GU

Question 1

which hormone causes enlargement of the prostate from boy > man?

Answer 1

dihydrotestosterone

Question 2

is cancer, or benign prostate enlargement more likely to push on the urethra?

Answer 2

benign
[benign - transitional zone
cancer - outer zone]

Question 3

what is PSA?

Answer 3

prostate specific antigen
non-specific blood test for prostate cancer
[liquefaction of semen, small leakage into blood]

Question 4

2 most common areas of mets in prostate cancer

Answer 4

lymph nodes

bone

Question 5

what are paraneoplastic sydromes?

Answer 5

rare
triggered by altered immune response to neoplasm
non-mets systemic effects w/ malignant neoplasm

Question 6

non-spec systemic symptoms of cancer

Answer 6

weight loss
fever
normocytic anaemia

Question 7

specific constitutional symptoms in cancer caused by hypercalcaemia

Answer 7

anorexia
thirst
confusion
collapse

Question 8

why does cancer cause hypercalcaemia?

Answer 8

bone breakdown
dehydration (vomiting) > kidney fn. impaired
parathyroid hormone related protein secreted by tumour > bone resorption & tubules

Question 9

specific constitutional symptoms in cancer caused by marrow replacement

Answer 9

purpura
anaemia
immune suppression

Question 10

examples of paraneoplastic syndromes

Answer 10

cushing's disease
dementia
cerebellar degeneration
peripheral neuropathy
acanthosis nigricans
erythrocytosis

Question 11

what type of cancer is prostate?

Answer 11

adenocarcinoma

[prostate GLAND]

Question 12

Which zone of the prostate is affected by adenocarcinoma?

Answer 12

peripheral zone

Question 13

5 cancers that tend to metastasise to bone

Answer 13

breast
lung
prostate
thyroid 
kidney

Question 14

what is an androgen?

Answer 14

male sex hormone e.g. testosterone

Question 15

prostate cancer genetics - oncogene that links with TMPRSS2 gene, leading to disruption of androgen receptor signalling

Answer 15

ERG

Question 16

reasons for elevated PSA other than prostate cancer

Answer 16

benign prostate enlargement
UTI
prostatitis
recent ejaculation

Question 17

how does prostate cancer grading [Gleason] differ from norm?

Answer 17

looks a TISSUE not cell

grading not related to cellular differentiation. How close/far from normal tissue?

Question 18

describe T1 stage in prostate cancer

Answer 18

no palpable tumour on DRE

Question 19

describe T2 stage in prostate cancer

Answer 19

palpable tumour confined to prostate

Question 20

describe T3 stage in prostate cancer

Answer 20

palpable tumour extending beyond prostate

Question 21

treatment for localised prostate cancer

Answer 21

surgery
radiotherapy
observation

Question 22

arguments against radical prostatectomy

Answer 22

erectile & sexual dysfn.
urinary incontinence
most die WITH not OF it

Question 23

what is the purpose of the wider diameter of the afferent arteriole than the efferent in the kidney?

Answer 23

increases blood pressure within glomerulus

forces water and solutes into bowman’s capsule

Question 24

most common disease of kidney/urinary tract in men?

Answer 24

benign prostatic hypertrophy

Question 25

most common disease of kidney/urinary tract in women?

Answer 25

UTI

Question 26

what is dysuria?

Answer 26

pain on micturition

Question 27

structural and functional abnormalities in which glomerular cell leads to nephrotic syndrome?

Answer 27

podocytes

Question 28

management of nephrotic syndrome

Answer 28

oedema: dietary salt restriction, thiazide diuretic
proteinuria: ACE inhibitors, angio2 rec. blockers
severe: cyclophosphamide/prednisolone
[treat underlying disease]

Question 29

how do ACE inhibitors/ angiotensin2 receptor blockers decrease proteinuria?

Answer 29

decrease BP in glomerulus so less forced filtration

Question 30

complications of nephrotic syndrome

Answer 30

venous thrombosis
sepsis
AKI

Question 31

how can nephrotic syndrome lead to sepsis?

Answer 31

loss of immunoglobulin in urine

^ infections

Question 32

how can nephrotic syndrome lead to venous thrombosis?

Answer 32

loss of clotting factors in urine

Question 33

what causes acute nephritic syndrome/ acute glomerulonephritis?

Answer 33

immune response triggered by infection e.g. post strep pharyngitis
bacterial antigen trapped in glomerulus

Question 34

clinical features of acute glomerulonephritis/ acute nephritic syndrome

Answer 34

haematuria
proteinuria
hypertension
oedema
oliguria
uraemia

Question 35

Tx of acute glomerulonephritis

Answer 35

HTN: salt restriction, loop diuretics, vasodilators
oedema: fluid restriction
if SLE/vasculitis: prednisolone, cyclophosphamide..