Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2 > Kidney & GU > Flashcards

Kidney & GU Flashcards

1
Q

Name an upper UTI

A

Pyelonephritis

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

Name the lower UTIs

A

Cystitis
Prostatitis
Urethritis
Epidydmo-orchitis

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

Causes of UTI

A

BACTERIAL!
KEEPS

Klebsiella
E.coli - (uropathogenic E.coli = 80% of UTIs)
Enterobacter
Proteus
Staph. spp - coag neg e.g. saprophiticus

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

Ix for ALL UTIs

A

1st - urine dipstick
+ve leukocytes
+ve nitrites
+/-ve haematuria

GS : Midstream (MCS)
Confirms UTI, identifies pathogen

–
Prostatitis has its own GS, Mid MCS is used for its 1st line

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

What does MCS stand for?

A

Microscopy
Culture
Sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do the bacteria adhere to in UTI?

A

Urothelium
Vaginal epithelium
Vaginal mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When is a UTI complicated?

A

Pregnant
Males
Catheterised Pxs
Recurrent/persistent infection
Immunocomp
Structural abnormality
Urosepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Pyelonephritis?

A

Infection of renal parenchyma and soft tissues of renal pelvis and upper ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Key presentation of Pyelonephritis

A

TRIAD OF :
1. Loin/flank pain
2. Fever
3. Pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What other symptoms might present in Pyelonephritis?

A

Back pain
Severe headache
N+V
Associated cystitis symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What other Ix might you do for a patient with Pyelonephritis?

A

URGENT US to detect stones, obstruction or incomplete bladder emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx Pyelonephritis

A

Hydration / Fluid replacement

IV Abx -
broad spectrum e.g. oral co-amoxiclav, oral ciprofloxacillin
if severe - IV gentamicin or IV co-amoxiclav
If pregnant - cefalexin

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

What is Cystitis?

A

Infection of the bladder

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

Cystitis occurs in whom?

A

Children
Females
Pregnancy
People w catheters

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

Why are women more susceptible to Cystitis?

A

Shorter urethra
∴ short proximity to anus
∴ allows bacteria transfer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Key Presentation of Cystitis

A

HD FUSS

Haematuria
Dysuria
Frequency
Urgency
Suprapubic pain
Smelly urine

+ confusion in elderly

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

Tx Cystitis

A

Trimethoprim/Nitofurantoin
(3 day course for women, 7 day for men/complicated women)

In pregnancy
Trimeth cannot be used in 1st tri
Nitrofurantoin cannot be used in 3rd tri
∴ amoxicilin, cefalexin can both be used

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

What is Urethritis?

A

Urethral inflammation due to infectious or non-infectious causes

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

Causes of Urethritis

A

Sexually acquired disease!

N. Gonorrhoea
Chlamydia

Trauma
Urethral stricture
Irritation
Urinary calculi

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

Key presentation of Urethritis

A

Dysuria +/- discharge, blood or pus
Skin lesion
Urethral pain
Penile discomfort/pruritus

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

What other Ix can be done for Urethritis?

A

NAAT (Nucleic Acid Amplification Test) - detects STI type for treatment

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

How is a NAAT taken?

A

Females - self-collected vaginal swab
endo-cervical swab
first void urine

Males - first void urine

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

Tx Urethritis

A

N. Gonorrhoea - IM ceftriaxone and oral azithromycin

Chlamydia trachomatis - Azithromycin or doxycycline

–
Partner notification

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

Major complication of Urethritis

A

Reactive Arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is Epididymo-orchitis?
Inflammation of epididymis extending to tests, usually due to cystitis or urethritis
26
Key presentation of Epididymo-Orchitis
Unilateral scrotal pain and swelling Pain relieved with elevating tests - Pos Prehn's sign! Cremaster reflex INTACT
27
What is Prehn's sign?
Relief when testes is lifted
28
What is important to rule out with Epididymo-Orchitis? Why?
Testicular torsion! bc urological emergency!!
29
What other Ix can you do with Epididymo-Orchitis?
NAAT - detest STI type for treatment
30
Tx Epididymo-Orchitis
Depends on where
31
What are features that suggest testicular torsion rather than Epididymo-Orchitis?
Short duration of pain - very acute, sudden Associated nausea, abdo pain High-riding/bell-clapper testis Scrotal elevation only relieves pain in epididymitis, NOT IN TORSION (i.e. torsion = Prehn's sign **-ve**)
32
Tx Epididymo-Orchitis
N. Gonorrhoea - IM ceftriaxone _and_ oral azithromycin Chlamydia trachomatis - Azithromycin _or_ doxycycline -- UTI - Trimethoprim/Nitofurantoin (3 day course for women, 7 day for men/complicated women)
33
Cause of Epididymo-Orchitis
Under 35 years - Urethritis Over 35 years - Cystitis Mumps Trauma In elderly - catheter!!
34
What is prostatitis associated with?
LUTS
35
Causes of Prostatitis
Acute : Strep. faecalis E. coli Chlamydia Chronic : Bacterial ^ Non-bacterial e.g. ↑ Prostatic pressure, pelvic floor myalgia
36
DDx Epididymo-Orchitis
Testicular torsion !!!!!!!!!!!!! Hydrocele Trauma Abscess formation
37
Presentation of Prostatits
Systemically unwell + Significant voiding LUTs Chronic is above > 3 months
38
Describe voiding LUTs
Straining Poor stream Hesitancy Incomplete emptying Post micturition dribbling Dysuria
39
Ix for Prostatitis
**GS** : DRE !!!!! prostate is tender or hot, hard from calcification
40
Tx Prostatitis
Acute : 1st - gentamycin + IV co-amoxiclav 2nd - trimethoprim Chronic : 4-6 week course of quinolone e.g. ciprofloxacin +/- a-blocker - Tamsulosin
41
What is BPH?
Benign proliferation of transitional zone of prostate, WITHOUT MALIGNANCY
42
Function of prostate
Testosterone and Dihydrotestosterone production Seminal fluid production Regulation of urine flow
43
RF BPH
Age > 60! Fhx DM Heart disease Obesity
44
Key presentation of BPH
LUTS (freq, urgency, dribbling, weak stream, nocturia)
45
Ix BPH
DRE - smooth and enlarged prostate Prostate specific antigen Urine test
46
Tx BPH
Tamsulosin, FInasteride
47
Nephrotoxic drugs
NSAIDs Acei Gentamicin Amphotericin Metformin
48
Types of Prostate cancer
Adenocarcinoma Transitional cell carcinoma Small cell prostate cancer
49
RF Prostate cancer
Mean age = 72 High testosterone levels FHx Obesity
50
Where does prostate cancer usually arise from?
Peripheral zone - far away from urethra ∴ can grow signif before affects anything
51
What do granular casts indicate?
Active renal disease
52
Ix prostate cancer
DRE - hard, irregular prostate PSA (non-specific) Ultrasound & MRI (trans-rectal ultrasound scann - TRUSS) **GS** : BIOPSY! + Gleason grading!
53
Describe Gleason Grading
Histological grades of 2 cell patterns Add 2 most common together Higher score = more aggressive 1 - Small, uniform glands 2 - More space between glands 3 - Distinct infiltration of cells from glands at margin 4 - Irregular masses of neoplastic cells, few glands 5 - Lack of/Only occassional glands, sheets of cells
54
Tx Prostate cancer
Radical prostatectomy (surgery) Radio/Chemotherapy Hormonal therapy : GnRH agonist - Zoladex
55
RF Bladder cancer
55+ FHx Smoking = 2-4x risk Bladder stones Occupational risk - carcinogen exposure Male
56
Key presentation of bladder cancer
Painless haematuria Frequency Back pain
57
Ix bladder cancer
Urinalysis **GS :** Cytoscopy and biopsy CT urogram - allows staging Other : CT, MRI, bone scan
58
Tx Bladder cancer
Depends on staging NON-muscle invading bladder cancer : T1 - transurethral resection (TURBT) or local diathermy Muscle invasion : T2-3 - radical cystectomy T4 - palliative chemo and radiotherapy
59
What is Hydrocele?
Build up of fluid in the tunica vaginalis
60
Key presentation of Hydrocele
Soft, non-tender lump Painless swelling
61
Ix Hydrocele
Shine light through sctorum FBC - check for infection
62
Tx Hydrocele
Usually resolves spontaneously Surgical drainage
63
What is Varicocele?
Enlargement of testicular veins "Bag of worms"
64
Key presentation of Varicocele
Dull ache, scrotal heaviness, mass "Bag of worms"
65
Ix Varicocele
Venography Colour doppler ultrasound
66
Tx Varicocele
Surgery if pain, infertility or testicular atrophy
67
What is testicular torsion?
Medical emergency!! Twisting of spermatic cord
68
Presentation of Testicular torsion
Acute, severe pain Unilateral and swollen **Prehn's sign -ve** Abd pain N+V
69
Ix Testicular torsion
DO NOT DELAY SURGERY Doppler ultrasound Urine test
70
Tx Testicular torsion
Surgical intervention! The quicker, higher the salvage rate
71
What is epididymitis?
Inflammation of epididymis
72
Causes of epididymitis
Infection STI Trauma
73
Presentation of epididymitis
Acute pain Unilateral **Prehn's sign +ve**
74
Ix epididymitis
STI screening Ultrasound Bloods Urine testing
75
Tx epididymitis
Abx - IM Ceftriaxone and doxycycline
76
At what age do epididymal cysts usually occur?
~ 40 years
77
Where are epididymal cysts positioned in regards to the tests?
Lie above and behind
78
Key presentation of epididymal cysts
Lumps - often multiple Can be bilateral Are transluminate (bc fluid-filled)
79
How can you differentiate between epididymal cyst and hydrocele?
Transillumination Testes palpable separately from cysts in epididymal cyst
80
Ix epididymal cyst
Transillumination Scrotal ultrasound
81
Tx epididymal cyst
Usually not necessary Surgery if painful and symptomatic
82
What is the most common cancer in males 15 - 44?
Testicular cancer
83
Key presentation of Testicular cancer
LUMP! (can be painless/painful) in testicle Heaviness Dull ache Swelling Gynecomastia Back pain
84
What does cough and dyspnoea indicate with testicular cancer?
Lung metastases
85
Testicular torsion can lead to ischaemia. What cells are the most susceptible to ischaemia?
Germ cells
86
With testicular torsion, when should you aim to perform surgery?
Within 6 hours of presentation
87
Which testis is more commonly affected with testicular torsion?
Left
88
DDx of Testicular torsion
Epididymo-Orchitis ! But px tends to be older and symptoms of UTI are also present More gradual onset of pain
89
Cause of Torsion of testicular appendage
Surge in gonadotrophins that signal onset of puberty ∴ usually occurs in boys between 7-12 years
90
How does testicular appendage torsion present?
Less pain than testicular torsion Small blue nodule under scrotum
91
BPH is
A histological diagnosis
92
BPE (benign protastic enlargement)
A clinical diagnosis
93
Ix Testicular Cancer
Ultrasound Biopsy and histology - fried-egg cells Serum tumour markers - AFP (alpha feto-protein) and/or B-hCG) Lactate dehydrogenase Normal AFP - seminoma ↑ AFP & ↑ B-hCG - non-seminoma germ cell tumours
94
Types of Testicular cancer
**96% germ cells** - Seminomas - most common! 25 - 40, 60+ Teratomas - infancy **Non-germ cells** Leydig cell tumours Sertoli cell tumours Sarcomas

Phase 2 (24 decks)

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