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Phase 2a > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

What is nephrolithiasis?

A

The presence of crystalline stones within the urinary system (Renal colic)

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2
Q

What are the risk factors for nephrolithiasis?

A
  • Dehydration
  • High salt diet
  • White
  • Male
  • Obesity
  • Crystalluria
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3
Q

What are the signs and symptoms of nephrolithiasis?

A
  • Nausea and vomiting
  • Urinary frequency/urgency
  • Haematuria
  • Testicular pain
  • Fever
  • Tachycardia
  • Hypotension
  • Loin pain
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4
Q

How is nephrolithiasis diagnosed?

A
  1. If pregnant/child - renal ultrasound
  2. Non-pregnant adult - Non-contrast CT Kidneys, Ureter, Bladder (NCCT-KUB)
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5
Q

How is nephrolithiasis managed?

A
  1. Symptomatic relief
    - Hydration
    - Analgesia
    - Antiemetics
  2. Watch and wait (if asymptomatic and stone <5mm)
    - Observe for sepsis
  3. Surgery for stones >10mm (or intolerable pain)
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6
Q

What are the methods of drainage for obstructed kidneys?

A
  • Nephrostomy
  • Ureteric stent
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7
Q

What is the surgical management of kidney stones?

A
  • Shock wave lithotripsy
  • Ureteroscopy
  • Percutaneous nephrolithotomy (larger stones)
  • Nephrectomy
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8
Q

What is the management of ureteric stones?

A
  • Conservative management
  • Drainage
  • Medical expulsive therapy
  • Surgical management
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9
Q

What is the management of bladder stones?

A
  • Conservative management
  • Endoscopy
  • Open/laparoscopic surgery (larger stones)
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10
Q

What is acute kidney injury (AKI)?

A

An acute decline in kidney function → rise in serum calcium and/or fall in urine output

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11
Q

What is the pathophysiology of acute kidney injury?

A
  • Pre-renal: impaired kidney perfusion
  • Renal: dysfunction of the kidney
  • Post-renal: blockage of urinary outflow tract
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12
Q

What are the risk factors for AKI?

A
  • Age (>65)
  • Previous AKI
  • Myeloproliferative disorder
  • NSAIDs, ACEi and ARB
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13
Q

What are the signs and symptoms of AKI?

A
  • Hypotension/hypovolaemia
  • Reduced urinary output
  • Lower urinary tract symptoms (LUTS)
  • Nausea and vomiting
  • Haematuria
  • Fever/rash
  • Dizziness
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14
Q

How is AKI diagnosed?

A
  • Urinary output < 0.5ml/kg/hour for more than 6 hours
  • Serum creatinine increased by 1.5x (in past week)
  • Serum creatinine increase by >25µmol/l in 48 hours
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15
Q

What are the differentials for AKI?

A
  • CKD
  • Increased muscle mass
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16
Q

What is the management for AKIs?

A
  • Supportive therapy with monitoring of volume status and electrolytes
  • Treatment of the underlying cause
  • Management of complications
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17
Q

What are the complications of AKI?

A
  • Hyperphosphataemia
  • Uraemia
  • Hyperkalaemia
  • Chronic progressive kidney disease
  • End-stage kidney disease
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18
Q

What is chronic kidney failure?

A
  • Chronic renal failure
  • Abnormalities of kidney structure or function
  • Present for >3 months
  • Health implications
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19
Q

How is CKD defined?

A

GFR <60 ml/min/1.73m^2

Or one of the following:
- Albuminuria/proteinuria
- Urine sediment abnormalities
- Electrolyte abnormalities
- Histological abnormalities
- Structural abnormalities
- Kidney transplant

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20
Q

What are the causes of CKD?

A
  • Diabetes
  • Hypertension
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21
Q

What are the risk factor for CKD?

A
  • Diabetes Mellitus
  • Hypertension
  • Age >50
  • Childhood kidney disease
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22
Q

What are the common signs and symptoms of CKD?

A
  • Fatigue
  • Oedema
  • Nausea (and/or vomiting)
  • Pruritis
  • Anorexia
  • Rashes
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23
Q

What are the less common signs and symptoms of CKD?

A
  • Arthralgia
  • Enlarged prostate
  • Foamy/cola urine
  • Orthopnoea/dyspnoea
  • Seizures
  • Retinopathy
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24
Q

How is CKD diagnosed?

A
  • Renal chemistry (serum creatinine and electrolytes)
  • eGFR
  • Urine analysis (haematuria, proteinuria)
  • Urinary albumin
  • Ultrasound (size, obstruction, renal colic)
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25
Q

What are the differentials for CKD?

A
  • Diabetic kidney disease
  • Hypertensive nephrosclerosis
  • Ischaemic neuropathy
  • Obstructive uropathy
  • Nephrotic syndrome
  • Glomerulonephritis
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26
Q

What is the management of CKD?

A
  • Slow the progression of loss of kidney function
  • Prevent need for transplant/renal replacement therapy
  • Manage underlying cause
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27
Q

What are the complications of CKD?

A
  • Anaemia
  • Renal osteodystrophy
  • CVD
  • Protein malnutrition
  • Metabolic acidosis
  • Hyperkalaemia
  • Pulmonary oedema
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28
Q

What is the pathophysiology of prostate cancer?

A
  • High-grade prostatic intra-epithelial neoplasm
  • Cellular proliferation along existing ducts and glands
  • Cytological changes mimicking neoplasm
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29
Q

What are the risk factors for prostate cancer?

A
  • Age >50
  • Black
  • Family history
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30
Q

What are the signs and symptoms of prostate cancer?

A
  • Nocturia
  • Urinary frequency/hesitancy
  • Dysuria
  • Abnormal digital rectal examination
  • Haematuria
  • Weight loss
  • Lethargy
  • Palpable lymph nodes
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31
Q

How is prostate cancer diagnosed?

A
  • Raised prostate-specific antigen
  • Prostate biopsy
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32
Q

What are the differentials for prostate cancer?

A
  • Benign prostatic hyperplasia
  • Chronic prostatitis
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33
Q

What is the management of prostate cancer?

A
  • Active surveillance
  • Androgen deprivation therapy
  • External-beam radiotherapy
  • Brachytherapy
  • Radical prostatectomy
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34
Q

What are the risk factors for testicular cancer?

A
  • Cryptochidism
  • Gonadal dysgenesis
  • Family/personal history
  • Testicular hypertrophy
  • White
  • HIV infection
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35
Q

What are the signs and symptoms of testicular cancer?

A
  • Lump/enlargement of one testicle
  • Feeling of heaviness in the scrotum
  • Dull ache in the abdomen or groin
  • Fluid in the scrotum
  • Pain or discomfort
  • Back pain
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36
Q

How is testicular cancer diagnosed?

A
  • Ultrasound with colour doppler of testis
  • Serum beta-human chorionic gonadotrophin
  • Serum-alpha-fetoprotein
  • Serum LDH
  • Histology
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37
Q

What are the differentials for testicular cancer?

A
  • Testicular torsion
  • Epididymo-orchitis
  • Scrotal hernia
  • Hydrocele
  • Epididymal cyst
  • Haematoma
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38
Q

How is testicular cancer managed?

A

Removal of affected testes.

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39
Q

What are the complications of testicular cancer?

A

Infertility

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40
Q

What is the pathophysiology of benign prostatic hyperplasia?

A
  • Hyperplasia of both epithelial and stromal prostatic components
  • Increased stomal: epithelial ratio
  • Can result in bladder obstruction
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41
Q

What are the risk factors for benign prostatic hyperplasia?

A
  • Age
  • Family history
  • Smoking
  • Male pattern baldness
  • Metabolic syndrome
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42
Q

What are the signs and symptoms of benign prostatic hyperplasia?

A
  1. Storage symptoms
    - Frequency
    - Urgency
    - Nocturia
  2. Voiding symptoms
    - Weak stream
    - Hesitancy
    - Intermittency
    - Straining
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43
Q

How is benign prostatic hyperplasia diagnosed?

A

Prostate-specific antigen (PSA) test.

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44
Q

What are the differentials for benign prostatic hyperplasia?

A
  • Overactive bladder
  • Prostatitis
  • UTI
  • Bladder cancer
  • Neurogenic bladder
  • Urethral structure
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45
Q

How is benign prostatic hyperplasia managed?

A
  • Behavioural management
  • Medication review
  • Alpha blockers
  • Surgery
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46
Q

What are the complications of benign prostatic hyperplasia?

A
  • UTI
  • Renal insufficiency
  • Bladder stones
  • Haematuria
  • Sexual dysfunction
  • Acute urinary retention
  • Overactive bladder
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47
Q

What is urethritis?

A
  • Usually an STI
  • Divided into gonococcal and non-gonococcal
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48
Q

What is the pathophysiology of urethritis?

A
  • Bacteria generally must attach to human cells to infect them
  • Antigenic variation arises quickly (can bind to multiple cells and avoid immune system)
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49
Q

What causes urethritis?

A
  • N. gonorrhoeae
  • C. trachomatis
  • M. genitalium
  • U. urealyticum
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50
Q

What are the risk factors for urethritis?

A
  • 15-24 years old
  • Female sex
  • MSM
  • Low socio-economic status
  • Multiple/new sexual partners
  • Prior/current STI
  • Unprotected sex
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51
Q

What are the signs and symptoms of urethritis?

A
  • Urethral discharge
  • Urethral pruritus/irritation
  • Dysuria
  • Orchalgia
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52
Q

How is urethritis diagnosed?

A
  • Gram stain of urethral discharge
  • Nucleic acid amplification test
  • Culture of urethral discharge
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53
Q

What are the differentials for urethritis?

A
  • Candida balanitis or vaginitis
  • Non-infectious urethritis
  • Nephrolithiasis
  • Interstitial cystitis
  • Chronic prostatitis
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54
Q

How is urethritis managed?

A
  • Alleviate acute symptoms and prevent transmission
  • Sex abstinence
  • Treat both gonococcal and non-gonococcal until confirmed which it is
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55
Q

What are the possible complications of urethritis?

A
  • Chronic non-gonococcal urethritis
  • Genitourinary abscess
  • Urethral stricture/fistula
  • Epididymitis
  • Disseminated gonococcal infection
  • Pneumonia
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56
Q

What is pyelonephritis?

A

A severe infectious inflammatory disease of the kidney which can be acute, recurrent or chronic.

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57
Q

What is the pathophysiology of acute pyelonephritis?

A
  • A result of ascending UTI
  • Haematogenous seeding in patients with bacteraemia
  • Blockage can lead to treatment failure and renal abscess
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58
Q

What are the causes of acute pyelonephritis?

A
  • Gram-negative bacteria
  • E.coli most common
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59
Q

What are the risk factors for acute pyelonephritis?

A
  • Hx/FHx of UTIs
  • Stress incontinence
  • Diabetes
  • Catheter/renal stones
  • Urinary abnormality
  • Immunosuppression
  • New sexual partner
  • Pregnancy
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60
Q

What are the investigations for acute pyelonephritis?

A
  1. Urinalysis:
    - +ve leukocytes
    - +ve nitrites
    - Non-visible haematuria
    - WBC casts
  2. Urine culture and sensitivity
  3. US to rule out obstruction
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61
Q

What are the differentials for acute pyelonephritis?

A
  • LUTI
  • Cystitis
  • Acute prostatitis
  • Urethritis
  • Chronic pyelonephritis
  • Pelvic inflammatory disease
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62
Q

What is the management of acute pyelonephritis?

A
  • Antibiotics
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63
Q

What are the possible complications of acute pyelonepritis?

A
  • Renal failure
  • Sepsis
  • Renal abscess formation
  • Emphysematous pyelonephritis
  • Parenchymal renal scarring
  • Recurrent UTIs
64
Q

What are the causes of chronic pyelonephritis?

A
  • Recurrent infections resulting from anatomical abnormalities
  • Vesicoureteral reflux
  • Inadequate treatment/recurrence of acute pyelonephritis
65
Q

What are the risk factors for chronic pyelonephritis?

A
  • Acute pyelonephritis
  • Vesicoureteral reflux
  • Obstruction
  • Renal caliculi
  • Diabetes mellitus
66
Q

How is chronic pyelonephritis diagnosed?

A
  • Renal function tests
  • Electrolyte panel
  • FBC
  • Renal ultrasound
  • Kidney-ureter-bladder X-ray
  • CT abdomen
67
Q

What are the differentials for chronic pyelonephritis?

A
  • Acute pyelonephritis
  • Renal caliculi
  • Renal cancer
68
Q

How is chronic pyelonephritis managed?

A
  • No specific treatment available
  • Renal damage is not reversible
  • Eliminate UTIs
  • Repair anatomical or functional issues
69
Q

What are the possible complications of chronic pyelonephritis?

A
  • AKI
  • Hyperparathyroidism
  • Obstruction
  • CKD
70
Q

What is the pathophysiology of prostatitis?

A
  • Many ways to develop it
  • Intraprostatic reflux
  • Elevated IgG and IgA
71
Q

What causes prostatitis?

A

E coli

72
Q

What are the risk factors for prostatitis?

A
  • UTI
  • Benign prostatic enlargement
  • Urinary tract instrumentation/manipulation
73
Q

What are the signs and symptoms of prostatitis?

A
  • Fever
  • Chills
  • Malaise
  • Tender prostate
  • <50
  • Urinary frequency
  • Dysuria
74
Q

How is prostatitis diagnosed?

A
  • Urinalysis
  • Urine culture
  • Culture of prostatic secretions
  • Blood cultures
75
Q

What are the differentials for prostatitis?

A
  • BPH
  • Prostate cancer
  • UTI
  • Bladder cancer
  • Colorectal cancer
  • Epididimytis/orchiditis
76
Q

How is prostatitis managed?

A

Antibiotics (quinolone)

77
Q

What are the possible complications of prostatitis?

A
  • Urinary retention
  • Sepsis
  • Prostatic abscess
  • Chronic prostatitis
78
Q

What is the pathophysiology of cystitis?

A
  • E. coli commensal to GIT or vagina can infect the urethra
  • Can occur due to sex or infection of surrounding tissues
79
Q

What causes cystitis?

A

E coli

80
Q

What are the risk factors for cystitis?

A
  • Frequent sexual intercourse
  • History of UTIs
  • Congenital abnormality
  • Urinary catheter
  • Diabetes mellitus
  • Spinal cord injuries
  • Pregnancy
  • Immunodeficiency
  • Older age
81
Q

What are the signs and symptoms of cystitis?

A
  • Dysuria
  • Urgency and frequency
  • Suprapubic pain
  • Abdo pain
  • Fever
  • Vaginal discharge and pruritus
82
Q

What are the investigations for cystitis?

A
  • Urinalysis
  • Urine microscopy
  • Urine culture and sensitivity
83
Q

What are the differentials for cystitis?

A
  • Pyelonephritis
  • Vaginitis
  • Interstitial cystitis
  • Chlamydia urethritis
84
Q

What is the management for cystitis?

A

Antibiotics

85
Q

What are the possible complications of cystitis?

A
  • Pyelonephritis
  • Preterm delivery
  • Urinary retention
  • Recurrent UTIs
86
Q

What is a varicocele?

A

Abnormal dilation of the internal spermatic veins and pampiniform plexus.

87
Q

What is the pathophysiology of a varicocele?

A

The exact cause is unknown, thought to be a dysfunction of the countercurrent multiplier system.

Associated with:
- Abnormal gonadotropin levels
- Impaired spermatogenesis
- Histological changes to sperm
- Infertility

88
Q

What are the signs and symptoms of varicocele?

A
  • Painless scrotal mass
  • Left-sided signs/symptoms
  • Small testicle
  • Infertility
89
Q

How are varicoceles diagnosed?

A

Clinical examination.

90
Q

What are the differentials for varicoceles?

A
  • Paratesticular mass
  • Cord hydrocele
  • Inguinal hernia
  • Spermatocele
91
Q

How are varicoceles managed?

A

Surgical repair.

92
Q

What is an epididymal cyst?

A

A smooth, extratesticular, spherical cyst in the head of the epididymis.

93
Q

What is the pathophysiology of an epididymal cyst?

A
  • Clean and milky (spermatocele) fluid
  • Lie above the head of the testes
94
Q

What is the clinical presentation of an epididymal cyst?

A
  • Lump
  • May be painful if large
  • Well defined
  • Testis palpable separate to the cyst
95
Q

How is an epididymal cyst diagnosed?

A

Ultrasound

96
Q

What are the differentials for an epididymal cyst?

A
  • Spermatocele
  • Hydrocele
  • Varicocele
97
Q

How is an epididymal cyst managed?

A
  • Treatment normally not required
  • If painful and symptomatic; excision
98
Q

What is a hydrocele?

A

A collection of serous fluid between tunica vaginalis that surrounds the testes or along the spermatic cord.

Can be communicating and non-communicating.

99
Q

What are the risk factors for hydrocele?

A
  • Male sex
  • Prematurity/ low birth weight
  • Infant
  • Late descent of testes
  • Increased intraperitoneal fluid/pressure
  • Inflammation/injury within scrotum
  • Testicular cancer
  • Connective tissue disorders
100
Q

What are the signs and symptoms of hydrocele?

A
  • Scrotal mass
  • Transillumination
  • Enlargement of scrotal mass following activity
  • Variation in scrotal mass during the day
101
Q

How are hydroceles diagnosed?

A

Clinically - no tests are done

102
Q

What are the differentials for hydroceles?

A
  • Inguinal hernia
  • Testicular cancer
  • Epididymitis
  • Epididymo-orchitis
  • Epididymal cyst
  • Scrotal oedema
  • Testicular torsion
  • Varicocele
103
Q

How are hydroceles managed?

A
  • Surgery if large or uncomfortable
  • Aspiration can be considered
104
Q

What are the possible complications of hydroceles?

A
  • Haematoma
  • Inguinal hernia
  • Pain in inguinal area
  • Lower extremity oedema
  • Testicular atrophy
  • Infertility
105
Q

What is nephritic syndrome?

A

A collection of signs and symptoms that occur as a result of inflammation in the kidneys.

Affects kidney function and causes protein and blood to leak into the urine.

106
Q

What is the pathophysiology of nephritic syndrome?

A

Largely triggered by immune-mediated injury exhibiting both humoral and cellular components.

A variety of non-immunological metabolic, haemodynamic and toxic stress can also induce glomerular injury.

107
Q

What causes nephritic syndrome?

A
  1. Type III hypersensitivity
    - Post-streptococcal glomerulonephritis
    - IgA nephropathy
    - Diffuse proliferative glomerulonephritis
  2. Multiple causes
    - Membranoproliferative glomerulonephritis
    - Rapidly progressive glomerulonephritis
  3. Defect in collagen synthesis
    - Alport syndrome
108
Q

What are the risk factors for nephritic syndrome?

A
  • Infection
  • Systemic Lupus Erythematosus
  • Systemic vasculitis
  • Neoplasms (lymphoma, lung, colorectal etc)
  • Haemolytic uraemia syndrome
  • Drugs
109
Q

What are the signs and symptoms of nephritic syndrome?

A

Most common:
- Haematuria
- Sub-nephrotic-range proteinuria
- Oedema
- Hypertension
- Oliguria

110
Q

How is nephritic syndrome diagnosed?

A
  • Bloods (increased creatinine and BUN)
  • Urinalysis (haematuria and proteinuria)
  • Renal biopsy
111
Q

What are the differentials for nephritic syndrome?

A
  • Nephrolithiasis
  • Bladder cancer
  • Renal cancer
  • Pre or post-renal failure
112
Q

How is nephritic syndrome managed?

A
  • Reverse renal damage + preserve renal function
  • Treat systemic cause
  • Immunosuppression (eg. steroids)
  • Blood pressure control (ACEi/ARB)
113
Q

What are the possible complications of nephritic syndrome?

A
  • AKI
  • CKD
114
Q

What is nephrotic syndrome?

A

Triad of:
- Proteinuria
- Hypoalbuminemia
- Peripheral oedema

Hyperlipidaemia and thrombotic disease often comorbid.

115
Q

What is the pathophysiology of nephrotic syndrome?

A

Glomerular proteinuria develops when components of the filtration barrier are disrupted.

The liver compensates the loss of albumin, contributing to the development of lipid abnormalities including hypercholesterolaemia and hypertriglyceridaemia.

116
Q

What causes nephrotic syndrome?

A
  • Can be primary or secondary
  • Focal segmented glomerulosclerosis
  • Membrane nephropathy
  • Diabetic nephropathy
  • Amyloidosis
117
Q

What are the risk factors for the development of nephrotic syndrome?

A
  • Conditions affecting the kidneys
  • Drugs (eg. NSAIDs)
  • Infections (HIV, Hep B/C, malaria)
118
Q

What are the signs and symptoms of nephrotic syndrome?

A
  • Oedema
  • Foamy urine
  • Weight gain (fluid retention)
  • Fatigue
  • Loss of appetite
  • Albuminuria
  • Hyperlipidaemia
  • Proteinuria
119
Q

How is nephrotic syndrome diagnosed?

A
  • 24h urine collection (protein levels >3.5mg)
  • Renal biopsy
120
Q

What are the differentials for nephrotic syndrome?

A
  • Minimal change disease
  • Focal segmental glomerulosclerosis
  • Membranous nephropathy
  • Diabetic nephropathy
  • Multiple myeloma-associated AL amyloidosis
  • IgA nephropathy
121
Q

How is nephrotic syndrome treated?

A
  • Sodium and fluid restriction
  • High dose diuretic treatment
  • Steroids
  • Blood pressure control
122
Q

What are the possible complications of nephrotic syndrome?

A
  • Infections
  • Venous thromboembolism
  • AKI
  • CKD
  • Osteitis fibrosa cystica
  • Osteomalacia
123
Q

What are the 3 main risk factors for renal cancer?

A
  • Smoking
  • Obesity
  • Genetic

(Also hypertension and dialysis)

124
Q

How does renal cell carcinoma present?

A
  1. Classic triad
    - Haematuria
    - Loin pain
    - Mass

Usually diagnosed incidentally from a scan.

125
Q

What investigations are done for renal cell carcinoma?

A
  • US kidneys
  • CT renal (and chest if enhancing mass)
  • MRI if extending into vein
  • Investigate bones and brain for metastatic disease
126
Q

When should a biopsy be considered for renal cell carcinoma?

A
  • Indeterminable mass
  • Prior to ablation
  • Metastatic disease systemic therapy
127
Q

What is the management of renal cell carcinoma?

A
  • Active surveillance
  • Radiofrequency ablation
  • Partial nephrectomy
  • Radical nephrectomy
  • Palliative embolisation
  • Immunotherapy
128
Q

What are the risk factors for bladder cancer?

A
  • Smoking
  • Aromatic hydrocarbons
  • Dyes
  • Rubber
  • Industrial exposures (eg. leather workers, hairdressers)
  • Drugs (most commonly cyclophosphamide)
129
Q

How does bladder cancer present?

A
  • Haematuria (painless visible 85%)
  • LUTS
  • Recurent UTIs
130
Q

What investigations are done for bladder cancer?

A
  • Flexible cystoscopy
  • US
  • CT urogram
131
Q

What is the management of bladder cancer?

A
  • Transurethral resection
  • Intravesical therapy (mitomycin or BCG)
  • Radical cystoprostatectomy
  • Anterior exentoration (in women)
  • Radiotherapy

(Surgical management for muscle invasive cancers)

132
Q

What is an anterior exentoration?

A

Removal of the bladder, uterus and ovaries.

133
Q

What are the types of bladder cancer?

A
  • Transitional cell carcinoma (90%)
  • Squamous cell carcinoma
  • Adenocarcinoma (rare, poor prognosis)
134
Q

What is bacteriuria?

A

The presence of bacteria in the urine

135
Q

What is pyuria?

A
  • The presence of leukocytes in the urine
  • Associated with infection
  • Can be sterile pyuria
136
Q

What is an uncomplicated UTI?

A

UTI in non-pregnant women

137
Q

What is a complicated UTI?

A
  • Pregnant women
  • Men
  • Catheterised patients
  • Children
  • Recurrent/persistent infection
  • Immunocompromised

Any UTI other than in non-pregnant women.

138
Q

What are the most common causes of UTIs?

A
  • E. coli
  • Proteus
  • Klebsiella
  • Enterococci
  • Staph infection
139
Q

What are the pathogenic causes of UTI?

A
  • Stasis during pregnancy
  • Ureteric stones
  • Low urinary volume
  • Bladder stones or tumour
  • Obstruction from prostatic hypertrophy
  • Catheterisation allowing colonisation
140
Q

What are the symptoms of lower urinary tract infection?

A
  • Dysuria
  • Frequency
141
Q

What are the symptoms of upper urinary tract infection?

A
  • Systemic symptoms eg. fever
  • Loin pain
  • Pyuria
142
Q

What investigations are done for UTIs?

A

Urinalysis and microscopy.

143
Q

What does urinalysis tell us may be present in the urine?

A
  • Blood
  • Protein
  • pH
  • Glucose
  • Leukocytes
  • Nitrates
  • Ketones
144
Q

Give examples of types of urine samples.

A
  • MSU
  • CSU
  • Bag urine
  • Clean catch
  • SPA aspirate
  • Early morning (specifically for TB)
145
Q

How is an uncomplicated UTI treated?

A

3 day course of antibiotics

146
Q

How is a complicated UTI treated?

A
  • Send a sample for culture
  • 7 day course of antibiotics
147
Q

What are the first line antibiotics used to treat UTIs?

A

Avoid broad spectrum antibiotics

  • Nitrofurantoin
  • Fosfomycin
  • Pivemcillinam
148
Q

What are the complications of long-term catheters?

A
  • UTI/pyelonephritis
  • Stones
  • Obstruction
  • Chronic inflammaiton
149
Q

What factors increase the prevalence of UTI in pregnancy?

A
  • Age
  • Parity
  • Sexual activity
  • Diabetes
  • Previous UTI
150
Q

What are the potential complications of pyelonephritis?

A
  • Renal abscess
  • Emphysematous pyelonephritis
151
Q

What is the innervation of the penis?

A
  • Erection = parasympathetic (S2-4)
  • Ejaculation = sympathetic (T11-L2)

Point and shoot!

152
Q

What can cause erectile dysfunction?

A
  • Hypogonadism
  • Trauma
  • Drugs
  • Psychosomatic
153
Q

What is the pathophysiology of erectile dysfunction?

A
  • Neurogenic = failure to initiate
  • Arteriogenic = failure to fill (commonest)
  • Venogenic = failure to store
154
Q

What are the risk factors for erectile dysfunction?

A
  • CVD
  • Diabetes
  • Depression
  • Obesity
  • Alcohol
  • Medicaitons
  • Pelvic surgery
155
Q

What is the management of erectile dysfunction?

A
  • Treat underlying cause
  • Consider referral to other specialties
  • Psychosexual counseling
156
Q

What is the medical management of erectile dysfunction?

A
  • PDE-5 inhibitors (viagra)
  • Intraurethral suppository
  • Vacuum-assisted device
  • Implant

Phase 2a (11 decks)

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