Presentations

Question 1

how is haematuria classified

Answer 1

gross/visible/frank/macroscopic
or
non-visible/microscopic/dipstick +ve

Question 2

define visible haematuria

Answer 2

1ml blood per 100ml urine

Question 3

what percentage of visible haematuria is due to cancer

Answer 3

20%

Question 4

can BPH cause haematuria

Answer 4

it can

Question 5

what is the 1st investigation you should do for visible haematuria in a patient over 50 years old

Answer 5

PR exam

Question 6

what investigations should you do in primary care for visible haematuria in a patient over 50 years old

Answer 6

urinalysis, FBC, U+Es, refer for imaging

Question 7

what should you always do before giving IV contrast

Answer 7

check U+Es

Question 8

what imaging should be done in secondary care for a patient over 50 years old with visible haematuria

Answer 8

CTU

Question 9

what are the contraindications to CTU

Answer 9

pregnant, renal impairment, contrast allergy

Question 10

what should be done following CTU which was unclear or if you require a biopsy for a patient over 50 years old with visible haematuria

Answer 10

flexible cystoscopy

Question 11

what does cytology detect

Answer 11

high grade malignancy

Question 12

what is the 1st investigation for a patient under 50 years with visible haematuria and what are you looking for

Answer 12

US kidney for calculi or tumour

Question 13

what is the next step for a patient under 50 years old with visible haematuria and a positive ultrasound

Answer 13

flexible cystoscopy

Question 14

management of a patient with frank haematuria and clot retention

Answer 14

3 way catheter

Question 15

what should be done next after finding proteinuria on urinalysis

Answer 15

quantify proteinuria with 24hour collection or UPCR

Question 16

what are the 4 stages of proteinuria

Answer 16

microalbuminuria
asymptomatic
heavy
nephrotic

Question 17

what is microalbuminuria

Answer 17

30-300mg /day

Question 18

is microalbuminuria dipstick +ve

Answer 18

no

Question 19

what is asymtomatic proteinuria

Answer 19

<1g / day

Question 20

what is heavy proteinuria

Answer 20

1-3g / day

Question 21

what is nephrotic proteinuria

Answer 21

> 3g / day

Question 22

how are urinary symptoms classified

Answer 22

irritative (can’t keep) or voiding (can’t empty)

Question 23

give examples of irritative urinary symptoms

Answer 23

urgency, polyuria, nocturia, incontinence

Question 24

give examples of voiding urinary symptoms

Answer 24

hesitancy, intermittency, incomplete emptying, straining, post micturition dribbling, anuria

Question 25

what is anuria

Answer 25

acute urinary retention

Question 26

what drug can cause anuria

Answer 26

anticholinergic

Question 27

what is the management of acute anuria

Answer 27

catheter + alpha blocker alfuzosin

Question 28

why are females more prone to urinary incontinence

Answer 28

only have 1 sphincter

Question 29

what are the 5 types of urinary incontince

Answer 29

``` stress urge overflow true extra-urethral ```

Question 30

what are the triggers of stress incontinence

Answer 30

cough, sneeze, laugh, pregnant

Question 31

what is the cause of stress incontinence

Answer 31

weak pelvic floor muscle

Question 32

management of stress incontinence

Answer 32

pelvic floor strengthening exercises, lifestyle, duloxetine

Question 33

cause of true incontinence

Answer 33

abnormal vagina/urinary tract

Question 34

cause of overflow incontinence

Answer 34

bladder obstruction, renal, nerve damage, tumour

Question 35

management of overflow incontinence

Answer 35

catheter

Question 36

cause of urge incontinence

Answer 36

overactive detrusor

Question 37

management of urge incontinence

Answer 37

bladder training, lifestyle, antimuscarinic M2/3, botox

Question 38

investigations for incontinence

Answer 38

US, urodynamics, uroflowmetry, urinalysis

Question 39

what are the sites where ureteric calculi are most likely to get stuck

Answer 39

pelviureteric junction pelvic brim vesicoureteric junction

Question 40

what effect do ureteric calculi have on Starling's forces within the glomerulus

Answer 40

increase bowman's capsule hydrostatic pressure

Question 41

name 2 risk factors for ureteric calculi

Answer 41

hypercalcaemia (in primary hyperparathyroidism) and thiazide diuretics

Question 42

gender and age most affected by kidney stones

Answer 42

F, 30

Question 43

general presentation of kidney stones

Answer 43

renal colic (loin to groin pain) + nausea and vomiting

Question 44

1st imaging choice for kidney stones

Answer 44

KUB XR

Question 45

definitive imaging for kidney stones

Answer 45

non-contrast enhanced CT

Question 46

what is the pain killer of choice for kidney stones

Answer 46

NSAID diclofenac

Question 47

management of large kidney stones >4mm causing anuria

Answer 47

lithotripsy fragmentation

Question 48

management of a large kidney stone in a pyrexic patint

Answer 48

nephrostomy

Question 49

what drugs can help kidney stones pass

Answer 49

alpha blocker tamsulosine | CCB nifedipine