Pestana- 12. Urology

Question 1

What do you expect in a young man with severe, sudden testicular pain with swollen, high riding testicle?

Answer 1

testicular torsion

Question 2

What is the treatment for testicular torsion?

Answer 2

immediate surgery to untwist testis + orchiopexy

Question 3

What condition is suspected in sexually active males with severe, sudden testicular pain + fever + pyuria and testicle in hormal position?

Answer 3

acute epididymitis

Question 4

How do you treat acute epididymitis?

Answer 4

antibiotics and ultrasound (so you do not miss torsion)

Question 5

What is included in a urological workup?

Answer 5

IVP?
CT (look for renal tumors)
sonogram (look for dilation)

Question 6

What is the only way to look at bladder mucosa?

Answer 6

cystoscopy

Question 7

What do you expect in old man with chills, fever, dysuria, frequency, diffuse low back pain and exquisitely tender prostate on rectal exam?

Answer 7

acute bacterial prostatitis

Question 8

What do you need to remember with acute bacterial prostatitis?

Answer 8

ONLY DO 1 PROSTATE EXAM! continued massage can lead to septic shock

Question 9

What is the most common reason that a new-born boy does not urinate on his day of birth?

Answer 9

posterior urethral valve

Question 10

How do you manage posterior urethral valve?

Answer 10

catheterization

Question 11

What is the diagnostic test for posterior urethral valves?

Answer 11

voiding cystourethrogram

Question 12

What side of the penis is hypospadias opening?

Answer 12

ventral side

Question 13

Can you circumcise a child with hypospadias?

Answer 13

NO (need all of that skin for plastic reconstruction)

Question 14

What do you not need to miss in a child with a UTI?

Answer 14

vesicureteral reflux

Question 15

How do you fix vesicureteral reflux?

Answer 15

long-term abx until child grows out of the problem

Question 16

What do you expect in a little girl who pees appropriately but is wet with urine all the time?

Answer 16

low implantation of the ureter

Question 17

What should you expect if you see an adolescent who binge drinks for the first time then develops colicky flank pain?

Answer 17

Ureteropelvic junction obstruction (normal UOP until you have large diuresis)

Question 18

What is the workup of hematuria?

Answer 18

CT and cystoscopy

Question 19

What metabolic abnormality is seen with RCC?

Answer 19

hypercalcemia

Question 20

How do you diagnose testicular cancer?

Answer 20

radical orchiectomy

Question 21

When do old men with BPH typically develop acute urinary retention?

Answer 21

after a cold (using antihistamines and drinking tons of fluids)

Question 22

How long do you need to cath a patient with acute urinary retention?

Answer 22

3 days (at least)

Question 23

What is the first line treatment for BPH?

Answer 23

alpha-blockers (tamsulosin)

Question 24

What is the treatment for very large BPH glands?

Answer 24

5-alpha-reductase inhibitors

Question 25

What is the final surgical option for BPH?

Answer 25

TURP

Question 26

How small must a kidney stone be to have a good chance of passing spontaneously (70%)?

Answer 26

= 3mm

Question 27

What is the most common tool for breaking up large kidney stones?

Answer 27

extracorporeal shock-wave lithotripsy

Question 28

What is the most comon cause of pneumaturia?

Answer 28

diverticulitis