Renal

Question 1

What is Berger’s Disease?

Answer 1

IgA Nephropathy ie. GN (usually haematuria) occurring at same time as resp infection/gastroenteritis

Question 2

15yo boy, haematuria, left loin pain, proteinuria. Enlarged L kidney on USS. Dx?

Answer 2

Renal vein thrombosis secondary to nephrotic syndrome

Question 3

Most common cause of nephrotic syndrome in adults

Answer 3

focal segmental glomerulosclerosis

Question 4

2mo boy with UTI and deranged renal function. Bilateral hydronephrosis found on ultrasound. Likely Dx and best Ix?

Answer 4

Micturating cystogram

Posterior urethral valves causing reflux

Question 5

Indications for EPO in context of CKD

Answer 5

Symptomatic anemia
OR
Hb <11

Question 6

Indication for Dialysis in CKD

Answer 6

eGFR <15

NB. Depending on clinical context, symptom control may be more appropriate

Question 7

Conditions for peritoneal dialysis

Answer 7

No associated comorbidities

Question 8

Patient with chronic back pain presents with moderate renal impairment.

Answer 8

Analgesic nephropathy (even paracetamol)

Question 9

Gold standard Ix for renal artery stenosis

Answer 9

Digital subtraction angiography

Question 10

Commonest bladder cancer worldwide

Answer 10

SCC

TCC commonest in UK

Question 11

Surgical options for urge incontinence

Answer 11

Sacral nerve stimulation
Botulinum toxin
Augmenation cystoplasty
Urinary diversion

Question 12

Phimosis vs paraphimosis

Answer 12

Phimosis: tight foreskin
Paraphimosis: cannot replace foreskin once pulled back

Question 13

When to offer TUIP rather than TURP

Answer 13

If prostate mass <30g

NICE guidelines suggest that prostate mass of 30g or less does not suggest benign prostatic enlargement

Question 14

What is Peyronie’s disease?

Answer 14

When penis bends in middle of shaft during erection

Associated with Dupuytrons

Question 15

Prostate Ca meds with gynaecomastia SE

Answer 15

Filutamide (tablet)
GnRH analogues (Gosurelin injection)

Question 16

Urology medication that should not be handled by women with childbearing potential

Answer 16

Dutasteride/Finasteride

Question 17

Prostate Ca treatment

Answer 17

Gleason score:

Low: active surveillance
Intermediate: Prostatectomy + radiotherapy
High: Prostatectomy + radiotherapy (if realistic prospect of disease control)

Question 18

Which prostate ca medication does not affect sexual function?

Answer 18

Bicalutamide

Question 19

Which medication used in Urology exacerbates MG?

Answer 19

Doxycycline (Rx for epidymo-orchitis)

Question 20

Treatment of met prostate cancer initiated, develops back pain and leg weakness. ?cause

Answer 20

Gosurelin, causes flare first, like in this case causing SCC

Question 21

Testicular Cancer RFs

Answer 21

Cryptorchidism (absence from scrotum)
FH
Infertility
Ca in contralateral testicle
Klinefelter's syndrome

Question 22

Seminoma v Teratoma age of onset

Answer 22

SSSeminoma SSSlow growing

Seminoma: 30-40yo
Teratoma: <30

Question 23

Signs + RX of renal osteodystrophy

Answer 23

Bone pain, low calcium, high phosphate
due to lack of vitamin D

Rx: alfacalcidol (vitamin d prologue only requiring activation by liver)