Genitourinary 2a

Question 1

How would you treat prostate cancer?

Answer 1

Localised - radical prostatectomy and radiotherapy, hormone therapy or observation
Metastatic - surgical castration and radiotherapy

Question 2

What is pyelonephritis?

Answer 2

infection of renal parenchyma and soft tissues of renal pelvis/upper ureter

Question 3

What are the symptoms of syphillis?

Answer 3

Primary - single painless chancre
Secondary - skin rash
Tertiary - lymphadenopathy, alopecia, bone pain, deafness, meningitis

Question 4

What is schistosomiasis and its significance?

Answer 4

parasite that enters through skin and caused chronic inflammation of urinary tract and leads to squamous cell carcinoma of bladder
- causes 50% of all bladder cancers

Question 5

How common is sepsis in the UK?

Answer 5

100,000/year

37,000 deaths

Question 6

How would you test for suspected prostate cancer?

Answer 6

DRE 
PSA 
IPPS test 
urine test 
TRUSS 
prostate biopsy 
grading

Question 7

What are the main types of UTIs and how do you test for them?

Answer 7

cystitis 
urethritis 
pyelonephritis 
prostatis 
epididymo-orchitis

Question 8

How does the epidemiology of chlamydia and gonnorhea compare?

Answer 8

chlamydia is more common, peak at 20

gonorrhoea is more common in men, peak at 25 years

Question 9

What is the treatment of bladder cancer?

Answer 9

TURBT - to grade
non-invasive - resection +/- chemo
invasive - cystectomy +/- urethrectomy +/- chemo or radical radiotherapy

Question 10

How do you treat sepsis?

Answer 10

sepsis 6

BUFALO

Question 11

What is the difference in treating acute and chronic prostatis?

Answer 11

acute - quinolone (levofloxacin, ciprofloxacin)

chronic - quinolone, alpha blocker, NSAID

Question 12

What are some symptoms of cystitis?

Answer 12

dysuria, frequency, urgency, suprapubic pain, haematuria, cloudy urine, fever

Question 13

What are kidney stones commonly made from?

Answer 13

calcium oxalate

Question 14

What is the main symptom of bladder cancer and some risk factors?

Answer 14

haematuria

RF - smoking, exposure to carcinogens, being older, being male

Question 15

What are the stages of CKD?

Answer 15

GFR 
1 - >90
2 - 60-89
3A - 45-59
3B - 30-44
4 - 15-29
5 - <15

Question 16

How do you treat testicular cancer?

Answer 16

radical orchiectomy
radio
chemo

Question 17

How do you test for chlamydia?

Answer 17

NAAT - nucleic acid amplification tests

Question 18

What is the treatment of chlamydia, gonnorhea and syphilis?

Answer 18

chlamydia - azithromycin (once), doxycyclin, ethromycin
gonorrhea - ceftriaxone
syphilis - penicillin

Question 19

How do you treat benign prostatic hyperplasia?

Answer 19

watchful waiting when minimal symptoms
lifestyle modification
drugs - alpha blocker (e.g. tamulosin), 5-alpha reductase inhibitor (e.g. finesteride)
surgery - prostatectomy, TURP

Question 20

What is SIRS?

Answer 20

severe inflammatory response syndrome
2 of: temp (>38 or <36)
HR >90 
RR>20 
pCO2 <4.3 
WCC >12,000 or <4,000

Question 21

How do you treat nephrotic syndrome?

Answer 21

treat underlying cause
reduce oedema - loop diuretics
reduce proteinuria - ACE-i

Question 22

What are the antibiotics you would use to treat urethritis?

Answer 22

azithromycin
doxycline
erythromycin

Question 23

What is the difference between sepsis, severe sepsis and septic shock?

Answer 23

sepsis: 2 SIRS and infection
severe sepsis: sepsis & end organ damage, hypotension or lactate > 2mmol
septic shock: severe sepsis & persistant hypotension

Question 24

What are the two main causes of epididymo-orchitis and how do you treat them?

Answer 24

<35 years - STI most commonly cause
treat with ciprofloxacin
.35 years - most commonly UTI
treat with doxycycline +/- azithromycin

Question 25

What are the symptoms of chlamydia and gonorrhoea?

Answer 25

dysuria, discharge
male - epididmyo-orchitis
female - menstrual irregularity

Question 26

What is acute nephritic syndrome?

Answer 26

rapid deterioration in kidney function due to glomerulonephritis

Question 27

What is nephrotic syndrome?

Answer 27

oedema
proteinuria
hypoalbuminaemia

Question 28

How do you treat polycystic kidney disease?

Answer 28

tolvaptan delays progression (vaopressin 2 receptor antagonist)
treat hypertension

Question 29

What determines diagnosis of ARPKD (autosomal recessive polycystic kidney disease)?

Answer 29

age
15-39 >/=3 cysts unilaterally
40-59 >/= 2 cysts in each kidney
>60 >/= 4 cysts in each kindey