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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
Q

Renal colic - Risk factors

A

Dehydration
Diet/obesity
Medication
M>F

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26
Q

Renal colic - 3 Sites stone gets stuck

A

PUJ (Pelvi-ureteric junction)
Pelvic brim
Vesico-ureteric junction

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27
Q

Stone types (CUCS)

A 
Calcium stone (most common, oxalate rich foods such as spinach, choc, rhubarb, tea)
Uric acid stone (Gout)
Cystine stone (Genetic)
Struvite stone (Infection)
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28
Q

Renal colic - Investigations

A

Urine dipstick (haematuria)
KUB XR
KUB CT

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29
Q

Renal colic - Treatment

A 
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
Q

Renal colic - Differential diagnoses

A

Appendicitis

Diverticulitis

31
Q

Glomerulonephritis - Causes

A

Inflammation
Infection - Strep
Cancer

32
Q

Glomerulonephritis - Symptoms

A

Proteinuria

Haematuria

33
Q

Glomerulonephritis - Pathophysiology

A

Damage to filtration mechanism (glomerulus)

34
Q

Glomerulonephritis - Investigation

A

Renal biopsy

35
Q

Glomerulonephritis - Complications

A

CKD

Renal failure

36
Q

Nephritic syndrome - Pathophysiology

A

1) Glomerulus damage
2) Restricted blood flow
3) Compensatory increase in BP

37
Q

Nephritic syndrome - Cause

A 
IgA nephropathy (inflammation) 
Glomerulonephritis
38
Q

Nephritic syndrome - Symptoms

A

Haematuria
Proteinuria
Hypertension
Nausea

39
Q

Nephritic syndrome - Investigations

A

Dipstick - protein and blood
Blood test - FBC, U&E, LFT, CRP, Ig
Urine MCS
Renal biopsy

40
Q

Nephritic syndrome - Treatment

A

ACEi

Corticosteroid (anti-infl)

41
Q

Nephrotic syndrome - 3 Signs

A

Proteinuria (frothy urine)
Hypoalbuminaemia
Oedema (Ankles, abdomen, face)

42
Q

Nephrotic syndrome - Causes

A 
Diabetes
NSAIDs
Autoimmmune 
Neoplasia
Infection 
Idiopathic
43
Q

Nephrotic syndrome - Complications

A

Thromboembolism
Infection
Hyperlipidaemia

44
Q

Nephrotic syndrome - Treatment

A 
Warfarin
ACEi
Corticosteroid
Loop diuretic
Statins
Vaccinations (pneumococcal)
45
Q

2 Differences between nephritic and nephrotic syndromes

A

Nephrotic has more proteinuria and oedema than nephritic

46
Q

Non-malignant scrotal disease - Presentation

A

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
Q

Non-malignant scrotal disease - Investigation

A 
Cannot get above - Hernia
Seperate, cystic - Epididymal cyst 
Separate, solid - Varicocele
Testicular, cystic - Hydrocele
Testicular, solid - Tumour, haematocele, orchitis
48
Q

Testicular torsion - Pathophysiology

A

1) Twisted spermatic cord

2) Cut off blood supply to testes (ischaemia)

49
Q

Testicular torsion - Symptoms

A 
Sudden onset testicular pain
Hot, tender, swollen testicle
Unilateral
Abdo pain
N&V
50
Q

Testicular torsion - Treatment

A

Refer to urology ASAP
Scrotal doppler US
Surgery within 6 hours!

51
Q

A testicular lump is what until proven otherwise?

A

Cancer

52
Q

Benign prostatic hyperplasia (BPH) - Pathophysiology

A

Increased prostate size without malignancy

Inner transitional zone enlarges

53
Q

Benign prostatic hyperplasia (BPH) - Risk factors

A

Ageing
Family history
High levels testosterone

54
Q

Benign prostatic hyperplasia (BPH) - Symptoms (SHED FUND)

A 
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
Q

Benign prostatic hyperplasia (BPH) - Differential diagnoses

A

UTI

Too much alcohol/caffeine

56
Q

Benign prostatic hyperplasia (BPH) - Investigations

A

DRE (Digital rectal exam)
PSA (Prostate surface antigen)
Biopsy
Urinalysis

57
Q

Benign prostatic hyperplasia (BPH) - Treatment

A

Alpha-blocker - Tamsulosin
Anti-cholinergics (overactive bladder)
TURP (Transurethral resection of prostate)

58
Q

Acute kidney injury (AKI) - Pathophysiology

A

Rapid reduction in kidney function

Decline in GFR - Loss of normal water/solute/acid-base homeostasis

59
Q

Acute kidney injury (AKI) - Signs

A

Raised creatinine

Reduced urine output

60
Q

AKI (Acute kidney injury) - Risk factors

A 
Sepsis
Age
Cardiac failure
Drugs
Increased fluid loss+decreased fluid intake
61
Q

AKI (Acute kidney injury) - Causes

A

Compromised renal perfusion (obstruction of flow)
Volume depletion (Hypovolaemia)- haemorrhage, diarrhoea, dehydration
Hypotension
Atherosclerosis
Ischaemia
Glomerulonephritis
SLE
Vasculitis
Outflow obstruction (renal stone, tumour)

62
Q

Acute kidney injury (AKI) - Symptoms

A 
Anuria (failure of kidneys to produce urine)
Oliguria (reduced urine output)
N&V
Confusion
Peripheral oedema
Hypertension
63
Q

Acute kidney injury (AKI) - Emergency sign

A

Hyperkalaemia - ECG shows prolonged QRS complex

64
Q

Acute kidney injury (AKI) - Investigations

A 
Bloods - U&E, Salt, creatinine
Renal US (blockages)
CT/XR
Dipstick urinalysis
ECG (QRS - hyperkalaemia)
BP 
Urine output
65
Q

Acute kidney injury (AKI) - Treatment

A 
Fluid resus
Antibiotics (sepsis)
Stop nephrotoxic drugs
Furosemide (diuretic)
Dialysis (last resort)
66
Q

Chronic kidney disease (CKD) - Pathophysiology

A

Chronic kidney function/structure abnormalities

Irreversible loss of nephron function (glomerulosclerosis)

67
Q

Chronic kidney disease (CKD) - Causes

A 
Hypertension
Diabetes
AKI
Pyelonephritis 
Glomerulonephritis 
Polycystic kidney disease
68
Q

Chronic kidney disease (CKD) - Symptoms

A

Hypertension
Oedema
Cardiomyopathy
Nocturia

69
Q

Chronic kidney disease (CKD) - Investigations

A 
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
Q

Chronic kidney disease (CKD) - Treatment

A 
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
Q

Post-transplant treatment

A

Cyclosporin (immunosuppression)

Phase 2A Med Concise (18 decks)

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