Genitourinary Flashcards
what is the most common type of kidney stone?
calcium makes up 85% of kidney stone
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 5 mm
List three possible treatments for stress incontinence in women.
Kegels, estrogen therapy, surgical placement of a urethral sling
A 65 year old male presents with frequency. On digital rectal exam you feel an elastic moderately enlarged prostate. What is the most likely diagnosis?
BPH
A PSA above what level should start to make you concerned?
more than 4.0
Give two major risk factors for erectile dysfunction
Diabetes, hypertension, depression, coronary artery disease
List one major risk factor for bladder cancer?
Smoking
Define paraphimosis
foreskin is retracted and cannot by 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 diagnosis?
varicocele
A fluid filled painless mass found in the scrotum which transilluminates should make you think of what diagnosis?
hydrocele
What is the first line treatment for a varicocele?
Watchful waiting unless there is a 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 diagnosis?
Nephrotic syndrome
What is the imaging study of choice if you suspect bladder cancer?
Cystoscopy and biopsy
What is the most likely diagnosis 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 years old
Where is the epididymis found?
It is found at the posterior upper pole.
What is the best imaging to rule out testicular torsion?
Doppler U/S for decreased blood flow to the testes.
What are the two most common causes of epididymitis?
Neisseria gonorrhea and chlamydia
What medicaton classes are prescribed in order to help prevent chronic renal failure in diabetic patients?
ACEIs or ARBs
Will epididymitis feel better with scrotal elevation?
Yes
What is the normal level of serum bicarbonate (HCO3)?
24 mEq/Liter
What is the treatment 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 diagnosis?
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?
Bactrim 4-6 weeks
List two risk factors for prostate cancer.
Advancing age, African American, positive family history, high fat diet.
What might you feel on a digital rectal exam of a patient with prostate cancer?
Enlarged prostate, hard nodules within the prostate.
Define priapism
painful persistent erection
A prostate biopsy consists of how many samples?
6 to 12
Painless hematuria should make you think of what diagnosis?
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 junction of the head and shaft of the penis. (Hint: It is often associated with hypospadias.)
chordee
How do you treat urethritis?
ceftriaxone and doxycycline
A 3 year old boy presents with hematuria and a painless palpable abdominal mass. What is the most likely diagnosis?
Wilms tumor
List three possible causes of prerenal renal failure.
CHF, severe dehydration, hemorrhage.
What is the most common cause of postrenal renal failure?
BPH, postrenal renal failure is secondary to an outflow obstruction.
Muddy brown sediment in the urine should make you think of what diagnosis?
Acute tubular necrosis
Tea colored urine with red cell casts should make you think of what diagnosis?
Glomerulonephritis
What are the two most common predisposing factors in the development of chronic renal failure?
HTN and DM
A sponge like prostate on digital rectal exam should make you think of what diagnosis?
Prostatitis, but be careful. You can cause sepsis with a digital rectal exam.
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 diagnosis?
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 diagnose urethritis?
Urine PCR
What is considered a normal PCO2?
40mmHg
An ABG shows a 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 diagnosis?
pyelonephritis
What area of the prostate is affected by BPH?
The transitional zone
What area of the prostate is the primary site for prostate cancer?
The peripheral zone
An involuntary loss of urine during coughing or laughing is what type of incontinence?
Stress incontinence
A patient 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 patients for prostate cancer? What two tests are used?
At age 50 an annual digital rectal exam and a PSA are recommended.
Often caused by chlamydia what is the syndrome characterized by urethritis (or cervicitis), arthritis and conjuctivitis?
Reiter’s syndrome
What is the most common type of testicular cancer?
Nonseminoma
