quesmed

Question 1

in a patient with advanced prostate cancer with bony mets what should be the treatment?

Answer 1

GNRG antagonist -ganirelix or degarelix

Question 2

what is the first line investigation of testicular lump?

Answer 2

usg of testes

Question 3

if a 3 month baby presents with undescended testes what should be the management plan?

Answer 3

referral at 6 months because the aim is to correct it by the age of 6-18 months

Question 4

what is the investigation of choice in a patient with suspected bladder cancer( frank haematuria)

Answer 4

CT urogram and flexible cystoscopy

Question 5

In a elderly confused patient who has haematuria high calcium level and chest x ray showing well circumscribed lesions what should bethe mode of investigation?

Answer 5

CT abdomen with arterial and venous phase////// canon ball metastasis with renal cell carcinoma and high calcium is sign of malignancy

Question 6

what is the management of a patient with renal cell carcinoma of stage t3

Answer 6

radical nephrectomy///// partial nephrectomy is done in a tumour wich Is less than 4cm or t1

Question 7

what is the cause of urinary retension?

Answer 7

bladder obstruction or tricyclic antidepressant or anti muscarinic drugs

Question 8

A 23 year old man presents with recurrent renal colic. His parents are present with him and they reveal that a few of their relatives suffer with renal colic too. The patient’s medical history includes learning difficulties, near-sightedness and a spontaneous deep vein thrombosis (DVT) treated appropriately with anticoagulation 2 years ago. A CTKUB is performed which reveals radio-opaque stones within the right ureter. The patient’s urinary pH is found to be acidic. What composition of stone is this patient most likely to present with?

Answer 8

cystine stones due to homocystine uria which is a a autosommal recessive pattern inheritence disorder..myopia, thrombosis and learning difficulty.

Question 9

what is the indication of TURP?

Answer 9

in a patient with urinary obstruction turp is done to remove some part of the prostate.

Question 10

in a patient with prostate cancer and gleason score of 8 what is the managemtn if there is no metastatsis

Answer 10

robotically assisted lap prostectomy

Question 11

treatment of metastatic prostate cancer is

Answer 11

hormonal therapy- gnrh analogue like goseroline or androgen antagonist or gnrh antagonist which blocks fsh and lh

Question 12

in a young patient with epididimo orchitis the investigation will be

Answer 12

NAAT And in older patient the investigation will be urine culture coz the cause will be most likely uti

Question 13

what is the contraindication for prescribing tamsulosin

Answer 13

postural hypotension instead you prescribe finestride which is a 5 alpha reductase

Question 14

which type of testicular cancer will have marked increase in the level of b hcg

Answer 14

choriocarcinoma……embryonal and yolk sac will have high alpha feto protein

Question 15

clot retension in the urine and very high psa

Answer 15

prostatic cancer

Question 16

terminal painful haematuria with pain in the penis

Answer 16

bladder calculi

Question 17

A 32 year old man presents to A&E with severe pain in his back and right testicle. He reports it came on suddenly, come and goes. He’s since vomited twice. On examination, his cremaster reflex is preserved, and elevation of the testicle eases the pain somewhat. A urine dipstick shows blood only.

What is the likely diagnosis?

Answer 17

renal colic

Question 18

in a suspected renal cell carcinoma what should be the first line invetsigation

Answer 18

uss abdomen

Question 19

what is a modifiable risk factor or renal cell carcinoma?

Answer 19

obesity and hypertension

Question 20

what are the example of alpha receptor blocker?

Answer 20

tamsulosin and doxazocin - which relax the prostate smooth muscle and release the tension

Question 21

urethritis is most commonly due to

Answer 21

gonnorhea

Question 22

long term catheterisation puts you at a risk of

Answer 22

squamous cell carcinoma and also schistosomiasis

Question 23

which stage of bladdder cancer is a paient offered curative cystectomy

Answer 23

t2n0m0-muscle invading but not metasiatsie…….t3 is perivesicle fat invading and t4 is adjacent organ

Question 24

what is phren’s test and when is it used?

Answer 24

it is used to differentiate between epididymitis and torsion…basically lift the testis and if the pain is relieved then the phrens test is positive and the cause of the pain is infective rather than torsion

Question 25

what is the antibiotic of choice in acute prostitis?

Answer 25

oral cipro…….ecoli i the most common cause of the prostitis

Question 26

cause of incontinence in a patient who is on lots of opiotes?

Answer 26

functional coz they are too sleepy to void

Question 27

Raised temp with a kidney stone the management will be

Answer 27

nephrostomy SIRS criteria met due to raisedd tmep and inreased heart rate(more than 90) tachypnoea (20 breath per minute) and increased leukocyte…at least 2 present then decompression

Question 28

what shoud be the management of bilteral undescnded testes in a new boen baby check?

Answer 28

referral to the paediatric reg senior for the problem associated which is congenital adrenal hyperplasia

Question 29

bilateral hydronephrosis is most commonly caused by

Answer 29

bph due to chronic retension

Question 30

A 52-year-old male presents to his GP with dull flank pain and fatigue. He is noted to have a blood pressure of 172/96. Bloods are performed and eGFR is 40 (90). His ESR and CRP are also raised. He is referred for further management and renal ultrasound shows bilateral hydronephrosis.

What is the most likely diagnosis?

Answer 30

retroperitoneal fibrosis causing raised esr and crp

Question 31

what is the management of painful pripriasm secondary to sickle cell disease?

Answer 31

aspiration from the corpus cavernosum