Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year 2 > Genitourinary: Part 7 > Flashcards

Genitourinary: Part 7 Flashcards

1
Q

Define EPIDIDMO-ORCHITIS

A

Acute epididymo-orchitis is a clinical syndrome of pain, swelling and inflammation of the epididymis that can extend into the testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What spread causes epididymo-orchitis

A

extension of infection from the urethra or bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Under 35 causes of epididymo-orchitis

A
  1. Chlamydia trachomatis

2. Neisseria gonorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Over 35 causes of epididymo-orchitis

A
  1. UTI (KEEPS):
  2. Mumps
  3. Trauma
  4. Catheter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Risk factors for epididymo-orchitis

A
  1. Previous infection
  2. Indwelling catheter
  3. Structura;/functional abnormality of urinary tract
  4. Anal intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical presentation of epididymo-orchitis

A
  1. Subacute onset of unilateral scrotal pain and swelling
  2. Urethritis or urethral discharge in STD
  3. Sweats/fever
  4. Tenderness and palpable swelling of the epididymis and testicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Differential diagnosis of epididymo-orchitis

A
  1. Testicular torsion - urological emergency (SURGICAL EXPLORATION)

NEEDS TO BE RULED OUT:

  1. Short pain duration (sudden)
  2. Associated nausea/abdo pain
  3. High-riding/bell-clapper testis
  4. Hydrocele, trauma, abscess formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Diagnostics of epididymo-orchitis

A
  1. NAAT (Nucleic acid amplification test):
    If intracellular gram-NEGATIVE DIPLOCOCCI are present - Gonorrhoea
  2. Mid-stream urine dipstick for UTI symptoms
  3. Ultrasound to rule out abscesses
  4. STD screening
  5. Urethral smear and swab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is Chlamydia treated

A
  1. ORAL DOXYCYCLINE 7 days
    OR
    STAT AZITHROMYCIN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is Gonorrhoea treated

A
  1. IM CEFTRIAXONE + STAT ORAL AZITHROMYCIN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is UTI treated

A
  1. ORAL CIPROFLOXACIN for 2-4 weeks
  2. NSAIDs
  3. ABSTAIN
  4. Partner notification and testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common STD

A

Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes Chlamydia Trachomatis

A

GRAM-NEGATIVE bacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes Neisseria gonorrhoea

A

gram-NEGATIVE diplococcus bacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In what parts of the body does chlamydia and gonorrhoea effect

A
  1. Urethra
  2. Endocervical canal
  3. Rectum
  4. Pharynx
  5. Conjunctiva
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In neonates, what part of the body is effected by chlamydia and gonorrhoea

A
  1. Conjunctiva

2. Atypical pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Primary site of CT and GC in males

A

Urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clinical presentation of CT and GT

A

Dysuria

Urethral discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Incubation for CT and GC

A

CT: 7-21 days
GC: 2-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Percentage of people who are asymptomatic

A
  1. CT: 50%

2. GC - 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Transmission rate female to male in CT and GC

A

CT: 70%
GC: 60-80% (20% if single encounter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Complication with CT

A

Epididymo-orchitis

Reactive arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

primary site of CT and GC in females

A

Cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Non-specific symptoms of CT and GC in females

A
  1. Dysuria
  2. Menstrual irregularity
  3. Discharge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Percentage of CT and GC who are asymptomatic
CT: Over 70% GC: 50%
26
Incubation time for GC in women
10 days
27
Complications for GC and CT in females
1. PELVIC INFLAMMATORY DISEASE 2. NEONATAL TRANSMISSION 3. FITZ HUGH CURTIS syndrome
28
What is pelvic inflammatory disease
Infection spreads up to the fallopian tube leading to inflammation and scarring
29
Complications of pelvic inflammatory disease
Tubular factor infertility 2. Ectopic pregnancy 3. Chronic pelvic pain
30
Symptoms in neonates with CT and GC
Conjunctivitis | Pneumonia
31
What is Fitz hugh syndrome
Peri-hepatitis but no decline in liver function
32
Cons of NAAT with first void urine
Lower sensitivity
33
How is gonorrhoea in females tested
1. Near patient test 2. Culture mid-stream urine 3. Antibiotic sensitivity testing 4. NAAT
34
What is the near patient test
1. Microscopy of gram stained smears of genital secretions - GRAM-NEGATIVE DIPLOCOCCI Sample from urethra in males + endocervix in females
35
How to treat chlamydia in pregnant women
1. ERYTHROMYCIN for 14 days or AZITHROMYCIN STAT
36
Parasympathetic control of LUT
S3,4,5
37
Sympathetic control of LUT
T10, L1 and L2
38
What causes sphincter weakness incontinence
1. Sphincter weakness | 2. Small leak of urine when intra-abdominal pressure rises (laughing, coughing and standing up)
39
Causes of sphincter weakness (stress incontinence)
1. Women secondary to birth trauma 2. Men: Post-prostatectomy 3. Neurogenic or congenital
40
Treatment of incontinence in females and males
1. Pelvic floor excursuses 2. DULOXETINE 3. Surgery: Sling or artificial sphincter 4. Males - artificial sphincter or male sling
41
What is DULOXETINE
Antidepressant
42
What is urge incontinence
Strong desire to void and unable to hold urine
43
What causes urge incontinence
Detrusor overactivity - rise in detrusor pressure on filling associated with urgency (most often in women) Bladder hypersensitivity due to UTI, stones or tumour
44
How is urge incontinence treated
1. Bladder exercises: gradually increasing the interval between voids 2. Behavioural therapy: controlling caffeine, alcohol and frequency volume charts 3. Drugs 4. Bladder augmentation
45
What drugs are given for urge incontinence
1. Anticholingeric agents 2. Beta 3 agonist 3. Botox of bladder
46
Name an anticholinergic agent
OXYBUTYNIN - decreases detrusor excitability
47
Name a beta 3 agonist
MIRABEGRON - activates beta 3 receptor on bladder, allowing detrusor relaxation
48
Why do we give botox to th bladder
Stops release of ACh from pre-synaptic terminal and paralyses the bladder
49
Surgical name for bladder augmentation
Detrusor myectomy | Cystoplasty
50
What is a cystoplasty
Adding bowel to bladder to increase SA Gives increased bladder capacity and reduced detrusor overactivity May have to self-catheterise due to muscle loss
51
Role of the periaqudecutal grey
1. Co-ordination | 2. Completion of voiding
52
What is the guarding reflex
A spinal reflex where proximal part of sphincter senses urine and sends impulses to spinal cord to tell onus's nucleus to store urine
53
What is spastic spinal cord injury
Reflexes work but not controlled by brain
54
Clinical features of spastic spinal cord injury
1. Supra-conical (high part of spinal cord) lesions 2. Loss of co-ordination and completion of voiding 3. Reflex bladder contractions 4. Poorly sustained bladder contraction 4. Kidney failure potentially
55
What is flaccid spinal cord injury
1. Conus lesions (lower spinal cord) - decentralised bladder
56
What three things are lost in flaccid spinal cord injury
1. Reflex bladder contration 2. Guarding reflex 3. Rece[tive relxation
57
Features of flaccid spinal cord injury
1. Areflexic bladder 2. Stress incontinence 3. Risk of poor compliance 4. Puts kidneys at risk
58
What is spastic paralysis
1. Conus functioning but not controlled by brain 2. Reflex bladder - involuntary urination 3. Reflex bowel - involuntary defecation
59
What is flaccid paralysis
1. Conus destroyed or non-functional 2. Areflexic bladder - fills til overflows 3. Areflexic bowel - fills til overflows
60
Three goals of flaccid and spastic injuries
1. Prevent autonomic dysreflexia 2. Maintain bladder safety 3. Symptom control 4. TAMSULOSIN or sphincterectomy 5. Cystoplasty 6. Permenant catheterisation
61
What causes autonomic dysreflexia
1. Over-distention of bladder in lesions above T6 Overstimulation of sympathetic nervous system below the levelk of lesion in response to stimulus
62
Symptoms of autonomic dysreflexia
headache Severe hypertension Flushing
63
Why do we want to maintain bladder safety
Puts kidneys at risk
64
Risk factors for bladder injuries
1. Raised bladder pressure 2. Vesico-ureteric reflux 3. Chronic infection (stones)
65
How do we control symptoms in flaccid and spastic issues
Suppress reflexes by converting bladder to flaccid type and empty regularly ORAL TAMSULOSIN or sphincterectomy
66
How do we treat sepsis
1. Give high flow oxygen via non-rebreathe bag 2. Take blood cultures 3. Give IV antibiotics 4. Start IV fluid resuscitation 5. Check lactate 6. Monitor hourly urine output and consider catheterisation 7. WITHIN 1 HOUR
67
Why is Saline given to patients
Replace fluids and increase BP if low - normal composition to ECF
68
What is onctained in each litre of normal saline
1. Around 150mmol of Na 2. Around 150 mol of Cl 3. Around 300mmol of osmotically active ions 4. NO K+
69
What type of drug is Sildenafil
Phosphodiesterase (TYPE V) inhibitors
70
When is Sildenafil given
1. Erectile dysfunction | 2. Primary pulmonary hypertension
71
Pharmacology of Sildenafil
1. Selective for phosphodiesterase type 5 which is found in smooth muscle of corpus cavernous of penis and lung arteries Causes vasodilatation by inhibiting PDE5 which breaks down Cyclic GMP - increased Cyclic GMP causes smooth muscle relaxation
72
Adverse effects of Slidenafil
1. Flushing, headache, dizziness, HYPOTENSION, tachycardia and palpitations 2. Increased risk of MI and stroke AVOID where vasodilatation is dangerous
73
What drugs contraindicate slidenafil
1. Drugs that increase NOX - severe vasodilatation and Cv collapse
74
How does OXYBUTYNIN work (anti-muscarnic)
1. Inhibits acetylcholine, blocking muscarinic receptors and promoting bladder relaxation to increase capacity SELECTIVE for M3
75
Adverse effects of Oxybutynin
1. Dry mouth 2. Tachycardia 3. COnstipation 4. Blurred vision 5. Contraindicated in UTI
76
Why can't oxybytynin be used in glaucoma
Causes rise in intraocular pressure and in patients with arrhythmias and those at risk of urinary retention
77
How does Bicalutamide work
1. Anti androgen - decreases body's response to androgens - prostate cancer
78
Contraindications for bicalutamide
GI disturbance and liver injury

Year 2 (155 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions