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Phase 2A (HV) > Miscellaneous- GU > Flashcards

Miscellaneous- GU Flashcards

1
Q

What nephrotoxic drugs should be stopped in AKI

A

NSAIDS
aminoglycosides- gentamicin
ACEIs/ARBs
Diuretics

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2
Q

What drugs should be suspended in AKI

A

Metformin
Lithium
Digoxin

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3
Q

Name 2 complications of CKD

A

Osteomalacia

Renal osteodystrophy

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4
Q

What histology change is seen in membranous glomerulopathy

A

Prominent spike and dome patterns on silver stain

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5
Q

What are the histological changes in IgA nephropathy

A

IgA deposition in the mesangium

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6
Q

What are the signs of nephrotic syndrome

A

Hypoalbuminaemia
Hyperlipidemia
Oedema
Proteinuria (>3g/24hr)

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7
Q

Sings of nephritic syndrome

A

Haematuria
Oliguria
Proteinuria (<3G/24hr)
HTN

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8
Q

Name 5 Nephritic syndromes

A 
IgA Nephropathy
Post streptococcal glomerulonephritis 
SLE
Hencoh purpura
Goodpastures
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9
Q

Schistosomiasis is associated with what type of bladder cancer

A

Squamous cell carcinoma

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10
Q

List 5 Sx of TCC

A 
Painless haematuria
Weight loss
Frequency 
Urgency 
Night sweats
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11
Q

List 5 rf of tcc

A 
Smoking 
Increase age 
FHx
Aromatic amines/Rubber industry
Male
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12
Q

Gs investigation for TCC

A

Flexible cystoscopy and biopsy

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13
Q

Tx for T0, T1 AND Tcis TCC

A

TURBT and chemo

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14
Q

Tx for T2 and T3 TCC

A

Radical cystectomy and chemo

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15
Q

Tx for T4/TCC

A

Palliative chemo + chronic catherisatioj

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16
Q

Where does bladder cancer metastasise to

A

Bone
Lungs
Liver

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17
Q

What is the treatment for stress incontinence in females

A

Pelvic floor exercises
Duloxetine (concerns for se)
Surgery

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18
Q

Tx for stress incontinence in males

A

Artificial sphincter

Sling

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19
Q

List 5 symptoms for BPH

A 
Increased frequency 
Hesitancy
nocturia 
Post void dribbling 
Urgency
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20
Q

Treatment for mild BPH

A

Watchful waiting

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21
Q

Pharmacological tx for BPH

A

Tamsulosin (alpha blocker)

Finestaride (5 alpha reductase inhibitor)

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22
Q

Surgical tx for BPH

A

TURP

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23
Q

Where is prostate cancer most likely found

A

In the peripheral zone

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24
Q

1st line investigation for prostate cancer

A

Multiparametric MRI

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25
Q

Gs Ix for prostate cancer

A

Trans rectal ultrasound guided biopsy

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26
Q

What hormonal tx is available for the tx of prostate cancer

A

GnRH agonists- gosrelin
Androgen receptor blockers- biculamatide
GnRH antagonist- degralix

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27
Q

Se of hormonal therapy in prostate cancer

A 
Hot flushes
Osteoporosis 
Gynecomastia 
Diabetes
Decreased libido
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28
Q

3 rf for RCC

A

Smoking
Obesity
Hypertension

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29
Q

What grading system is used in prostate cancer

A

Gleason grading

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30
Q

What is the most likely cause of epididymo-orchitis in
A) under 35
B) over 35

A

A) sti e.g. chlamydia

B) UTI

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31
Q

What nerves innervated the relaxation of the detrusor muscle

A

Hypogastric nerve (t10-l2)

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32
Q

What nerve is responsible for detrusor muscle contraction

A

Pelvic nerve

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33
Q

What are the main causative organisms in UTIs

A 
Klebsiella
E-coli
Enterococci
Proteus 
S.sapprophyticus
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34
Q

Tx for gonorrhoea

A

IM ceftriaxone + azithromycin

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35
Q

Tx for chlamydia

A

Doxycycline 7 days

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36
Q

Tx for syphyllis

A

IM benzylpenicilin

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37
Q

Which stone is radiolucent on X-ray

A

Uric acid stones

38
Q

Most common places to find renal stones

A

Pelvic brim
Pelvicoureteric junction
Vesicoureteric junction

39
Q

Gs Ix for CKD

A

eGFR- 2x tests 3 months apart

40
Q

Name 4 tx options for prostate cancer

A 
Radical prostectomy 
TURP
Hormone therapy 
Brachytherapy
External beam therapy
41
Q

What are the tumour markers for testicular cancer

A

LDH
Alpha fetoprotein
Beta HCG

42
Q

Tx for nephrotic syndrome

A 
Fluid and salt restriction 
Loop diuretics
Treat cause
ACEIs/ARBs
Give statins
43
Q

Tx for nephritic syndrome

A

ACEIs/ARBs

Corticosteroids

44
Q

Pharmacological tx for urge incontinence

A

Anti ACh- oxybutinin

45
Q

What changes can be observed in minimal change disease

A

Effacement of podocyte foot processes

46
Q

What is the causative Agent in PSG

A

Group a beta haemolytic strep

47
Q

What is a +ve phren sign and in which disease may it be implicated in

A

Pain relieved when scrotum elevated

Seen in epididymo-orchitis

48
Q

What is klinfelters syndrome

A

47XXY

Tall stature
Hypogonadism
Gynecomastia
Delayed puberty

49
Q

Where are changes seen in BPH

A

Transitional zone

50
Q

What is the triad associated with pyelonephritis

A

Unilateral loin pain
Fever
N+V

51
Q

Most common nephrotic syndrome in adults

A

Focal segmental glomerulonephritis

52
Q

What is the gs Ix of nephrolithiasis

A

Non contrast CT KUB

53
Q

What pharmacological drug can be given to aid the removal of stones

A

Tamsulosin

54
Q

What advice would you give to someone to prevent renal stone formation

A

Keep hydrated- increase fluid intake
Low salt diet
Decrease intake of carbonated drinks
All lemon juice to water

55
Q

What classification is used to risk stratify AKI

A

KDIGO Classification

Stage 1- x1.5 creatinine levels + >0.5ml/kg an hour for > 6hours
Stage 2- x2 creatinine level + <0.5ml/kg and hour for >12 hours
Stage 3- x3 creatinine level <0.3ml/kg/hour for >24 hours

56
Q

List 5 causes of AKI

A

Pre renal- hypovolameia, shock, renal artery stenosis

Renal- acute tubular necrosis, acute interstitial necrosis, glomerulonephritis, haemolytic uraemia syndrome. Tumour lysis syndrome, rhbdomyolysis

Post renal- BPH, obstruction (renal stone), tumour

57
Q

What ECG changes may you see in AKI

A

Hyperkalaemia

58
Q

Causes of CKD

A 
Diabetes 
HTN 
Nephritic and nephrotic syndromes
Obstructive uropathy 
Infections 
SLE/RA
medications
59
Q

What investigations may you do in CKD

A

eGFR
Urine dipstick
Renal ultrasound

60
Q

What is the management in CKD

A

Slow progression of disease- diabetic and hypertensive control
Reduce CVS risk
Exercise, stop smoking
Special diet (low sodium, protein, potassium)

61
Q

What is the most common malignancy in men 20-30

A

Testicular cancer

62
Q

Where does testicular cancer metastasise to

A

Lungs
Lymph nodes of chest
Pelvis
Base of neck

63
Q

List 4 types of testicular cancer

A

Seminomas- central nuclei, clear cytoplasm, surrounded by lymphocytes

Teratomas-

Yolk sac- Schiller duval bodies

Choriocarcinoma- cause frequent bleeding, secrete high level of b HCG

64
Q

What is 1st line Ix for testicular cancer

A

Scrotal uss

65
Q

What is the commonest kidney cancer of childhood

A

Wilms tumour

66
Q

Sx of kidney cancer

A

Hameaturia
Flank pain
Palpable abdo mass

67
Q

What occasion can result in a high PSA level

A 
Prostate cancer
BPH
Prostatitis
UTI 
Exercise 
Recent ejaculation
68
Q

Storage Sx of LUTs

A

Frequency
Urgency
Nocturia
Dysuria

69
Q

Voiding Sx of LUTs

A

Straining
Hesitancy
Incomplete emptying
Poor stream

70
Q

Management of ED

A

Cx- lose weight, stop smoking, education and counselling of patient and partner

Rx-
1st line- phosphodiesterase inhibitors- sildenafil
2nd line- intra cavernous injections/ vacuum devices
3rd line- penile prosthesis implantation

71
Q

Rf for Ed

A

Smoking
Obesity
Dm
Lack of exercise

72
Q

Triad of Sx in urethritis

A

Dysuria
Urethral discharges
Urethral puritis

73
Q

1st line tx for pyelonephritis

A

Cefalexin

74
Q

What is the triad associated with pyelonephritis

A

N+v
Loin pain
Fever

75
Q

Which cancers spread to bone

A 
Lung 
Kidney 
Prostate 
Thyroid 
Breast
76
Q

What is gs ix for varicocele

A

Ultrasound with Doppler imaging

77
Q

Where does the right renal vein drain into

A

IVC

78
Q

1st line tx for Goodpastures

A

Oral prednisalone

79
Q

1st line tx for minimal change

A

Corticosteroids

80
Q

Causes of FSGN

A 
Idiopathic
Secondary to renal pathology 
HIV- viral infections
Obesity 
Sickle cell
Alports
Heroin lithium
81
Q

Commonest cause of glomerulonephritis worldwide

A

IgA nephropathy

82
Q

Is membranous nephropathy a nephritic or nephrotic syndrome

A

Nephrotic-

Idiopathic- anti M type phospholipase A2 antibody associated 
Autoimmune
Hep b and c 
Gold lithium 
Sarcoidosis
83
Q

Most common type of PKD

A

Autosomal dominant PKD type 1

84
Q

Where is the mutation found for
A- ADPKD type 1
B- ADPKD type 2

A

Chromosome 16

Chromosome 4

85
Q

What gene is found to be defected in ARPKD

A

Fibrocystin

86
Q

Sx of PKD

A 
Renal cysts 
HTN 
Hamaturia
Abdominal/flank pain 
Headaches 
Cyst in liver and pancreas
Berry aneurysms
Murmurs
87
Q

1st line Ix for PKD

A

Renal ultrasound

88
Q

What drug can slow down disease progression in PKD

A

Tolvaptan (vasopressin receptor 2 antagonist)

89
Q

What advice should be give to this with diagnosed chlamydia and gonorrhoea

A

Abstain from sex for 7 days
Refer to GUM for contact tracing and informing sexual partners
Advice on safe sex
Test and treat for any other STIs

90
Q

What condition is associated with hydroceles and may require surgery

A

Inguinal hernias

Phase 2A (HV) (13 decks)

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