Passmed Uro Flashcards
Complications of Transurethral Resection
TURP
Tur syndrome
Urethral stricture/UTI
Retrograde ejaculation
Perforation of the prostate
Features of TUR syndrome
1 Hyponatraemia: dilutional
- Fluid overload
- Glycine toxicity
How does rhabdomyolysis cause AKI
Acute tubular necrosis
3 causes of raised PSA
BPH / Ca
Prostatitis / UTI
ejaculation
urinary retention
Gold standard Ix for stones
non-contract CT scan.
Best Ix in bladder Ca
Flexible cystoscopy
Acute upper urinary tract obstruction due to stone mx?
nephrostomy
ESWL is for smaller
2 causes of unilateral / bilat hydronephrosis
Uni - PACT Pelvic-ureteric obstruction (congenital or acquired) Aberrant renal vessels Calculi Tumours of renal pelvis
Bilat - SUPER Stenosis of the urethra Urethral valve Prostatic enlargement Extensive bladder tumour Retro-peritoneal fibrosis
Mx of chronic urinary tract obstruction
Ureteric stent or a pyeloplasty
Renal cell carcinoma usual pres?
Paraneoplastic features?
haematuria
hypertension and polycythaemia
Nephroblastoma vs neuroblastoma on imaging
neuroblastoma is usually calcified
CI to circumscision
hypospadius
Which stones are caused by excessive tissue breakdown ? (they are radiolucent)
Uric acid
A 72-year-old man is diagnosed with prostate cancer and goserelin (Zoladex) is prescribed. Which one of the following is it most important to co-prescribe for the first three weeks of treatment?
cyproterone acetate
[Anti-androgen treatment such as cyproterone acetate should be co-prescribed when starting gonadorelin analogues due to the risk of tumour flare. This phenomenon is secondary to initial stimulation of luteinising hormone release by the pituitary gland resulting in increased testosterone levels.]
Which testie tumour often has normal afp / hcg levels
seminoma
Most common renal malignancy
renal adenocarcinoma
Key comp and Ix to check following acute urinary retention
AKI
Serum creatinine
How long does finasteride take to work/
SEs?
up to 6 months
erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia
2 inherited associations with RCC
von Hippel-Lindau syndrome
tuberous sclerosis
1st line mx for chronic urinary retention
intermittent self catheterisation
1 piece of advice and 2 drug options for noctuira
advise about moderating fluid intake at night
furosemide 40mg in late afternoon
desmopressin
When do you get a bulbar urethral rupture
traddle type injury e.g. bicycles
when do you get a membranous urethral rupture
pelvic fracture
Ix traumatic urethral injury.?
Mx?
Investigation
ascending urethrogram
Management suprapubic catheter (surgical placement)