinal hernia
testicular torsion

Question 12

what can a left-sided varicocele be an indicator of?

Answer 12

obstruction to left testicular vein caused by renal cell carcinoma

Question 13

presentation of Leydig cell tumour

Answer 13

testicular cancer

gynaecomastia

Question 14

staging of testicular cancer

Answer 14

Royal Marsden

Question 15

how to assess scarring of the kidney?

Answer 15

DMSA scan

Question 16

lifestyle advice for renal stones

Answer 16

increase fluids
add lemon juice (citric acid binds to calcium)
avoid carbonated drinks (phosphoric acid promotes calcium oxalate)
reduce salt
maintain calcium intake

Question 17

three most common types of renal cell carcinomas

Answer 17

clear cell
papillary
chromophobe

Question 18

typical immunosuppression regime of renal transplant

Answer 18

tacrolimus
myocphenolate
prednisolone

Question 19

side effects of transplant immunosuppression

Answer 19

seborrheic warts and skin cancers
tacrolimus = tremor
cyclosporine= gum hypertrophy
steroids and Cushing’s

Question 20

renal biopsy criteria

Answer 20

BP <160/95
Hb >90
platelets >100
clotting

stop aspirin 1 week, LMWH 24 hours

Question 21

management of Fanconi’s syndrome

Answer 21

replace phosphate

Question 22

what does Fanconi’s syndrome affect?

Answer 22

PCT

Question 23

management of ED

Answer 23

PDE-5 inhibitors e.g. sildenafil (NO)
testosterone treatment in hypogonadism
vacuum erection device
prosthetic implants

Question 24

haematuria investigations

Answer 24

<45 USS

flexible cystoscopy

Question 25

adverse of azathioprine

Answer 25

bone marrow suppression

Question 26

adverse of ciclosporin

Answer 26

lymphoma