urinary (incl male genitalia + prostate)

Question 1

urinary systemic enquiry

Answer 1

frequency
dysuria 
nocturia 
polyuria 
oliguria 
haematuria 
incontinence/urgency 
prostatic: difficulty, poor stream, terminal dribble

Question 2

causes dysuria

Answer 2

UTI, STI

Question 3

causes frequency

Answer 3

UTI

Question 4

causes urgency

Answer 4

UTI, detrusor instability

Question 5

causes nocturia

Answer 5

UTI, prostatic enlargement (e.g. BPH)

Question 6

causes haematuria

Answer 6

UTI, renal Ca, bladder Ca, trauma

Question 7

symptoms prostatic enlargemnet

Answer 7

hesitancy
dribbling
poor stream
nocturia

Question 8

renal causes fever + rigor

Answer 8

pyelonephritis

Question 9

renal causes weight loss

Answer 9

malignancy

uraemia

Question 10

uraemic symptoms

Answer 10

nausea + vomitting 
fatigue 
anorexia/weight loss
muscle cramps
pruitis 
confusion

Question 11

inspection male genitalia

Answer 11

pubic hair distribution
scrotal skin: scars, rashes
scrotal contours: swellings, scars, veins
urethral meatus: size (stenosis), position (hydrospadias)
foreskin: absence/presence, phimosis, paraphimosis
glans penis: inflammation (balantitis), warts, ulcers, tumours
penile discharge

Question 12

palpation male genitailia

Answer 12

Testis: size (normal 16cc), consistency (soft firm), texture (smooth, rough), masses
epididymis: nodules, swellings, tenderness
spermatic cord: to level superficial inguinal ring, assess presence varicocele

Question 13

if swelling of scrotum what to assess

Answer 13

separate from or involving testis 
is it reducible 
fluctuant (fluid) or solid
does it transluminate?
painful?

Question 14

position of patient during examination of male genitaila

Answer 14

lie down supine

stand up at end and cough

Question 15

prostate exam: inspection perianal area

Answer 15

skin excoriation 
external haemorrhoids
anal fissure
external bleeding 
anal fistula
bear down - prolapse, haemorrhoids

Question 16

prostate exam: anal tone

Answer 16

bear down, squeeze fingers

Question 17

prostate exam: rectal contents and masses

Answer 17

presence/absence stool - is it hard
abnormalities: size, location, consistency
tenderness
bear down to bring lesions from higher up down

Question 18

prostate exam: prostate

Answer 18

anterior wall
assess size (normal diameter 2-3cm, walnut shaped)
assess consistency (soft, firm) 
assess surface texture (smooth, rough) 
any tenderness

Question 19

prostate exam: finger withdrawal

Answer 19

presence blood, mucous, stool

Question 20

4 key features prostatic exam

Answer 20

size
surface texture (rough,, smooth)
consistency (soft, firm)
tenderness

Question 21

benign prostatic hyperplasia

Answer 21

patients>60

LUTS: poor flow, hesitancy, dribbling after micturition, frequency, nocturia

Question 22

BPH finding on prostate exam

Answer 22

enlarged, smooth and soft

Question 23

prostatitis

Answer 23

inflammation prostate gland

Question 24

prostatitis finding prostate exam

Answer 24

boggy, very tender, enlarged

Question 25

prostate cancer finding prostate exam

Answer 25

rough and firm nodule

Question 26

how does prostate exam normally feel

Answer 26

rough and firm