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Phase 2A Med Concise > Genitourinary > Flashcards

Genitourinary Flashcards

1
Q

Urinary incontinence - 3 Types (USO)

A

Urgency - OAB (Over-active bladder)
Stress (increased abdo pressure - coughing, exercising, lifting)
Overflow - dribbling post-micturition

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2
Q

OAB (Over-active bladder) - Pathophysiology

A

OAB = urgency + frequency +/- nocturia

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3
Q

OAB (Over-active bladder) - Cause

A

Overactive detrusor muscle

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4
Q

OAB (Over-active bladder) - Investigation

A

Bladder diary (urodynamics)

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5
Q

OAB (Over-active bladder) - Treatment

A

Cut out caffeine/alcohol

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6
Q

Stress incontinence - Causes

A

Coughing
Sneezing
Lifting
Exercising

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7
Q

Stress incontinence - Treatment

A

Pelvic floor strengthening

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8
Q

Urinary tract infection (UTI) - 2 Types

A 
Upper UTI (Kidneys and above) - Suspect pyelonephritis 
Lower UTI (Anywhere below kidneys - ureter, bladder, prostate, urethra)
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9
Q

Urinary tract infection (UTI) - Causes

A

E.coli
Kidney stone
Catheterised in hosp
Chlamydia

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10
Q

Urinary tract infection (UTI) - Risk factors

A 
Female>male
Post-menopausal
New sexual activity 
Catheter
Kidney stones
Immunosupression
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11
Q

Urinary tract infection (UTI) - Symptoms

A

Frequency
Haematuria (bloody urine)
Smelly urine

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12
Q

Urinary tract infection (UTI) - Investigation

A

Dipstick (proteins, pH)
Culture - E.coli, enterococcus, s.aureus
Bloods - WBC

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13
Q

Urinary tract infection (UTI) - Treatment

A 
Upper UTI (Pyelonephritis) - Co-amoxiclav (Broad-spec antibiotic)
Lower UTI - Trimethoprim, nitrofurantoin
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14
Q

Pyelonephritis - Symptoms

A

Fever (raised temp)

Back pain towards sides

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15
Q

Pyelonephritis - Investigations

A

Dipstick
MSU
Bloods - FBC, U&E, CRP, culture
USS

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16
Q

Pyelonephritis - Treatment

A

Fluids resus
Broad spec IV co-amox
Analgesia
Catheter

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17
Q

STIs - Chlamydia/gonorrhoea - Sign

A

Discharge

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18
Q

STIs - Syphillis/herpes - Sign

A

Genital ulcer

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19
Q

STIs - Investigations

A

Male - First void urine
Female - Vaginal swab
MCS - Microscopy, cuture and sensitivity

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20
Q

STIs - Treatment

A

Partner notification ASAP
Chlamydia - Doxycycline (antibiotic)
Gonorrhoea - Ceftriaxone (antibiotic)
Syphillis - Penicillin (antibiotic)

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21
Q

GU malignancy - Signs

A

RCC (Renal cell carcinoma) - Haematuria, flank pain, stones
Bladder cancer - Painless haematuria
Testicular cancer - may or may not involve pain

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22
Q

GU malignancy - Risk factors

A

Young men - testicular
Old men - bladder/RCC
Aromatic amines (bladder)
Smoking

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23
Q

GU malignancy - Investgations

A

Urine dip (LUTS - Lower urinary tract symptoms)
US/CT/MRI
Serum tumour markers

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24
Q

Renal colic - Pathophysiology

A

Nephrollithiasis - Presence of stones (calculi) within urinary system

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25
Renal colic - Risk factors
Dehydration Diet/obesity Medication M>F
26
Renal colic - 3 Sites stone gets stuck
PUJ (Pelvi-ureteric junction) Pelvic brim Vesico-ureteric junction
27
Stone types (CUCS)
``` Calcium stone (most common, oxalate rich foods such as spinach, choc, rhubarb, tea) Uric acid stone (Gout) Cystine stone (Genetic) Struvite stone (Infection) ```
28
Renal colic - Investigations
Urine dipstick (haematuria) KUB XR KUB CT
29
Renal colic - Treatment
``` Strong analgesic (Diclofenac) Antibiotics (Cefuroxime/gentamicin) MET (Medical expulsive therapy) - Tamsulosin (Alpha-blocker) PCNL (Percutaneous nephrolithotomy) Adequate hydration Reduce dietary salt, fat, protein and oxalate rich food Calcium stone - Thiazide diuretic Uric acid stone - Allopurinol Cysteine stone - Captopril ```
30
Renal colic - Differential diagnoses
Appendicitis | Diverticulitis
31
Glomerulonephritis - Causes
Inflammation Infection - Strep Cancer
32
Glomerulonephritis - Symptoms
Proteinuria | Haematuria
33
Glomerulonephritis - Pathophysiology
Damage to filtration mechanism (glomerulus)
34
Glomerulonephritis - Investigation
Renal biopsy
35
Glomerulonephritis - Complications
CKD | Renal failure
36
Nephritic syndrome - Pathophysiology
1) Glomerulus damage 2) Restricted blood flow 3) Compensatory increase in BP
37
Nephritic syndrome - Cause
``` IgA nephropathy (inflammation) Glomerulonephritis ```
38
Nephritic syndrome - Symptoms
Haematuria Proteinuria Hypertension Nausea
39
Nephritic syndrome - Investigations
Dipstick - protein and blood Blood test - FBC, U&E, LFT, CRP, Ig Urine MCS Renal biopsy
40
Nephritic syndrome - Treatment
ACEi | Corticosteroid (anti-infl)
41
Nephrotic syndrome - 3 Signs
Proteinuria (frothy urine) Hypoalbuminaemia Oedema (Ankles, abdomen, face)
42
Nephrotic syndrome - Causes
``` Diabetes NSAIDs Autoimmmune Neoplasia Infection Idiopathic ```
43
Nephrotic syndrome - Complications
Thromboembolism Infection Hyperlipidaemia
44
Nephrotic syndrome - Treatment
``` Warfarin ACEi Corticosteroid Loop diuretic Statins Vaccinations (pneumococcal) ```
45
2 Differences between nephritic and nephrotic syndromes
Nephrotic has more proteinuria and oedema than nephritic
46
Non-malignant scrotal disease - Presentation
Epididymal cysts (spermatocele) - Fluid above and behind testes Hydroceles - Fluid in tunica vaginalis Varicoceles - Dilated pampiniform plexus (fault valves) Haematoceles - Blood in tunica vaginalis (trauma) Epididymo-orchitis - Sudden onset testicular pain (testicular torsion) due to STI
47
Non-malignant scrotal disease - Investigation
``` Cannot get above - Hernia Seperate, cystic - Epididymal cyst Separate, solid - Varicocele Testicular, cystic - Hydrocele Testicular, solid - Tumour, haematocele, orchitis ```
48
Testicular torsion - Pathophysiology
1) Twisted spermatic cord | 2) Cut off blood supply to testes (ischaemia)
49
Testicular torsion - Symptoms
``` Sudden onset testicular pain Hot, tender, swollen testicle Unilateral Abdo pain N&V ```
50
Testicular torsion - Treatment
Refer to urology ASAP Scrotal doppler US Surgery within 6 hours!
51
A testicular lump is what until proven otherwise?
Cancer
52
Benign prostatic hyperplasia (BPH) - Pathophysiology
Increased prostate size without malignancy | Inner transitional zone enlarges
53
Benign prostatic hyperplasia (BPH) - Risk factors
Ageing Family history High levels testosterone
54
Benign prostatic hyperplasia (BPH) - Symptoms (SHED FUND)
``` LUTS - SHED FUND (Voiding and storage) Stream changes Hesitancy Emptying incomplete Dribbling Frequency Urgency Nocturia Dysuria ``` Also: Haematuria, loin/pelvic pain, renal stones, UTI, sexual/erectile difficulties
55
Benign prostatic hyperplasia (BPH) - Differential diagnoses
UTI | Too much alcohol/caffeine
56
Benign prostatic hyperplasia (BPH) - Investigations
DRE (Digital rectal exam) PSA (Prostate surface antigen) Biopsy Urinalysis
57
Benign prostatic hyperplasia (BPH) - Treatment
Alpha-blocker - Tamsulosin Anti-cholinergics (overactive bladder) TURP (Transurethral resection of prostate)
58
Acute kidney injury (AKI) - Pathophysiology
Rapid reduction in kidney function | Decline in GFR - Loss of normal water/solute/acid-base homeostasis
59
Acute kidney injury (AKI) - Signs
Raised creatinine | Reduced urine output
60
AKI (Acute kidney injury) - Risk factors
``` Sepsis Age Cardiac failure Drugs Increased fluid loss+decreased fluid intake ```
61
AKI (Acute kidney injury) - Causes
Compromised renal perfusion (obstruction of flow) Volume depletion (Hypovolaemia)- haemorrhage, diarrhoea, dehydration Hypotension Atherosclerosis Ischaemia Glomerulonephritis SLE Vasculitis Outflow obstruction (renal stone, tumour)
62
Acute kidney injury (AKI) - Symptoms
``` Anuria (failure of kidneys to produce urine) Oliguria (reduced urine output) N&V Confusion Peripheral oedema Hypertension ```
63
Acute kidney injury (AKI) - Emergency sign
Hyperkalaemia - ECG shows prolonged QRS complex
64
Acute kidney injury (AKI) - Investigations
``` Bloods - U&E, Salt, creatinine Renal US (blockages) CT/XR Dipstick urinalysis ECG (QRS - hyperkalaemia) BP Urine output ```
65
Acute kidney injury (AKI) - Treatment
``` Fluid resus Antibiotics (sepsis) Stop nephrotoxic drugs Furosemide (diuretic) Dialysis (last resort) ```
66
Chronic kidney disease (CKD) - Pathophysiology
Chronic kidney function/structure abnormalities | Irreversible loss of nephron function (glomerulosclerosis)
67
Chronic kidney disease (CKD) - Causes
``` Hypertension Diabetes AKI Pyelonephritis Glomerulonephritis Polycystic kidney disease ```
68
Chronic kidney disease (CKD) - Symptoms
Hypertension Oedema Cardiomyopathy Nocturia
69
Chronic kidney disease (CKD) - Investigations
``` Renal function - Reduced GFR - Reduced U&E FBC - Normochromic, normocytic anaemia (low Epo), raised urea, raised creatinine Urine dipstick - Haematuria/proteinuria US Renal biopsy ```
70
Chronic kidney disease (CKD) - Treatment
``` ACEi Diuretics Control blood sugar if DM Lifestyle - Smoking, diet, weight, exercise Stop nephrotoxins CVD - Statins, anticoag Dialysis (peritoneal - daily abdo cath/haemo - 3x/w fistula) Transplant ```
71
Post-transplant treatment
Cyclosporin (immunosuppression)

Phase 2A Med Concise (18 decks)

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