GUT

Question 1

what spinal levels do the kidneys lie between

Answer 1

t11-l3

Question 2

level of the renal artery

Answer 2

L1

Question 3

parasympathetic to bladder

Answer 3

pelvic nerve: S2-S4. ACh. Acts on M3. Contract bladder

Question 4

Sympathetic to bladder

Answer 4

hypogastric plexus. T10-L2. NAd. Stimulates beta 3. inhibits detrusor contraction, closes internal sphincter etc.

Question 5

Somatic to bladder

Answer 5

Pudendal. S2-S4. ACh

Question 6

Sensory from bladder

Answer 6

afferent pelvic nerve

Question 7

BPH treatment

Answer 7

Alpha adrenergic antagonist (tamsulosin). 5 alpha reductase inhibitors (finasteride, dutasteride)

Question 8

grading of prostate cancer

Answer 8

Gleason grading

Question 9

metastatic prostatic cancer treatment

Answer 9

gonadotrophin releasing hormone agonists, surgical castration, sympatomatic treatment, palliative

Question 10

neuropathic bladder gold standard investigation

Answer 10

urodynamics

Question 11

neurogenic bladder management

Answer 11

anticholinergics (botox), augmentation cystoplasty, ileal conduit, self catheterisation,

Question 12

anticholinergic (e.g. oxybutynin) side effects

Answer 12

dry mucus membranes, constipation, visual disturbances

Question 13

botox contraindications

Answer 13

MG, Eaton Lambert Syndrome

Question 14

botox SE

Answer 14

UTI, haematuria, retention, repeting after 9 months

Question 15

gold standard treatment for male stress incontinence

Answer 15

insertion of artificial urinary sphincter

Question 16

renal cell carcinoma epidemiology

Answer 16

more women. risk factors: smoking obesity, renal failure, hypertension, VHL syndrome (autosomal dominant)

Question 17

cyclophosphamide (immunosuppressive) SE

Answer 17

haemorrhagic cystitis, cancer (TCC), infections, infertility

Question 18

Goodpasteurs

Answer 18

acute glomerulonephritis & pulmonary alveolar haemorrhage. Anti GBM antibodies.

Question 19

CKD causes

Answer 19

diabetes, hypertension, chronic glomerulonephritis, obstructive uropathy, cystic disease, AKI

Question 20

medical bladder cancer treatment

Answer 20

mitomycin C & BCG for non muscle invasive

MVAC chemo for muscle invasive

Question 21

TCC epidemiology

Answer 21

more men than women

Question 22

pre renal causes

Answer 22

hypovolaemia secondary to diarrhoea/vomiting

renal artery stenosis

Question 23

intrinsic AKI causes

Answer 23

glomerulonephritis
Acute tubular necrosis 
acute interstitial nephritis
rhabdomyolosis
tumour lysis syndrome

Question 24

post renal AKI causes

Answer 24

stones, BPH, external compression of ureter

Question 25

nephrotoxic drugs

Answer 25

NSAIDs (& aspirin), ACEI, ARB, Aminoglycosides, loop diuretics

Question 26

how to reduce risk of CVD in CKD

Answer 26

atorvastatin 20mg

Question 27

nephritic syndrome causes

Answer 27

IgA nephropathy, post strep glomerulonephritis, SLE, small vessel vasculitis (ANCA), goodpasteurs

Question 28

nephritic syndrome treatment

Answer 28

BP control, treat underlying cause, corticosteroids

Question 29

nephrotic causes

Answer 29

minimal change, focal segmental glomerulosclerosis, membranous nephropathy. Secondary: DDANI: diabetes, drugs, autoimmune, neoplasia, infection

Question 30

nephrotic treatment

Answer 30

``` Fluid and salt restriction Loop diuretics- to manage oedema Treat cause ACE-I/ARB to reduce protein loss Manage complications ```

Question 31

renal cancer prognostic score

Answer 31

Mayo Score

Question 32

chlamydia presentation

Answer 32

``` men- testicular pain voiding symptoms, dysuria 50% are ASX Women- vaginal discharge and dysuria white, yellow or green discharge 70% are ASX ```

Question 33

STI diagnosis

Answer 33

NAAT

Question 34

chlamydia management

Answer 34

avoid sex until finished treatment | 7 days doxyclyclin OR 1g azithromycin (or erythromycin)

Question 35

gonorrhoea presentation

Answer 35

more likely to be ASX Men: dysuria, frequency, discharge Female: vaginal discharge dysuria, pelvic pain

Question 36

gonorrhoea treatment

Answer 36

Single Ceftriaxone IM dose

Question 37

diuretics: where do carbonic anhydrase inhibitors act (e.g. acetozolamide)

Answer 37

PCT

Question 38

example of an osmotic diuretic

Answer 38

mannitol

Question 39

where do osmotic diuretics act

Answer 39

PCT

Question 40

loop diuretic example

Answer 40

furosemide

Question 41

where do loop diuretics act

Answer 41

loop of henle

Question 42

where do thiazides act

Answer 42

(proximal) DCT

Question 43

potassium sparing diuretic example

Answer 43

spironolactone

Question 44

where do potassium sparing diuretics act

Answer 44

distal DCT/Collecting duct (inhibits aldosterone - spironolactone)

Question 45

what drug class is used as a first line for ED

Answer 45

phosphodiesterase inhibitors

Question 46

medical name for viagra

Answer 46

sildenafil