Summary of Essentials - Ch. 52-54 (GU) Flashcards
Presentation - N/V, testicular pain (<24 hours), superiorly displaced testicle, absent cremasteric reflex
Testicular torsion
Pathognomonic finding for appendix testicular torsion?
Blue-dot sign
Cremasteric reflex ___ in appendix testes torsion, ___ with testicula torsion
Present; absent
Work-up of suspected testicular torsion?
If low suspicion - UA to r/o UTI or epidymo-orchitis
Doppler U/S
Management of testicular torsion?
<6 hours - attempt manual detorsion followed by elective orchiopexy
> 6 hours - straight to OR for surgical detorsion, orchiectomy if necrotic
Most common type of testicular tumor?
Seminoma
Work-up of testicular mass?
U/S - solid mass in cancer
CT A/P for staging
Bx CONTRAINDICATED
Rx testicular cancer?
Radical orchiectomy
Radiation (seminoma)
Chemo (most)
RPLND (non-seminomas)
Which type of testicular cancer typically has elevated AFP/BCG levels?
Non-seminoma
Presentation - pain with hematuria?
UTI or obstruction
Presentation - painless gross hematuria?
Suspicious for malignancy, especially in the elderly
Most common renal cancer?
RCC
Most common bladder cancer?
Urothelial cell (transitional cell)
Most common prostate cancer?
Adenocarcinoma
Most common kidney stone type?
Calcium oxalate
Work-up of hematuria?
- Urine dipstick, microscopic UA
- If kidney stone is suspected -> non-contrast CT; U/S if woman of childbearing age and children
- If suspicious for malignancy -> CT urogram, urine cytology, cystourethroscopy
Dysmorphic RBCs or RBC casts suggest what?
Glomerular cause
Management of kidney stones?
<5 mm - will likely pass spontaneously
5-9 mm - individualized
>10 mm - lithotripsy, perc nephrostomy, ureteroscopy, rarely nephrolithotomy
Rx renal cancer?
Partial or radical nephrectomy
Rx bladder cancer?
Transurethral resection, infusion of mitomcyin or BCG, or radical cystectomy
Rx prostate cancer?
External beam radiation Brachytherapy Androgen deprivation Radical prostatectomy Active surveillance
