Corrections - Urology

Question 1

What are some factors that favour an ‘organic’ cause of ED?

Answer 1

1) normal libido

2) lack of tumescence

3) gradual onset of symptoms

Question 2

What are some factors that favour a ‘psychogenic’ cause of ED?

Answer 2

1) sudden onset of symptoms

2) decreased libido

3) good quality spontaneous or self-stimulated erections

4) major life events

5) problems or changes in relationship

6) previous psychological problems

7) history of premature ejaculation

Question 3

What are the 4 key features of multiple myeloma? (CRAB)

Answer 3

C - hyperCalcaemia: constipation, drowsiness & nausea

R - Renal failure

A - Anaemia & thrombocytopenia due to infiltration of the bone marrow: bruising & fatigue

B - Bone fractures/lytic lesions: pain

Question 4

Which diabetes medication is assocaited with an increased risk of UTIs?

Answer 4

SGLT-2 inhibitors (-glifozin) –> as increases urinary excretion of glucose.

Question 5

Managment of predominantly voiding LUTS?

Answer 5

1st line: conservative measures e.g. pelvic floor muscle training, bladder training, prudent fluid intake and containment products

2nd line: if ‘moderate’ or ‘severe’ symptoms offer an alpha-blocker

3rd line: if the prostate is enlarged and the patient is ‘considered at high risk of progression’ then a 5-alpha reductase inhibitor should be offered

4th line: if the patient has an enlarged prostate and ‘moderate’ or ‘severe’ symptoms offer both an alpha-blocker and 5-alpha reductase inhibitor

Question 6

What class of drug is used in the management of an overactive bladder?

Answer 6

antimuscarinics:
- oxybutynin
- tolterodine
- darifenacin

Question 7

What is the main side effect of oral magnesium?

Answer 7

Diarrhoea

Question 8

What malignancies can cause haematuria?

Answer 8

1) renal cell carcinoma: painful or painless

2) urothelial malignanies (90% are transitional cell carcinoma): painless haematuria

3) squamous cell carcinoma and adenocarcinoma: rare bladder tumours

4) prostate cancer

5) penile cancers: SCC

Question 9

Give 3 examples of antimuscarinics used for overactive bladders

Answer 9

1) oxybutynin
2) tolterodine
3) darifenacin

Question 10

Is tamuslosin an alpha 1 or 2 antagonist?

Answer 10

alpha 1 blocker

Question 11

What is the most common organic cause of ED?

Answer 11

Vascular causes e.g. CVD, HTN, hyperlipidaemia, diabetes, smoking

Question 12

What is the favoured antidepressant post MI?

Answer 12

Sertraline

Question 13

What are common adverse effects of thiazide diuretics e.g. indapamide?

Answer 13

1) dehydration

2) postural hypotension

3) hypokalaemia

4) hyponatraemia

5) hypercalcaemia

6) impotence

7) gout

8) impaired glucose tolerance