GU

Question 1

Required workup for painless hematuria in an adult over 35

Answer 1

Assessment for bladder cancer w/ CT urogram and cystoscopy

Question 2

Medication linked to hemorrhagic cystitis and bladder cancer?

What can be used to prevent this toxicity?

Answer 2

Cyclophosphamide

Prevent with Mesna (concentrates in bladder and forms conjugate with the toxic metabolite of cyclophosphamide, acrolein)

Question 3

Radiolucent kidney stone associated with needle-shaped crystals in the urine

Answer 3

Uric acid stones

Question 4

Kidney stones linked to fat malabsorption

Answer 4

Calcium oxalate (unabsorbed fat chelates calcium in the gut, freeing oxalate to be absorbed)

Question 5

Kidney stones seen in primary hyperparathyroidism and renal tubular acidosis

Answer 5

Calcium phosphate

Question 6

Kidney stones seen with acidic urine

Answer 6

Uric acid stones

Question 7

Kidney stones seen with increased cell turnover

Answer 7

Uric acid stones

Question 8

Treatment of uric acid stones

Answer 8

Hydration, low-purine diet, and alkalinization of the urine with oral potassium citrate. (Can add allopurinol if this regimen fails)

Question 9

Kidney stones seen patient with genetic defect in amino acid transporters

Answer 9

Cystine stones

Question 10

Radioopaque kidney stones with hexagonal crystals in the urine

Answer 10

Cystine stones

Question 11

Kidney stones associated with alkaline urine due to urease-producing bacteria

Answer 11

Struvite stones

Question 12

Organism associated with struvite stones

Answer 12

Proteus (could be other urease-producing bacteria, e.g. Klebsiella)

Question 13

UTI with alkaline urine

Answer 13

Urease-producing bacteria, most commonly Proteus mirabillis (can lead to recurrent UTIs and struvite stones)

(Klebsiella is a less common urease-producing bacterial cause of UTI)

Question 14

First treatment for BPH

Answer 14

Alpha1-blockers (e.g. tamsulosin, doxazosin, terazosin)

(5-alpha reductase inhibitors (e.g. finasteride, dutasteride) are either adjuvants or second-line if alpha1-blockers not tolerated)

Question 15

Treatment for chronic prostatitis

Answer 15

Antibiotics, alpha-blockers, 5-alpha reductase inhibitors

Question 16

Medications that can lead to erectile dysfunction

Answer 16

1. Antihypertensives (especially beta blockers and thiazides)
2. SSRIs
3. Anti-androgenic medications (e.g. spironolactone)

Question 17

Most common cause of priaprism, especially in an adolescent

Answer 17

Sickle cell disease

Question 18

Classic medication that can lead to priaprism

Answer 18

Trazadone (atypical antidepressant with some alpha-block)

Others: Valproate, Alpha1-blockers for BPH, Anticoagulants, Cocaine

Question 19

Hormone(s) produced by Leydig cell testicular tumor

Answer 19

Testosterone and estrogen

Question 20

Hormone(s) produced by choriocarcinoma testicular tumor

Answer 20

beta-HCG

Question 21

Hormone(s) produced by endodermal sinus testicular tumor a.k.a. yolk sac tumor

Answer 21

AFP

Question 22

Hormone(s) produced by seminoma testicular tumor

Answer 22

Usually none

Question 23

UTI symptoms with perineal pain and fever and chills in a man.
Diagnosis? Key test? Treatment?

Answer 23

Diagnosis: Acute bacterial prostatitis
Test: Urine culture to direct antibiotics
Treatment: 4-6 weeks of antibiotics