Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GS Medbear > Medbear Uro > Flashcards

Medbear Uro Flashcards

1
Q

Points of constriction in ureter?

A

Pelvic - Ureteric Junction
Pelvic Brim near bifurcation of common iliac arteries
Vesico-ureteric junction - entry to bladder

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

Types of ureter calculi?

A

Calcium Oxalate - 75%
Calcium phosphate - 10%
Struvite - 5~10%
Urate stones 5% Radiolucent
Cystine
Xanthine Radiolucent

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

Why is calcium oxalate stone significant (besides being 75%)

A

It causes symptoms when comparatively small owing to sharp surface

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

Which stones are caused by acidic urine

A

urate stones. The rest all alkaline urine.

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

Pain of calculi?

A

Pain - typically begins in early morning and intensifies over 15-30min
Develops in outbursts and related to movement of stones in ureter

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

Presentation of calculi?

A

Obstruction
Ulceration - haematuria
Chronic infection

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

Where can stones be?

A

kidneys
Ureter
Bladder

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

Are renal stones symptomatic

A

Mostly no, unless stone is lodged in PUJ causing hydronephrosis and subsequent infection -> pyonephrosis

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

Chracteristics of ureteric stones?

A

Even small stones cause severe symptoms
Severe intermittent loin-to-groin pain
Haematuria - 95%
Upper UTI
VUJ stone cause frequency, urgency, dysuria

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

What kind of diet to raise risk of stones?

A

High protein and sodium intake.

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

Predisposing conditions for stone formation?

A

Crohn’s
Gout
Renal Tubular Acidosis - Type 1, distal
Hyper PTH
Metastatic cancer, paraneoplastic syndrome

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

How to test for pyelonephritis on PE?

A

Positive renal punch (possibly)

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

PE is often unremarkable for stones

A

Yeaa

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

In PE, symptoms are often out of proportion to signs. What can be seen?

A

No guarding, no rebound

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

What does nitrite in urine mean?

A

it means UTI. Can be due to nitrite producing organisms like E. Coli, Klebsiella, Proteus

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

Principles of urolithiasis therapy?

A

Pain control
Treat any suspected UTI
Allow for spontaneous passage of stones OR active stone removal

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

Principles for Kidney stone removal?

A

Kidney stones often asymptomatic. Treat pre-emptively if u see any complications.
Observe if <5mm and monitor for growth. Treat if >7mm

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

Principles for ureteric stone removal?

A

Always symptomatic. Hence allow trial of passage if <7mm. Otherwise treat.

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

3 phases of CT Urogram?

A

Non-contrast phase for detection of stones
Renal parenchymal phase for detection of tumours
Excretory/delayed phase

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

Who is CT Urogram recommended for?

A

Patients with unexplained persistent gross haematuria

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

What is cystoscopy used for?

A

Gold Standard for evaluating lower urinary tract.
Can detect small bladder tumours as IVU may not detect tumours <1cm.
Biopsy can be taken together

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

Renal Cell Carcinoma etiology?

A

Mostly sporadic.
Higher rates seen in VHL disease and tuberous sclerosis complex.

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

Highest risk factor for RCC?

A

Smoking!!
2nd = prior kidney irradiation.
Family hx impt as well

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

Spread of RCC?

A

Infiltrate locally or by haematogenous spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Benign Differentials for RCC?

A

Angiomyolipoma
Renal Cyst
Renal adenoma / abscess
Pyelonephritis
Renal oncocytoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bosniak Classification of renal cysts

A

1 - simple cyst
2 - minimally complex
2F - Minimally complex, need follow up
3 - Indeterminate
4 - Clearly malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Triad of RCC?

A

Painless haematuria
Mass in flank
Flank Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How does mass feel in RCC?

A

Firm, homogenous, non-tender.
Moves with respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Paraneoplastic syndromes of RCC?

A

Hypertension - renin overproduction
Stauffer Syndrome -> ALP elevated
Hypercalcaemia
Cushings Syndrome
Androgen imbalance - Gonadotropin release
Polycythaemia - EPO prod by tumour

can have hypoNa due to renin too

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Cardinal signs of glomerular nephritis?

A

Hypertension
Proteinuria
Haematuria

31
Q

What imaging for RCC?

A

CT Kidneys (best)
US Kidneys
Do bone scan + CT thorax for staging

32
Q

What can be seen in RCC imaging?

A

Presumptive diagnosis made with imaging.
Renal parenchymal mass with thickened irregular walls and enhancement after contrast injection suggests malignancy

33
Q

How to differentiate cystic from solid renal mass with US?

A

3 criteria:
Classical cysts are
1. Round and sharply demarcated with smooth walls
2. Anechoic
3. Strong posterior acoustic enhancement.
No need for further evaluation if all 3 fulfilled. If not go for CT with contrast.

34
Q

Where does testis develop from?

A

Mesoderm of urogenital ridge

35
Q

4 Questions to be asked in scrotal swelling and pain

A

Can you get above the swelling?
Can you identify the testis and epididymis?
Is swelling transilluminable?
Is swelling tender?

36
Q

What is testicular torsion?

A

Sudden twisting of spermatic cord within the scrotum. Most commonly affects neonates and young men.

37
Q

Pain of testicular torsion?

A

Sudden-onset unilateral testicular pain. Can radiate to lower abdo (T10 innervation), with N/V.

Prev attacks of self-limiting pain, ppt by trauma, cycling, straining, sex

38
Q

Clinical findings of testicular torsion?

A

High-riding testis
Absent cremasteric reflex
Negative Prehn sign

39
Q

Most impt RF for prostatic CA?

A

Age >60

40
Q

Clinical presentation of Prostatic CA?

A
  • Persistent Painless hematuria 90%.
    Typically gross, painless, intermittent, occurs throughout the stream.
  • LUTS
41
Q

congenital PUJ obstruction recurs at what age and how?

A

Recur in teenagers as loin pain

42
Q

congenital PUJ obstruction management?

A

Close observation with prophylactic Abx first. Surgical intervention is called pyeloplasty.

43
Q

What is stress incontinence?

A

Incontinence on increase of abdominal pressures

44
Q

Risk factors for testicular torsion?

A

12-18yr age group
Cryptorchidism - undescended testis

45
Q

PE of testicular torsion shows?

A

Swollen and tender scrotum
High riding in scrotum with transverse lie
Absent cremasteric reflex
Negative Prehn sign

46
Q

Investigations for testicular torsion?

A

Colour Doppler US

47
Q

How long before irreversible damage to testis in testicular torsion?

A

irreversible damage after 12 hrs of ischemia

48
Q

Presentation of epididymo-orchitis?

A

Gradual testicular pain and swelling with UTI symptoms.
Cremasteric reflex positive

49
Q

Differentiate renal stone types on XR?

A

Urate and xanthine stones are radio-lucent.
The rest all radio-opaque

50
Q

What does Nitroprusside test for?

A

Cysteine kidney stones

51
Q

What is spastic incontinence?

A

when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine.

52
Q

Presentation of varicocele?

A

Dull aching, left scrotal pain - noticeable when standing and relieved by lying down.
Testicular atrophy
Lower fertility

53
Q

Majority of varicoceles resolve by when?

A

1 year old mark

54
Q

Is nocturia LUTS?

A

no

55
Q

Examples of urological emergencies?

A

ARU, Testicular Torsion, priapism, post-TURP Haemorrhage

56
Q

What is Jaboulay’s procedure?

A

To evert tunica vaginalis. Subtotal excision of Tunica Vaginalis sac

57
Q

By what age/month should testicles descend by?

A

6 months. After that unlikely to descend spontaneously

58
Q

Surgery to descend testis into scrotum?

A

Orchidopexy

59
Q

What conditions are undescended testis associated with?

A

Hernia
Testicular CA
Infertility

60
Q

What can orchidectomy of torsioned testes cause?

A

Subfertility! Cuz contralateral testes can produce anti-sperm Ab

61
Q

How does RBC type tell u origin of haematuria?

A

Dysmorphic RBC = glomerular bleed
Isomorphic RBC = non-glomerular or urological

62
Q

Why does varicocele mainly happen in left hemi-scrotum?

A

Left spermatic vein enters left renal vein at a 90 degree angle.
Intravascular Pa in left renal vein is higher than right.

63
Q

What is varicocele?

A

Dilatation of veins of pampiniform plexus of spermatic cord

64
Q

How serious of PVRU before seeking consult?

A

When PVRU >300mL

65
Q

Can trauma cause varicocele?

A

Yes - secondary varicoceles

66
Q

Modifiable risk factors for urolithiasis?

A

Diet - low fluid, low Ca, high oxalate, high protein, high sodium, high fructose
Dehydration - low urine volume
Massive ingestion of Vit D or Vit C
Milk-Alkali syndrome

67
Q

Risk factors for RCC?

A

Smoking top
Env exposure = cadmium in coke oven workers, asbestos, petroleum byproducts
VHL syndrome
Hereditary Papillary RCC (HPRCC)
ADPKD (30% riskier)

68
Q

Prostate volume for BPH?

A

30g according to Du Jingzeng

69
Q

1st line treatment for BPH?

A

Alpha-blockers.
Alfuzosin, Tamsulosin, Prazosin
Blocks a-1-adrenergic receptors in bladder neck, prostate and urethra.
Lowers outflow resistance and lowers bladder instability

ADR include postural hypotension, dizziness, lethargy

70
Q

Gold standard to find urogenital abnormalities?

A

CT urogram.
XR KUB is not sensitive enough to find tumour.

71
Q

Treatment principles for loca RCC without mets?

A

Radical nephrectomy.
RCC is unresponsive to chemo/radiotherapy.

72
Q

Surgical options for advanced RCC with mets?

A

Immunotherapy with high dose IL-2
Molecular targeted therapy (Sorafenib or Bevacizumab)

73
Q
A
73
Q

Does kidney stone cause LUTS?

A

No. usu more loin to groin pain

GS Medbear (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions