Genitourinary Flashcards
What is the most common type of kidney stone?
Calcium: 85% of stones
What is the most specific imaging modality for diagnosing kidney stones?
CT
Will a spermatocele transilluminate?
Yes
A kidney stone of less than what size will likely pass on its own?
Less than 5mm
List 3 possible txs for stress incontinence in women
Kegels
Estrogen therapy
Surgical placement of a urethral sling
A 65 yo male presents with frequency. On DRE you feel an elastic moderately enlarged prostate. What is the most likely dx?
BPH
A PSA above what level should start to make you concerned?
> 4.0
Give 2 major risk factors for erectile dysfunction.
Diabetes
HTN
Depression
Coronary artery disease
List one major risk factor for bladder CA
Smoking
Define paraphimosis
Foreskin is retracted and cannot be reduced
Which problem is an emergency: phimosis or paraphimosis?
Paraphimosis
What is the name of the condition that involves fibrous scar tissue in the penis causing a curvature of the erect penis?
Peyronie’s disease
Both testicles should be descended by what age?
3 months
Feeling a bag of worms in the scrotum should make you think of what dx?
Varicocele
A fluid filled painless mass found in the scrotum which transilluminates should make you think of what dx?
Hydrocele
What is the first line tx for a varicocele?
Watchful waiting unless there is question of fertility
Name the sign which is defined as decreased pain with scrotal elevation.
Prehn’s sign
Maltese crosses in the urine should make you think of what dx?
Nephrotic syndrome
What is the imaging study of choice if you suspect bladder cancer?
Cystoscopy and biopsy
What is the most likely dx for a free floating, painless, cystic mass found posterior and superior to the testis?
Spermatocele
What age range is typically associated with testicular torsion?
10-20 yo
Where is the epididymis found?
It is found at the posterior upper pole.
What is the best imaging to r/o testicular torsion?
Doppler u/s for decreased blood flow to the testes
What are the 2 most common causes of epididymitis?
Neisseria gonorrhea and chlamydia
What medication classes are ex’ed IOT help prevent chronic renal failure in diabetes patients?
ACEIs or ARBs
Will epididymitis feel better c scrotal elevation?
Yes
What is the normal level of serum bicarbonate (HCO3)?
24mEg/L
What is the tx for epididymitis?
Ceftriaxone and doxycycline
What is the first line antibiotic treatment for cystitis?
Bactrim
What is the most common organism that causes a bladder infection?
E. coli
Tenderness at the costovertebral angle should make you think of what dx?
Pyelonephritis
What is the condition where the urethral meatus is not at the tip of the penis?
Hypospadias and in far fewer cases epispadias
What is the most common organism responsible for prostatitis?
E. coli
What is the first line antibiotic for prostatitis?
Bactrium 4-6 wks
list 2 risk factors for prostate cancer
advancing age
African American
positive family hx
high fat diet
What might you feel on DRE of a pt c prostate ca?
Enlarged prostate, hard nodules within the prostate
Define priapism
Painful persistent erection
A prostate bx consists of how many samples?
6-12
Painless hematuria should make you think of what dx?
Bladder cancer
What is the most common bladder cancer?
Transitional cell cancer
Define phimosis
Foreskin cannot be retracted
Name the condition in which the head of the penis curves downward or upward, at the junctions of the head and shaft of the penis. (often assoc c hypospadias)
Chord
How do you treat urethritis?
Ceftriaxone and doxycycline
A 3 yo boy presents c hematuria and a painless palpable abdominal mass. What is the most likely dx?
Wilms tumor
List 3 possible causes of prerenal renal failure
CHF
severe dehydration
hemorrhage
What is the most common cause of postrenal renal failure
BPH: post renal renal failure is secondary to an outflow obstruction
Muddy-brown sediment in the urine should make you think of what dx
Acute tubular necrosis
Tea colored urine with red cell casts should make you think of what dx
Glomerulonephritis
What are the two most common predisposing factors in the development of chronic renal failure?
HTN and DM
A sponge-like prostate on DRE should make you think of what dx?
Prostatitis but be careful b/c you can cause sepsis with a DRE!
Will serum potassium be decreased or elevated in renal failure?
Elevated
A urine protein of >3.5 grams/day should make you think of what dx?
Nephrotic syndrome
What hereditary pattern does polycystic kidney disease follow?
Autosomal dominant
What is the normal pH of the blood?
7.35-7.45
What is the most accurate way to dx urethritis?
urine PCR
What is considered a normal PCO2?
40mmHg
An ABG shows ph of 7.2, a bicarb of 25 and a PCO2 of 50. Is this respiratory or metabolic acidosis?
Respiratory: CO2 is elevated
White blood cell casts should make you think of what dx?
pyelonephritis
What area of the prostate is the primary site for prostate cancer?
the peripheral zone
What are of the prostate is affected by BPH?
the transitional zone
An involuntary loss of urine during coughing or laughing is what type of incontinence?
stress incontinence
A pt who has normal bladder function but can not get to the bathroom has what type of incontinence?
Functional incontinence
What type of incontinence is often associated with BPH?
overflow incontinence: the bladder cannot empty sufficiently
At what age do you begin screening pts for prostate ca? What two tests are used?
At age 50 an annual DRE and PSA are recommended
Often caused by chlamydia what is the syndrome characterized by urethritis (or cervicitis), arthritis and conjunctivitis?
Reiter’s syndrome
What is the most common type of testicular cancer?
Nonseminoma
