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Uro-Preclin > Uro clinical > Flashcards

Uro clinical Flashcards

1
Q

Clinical Features: LMN neuropathic bladder

A

Overflow incontincence
urinary difficulty
nocturnal enuresis
bladder palpable, non-tender

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2
Q

Clinical Features: UMN neuropathic bladder

A

frequency and urgency
urge incontinence
bladder impalpable

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3
Q

Special Investigations for neuropathic bladder

A

US
Micturition cystic urethrogram
Urodynamic study (accurate Evaluation of bladder and urethral function)

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4
Q

Treatment for BPH

A

Alpha adrenergic blockers (Prazosin, doxazosin, tamsulosin)

5-alpha reductase Inhibitors (finasteride, dutasteride)

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5
Q

What do Alpha adrenegic blockers do in BPH

A

cause Relaxation of prostatic muscle

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6
Q

What do 5 ARI do in BPH

A

cause shrinkage of prostate

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7
Q

Nerve supply of bladder

A

parasympathetic: bladder centre S2-S4^( contract detrusor muscle)
Sympathetic: T11-L2 (contract prox sphincter)
Somatic: pudental nerve S2-S4 (voluntary contraction)

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8
Q

Classification of neuropathic bladder

A

Failure to store-LMN

Failure to empty-UMN

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9
Q

Treatment of neuropathic bladder

A

Clean intermittent self catheterisation (CISC)

Anti-cholinergic drugs (reduce bladder pressures)

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10
Q

Most common malignant tumour in RSA & USA

A

prostate cancer

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11
Q

Incidence of prostate cancer

A

30% of 50 yr old
70% of 80 yr old
almost never <40
Black african americans have higher incidence than whites

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12
Q

what percentage of prostate cancer victims have a genetic predisposition

A

10%

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13
Q

T/F most prostate cancers Regress after bilateral orchidectomy

A

True

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14
Q

In which part of the prostate does prostate cancer occur

A

peripheral zone

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15
Q

Pathology of prostate cancer

A

Generally adenocarcinomas (rarely transitional cell carcinoma or sarcoma of prostate)
Occurs on peripheral Zone and often multifocal
Grows and disseminates slowly

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16
Q

Gleason grading of prostate cancer

A

1-well differentiated to 5-poorly differentiated

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17
Q

Define the staging of tumours

A

staging of tumours refers to Invasion, lymphatic or heamatogenous dissemination

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18
Q

A raised PSA (prostate specific Antigen) may indicate

A

Prostate cancer
BPH
Prostatitis
May be raised in pts with urinary Retention, & after procedures of the prostate

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19
Q

clinical Features of prostatic cancer

A

LUTS
Complications of bladder outflow obstruction
May be mets

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20
Q

What indicates extracapsular spread of prostate cancer

A

Edge of prostate is poorly defined on rectal exam

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21
Q

How is prostate cancer diagnosed

A

Biopsy (at least 6 biopsy cores)

Make use of transrectal US

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22
Q

Biggest risk associated with transrectal biopsy of prostate

A

bacteraemia and septicaemia

23
Q

Which lymph nodes are usually involved in prostate cancer

A

iliac-lymph nodes

24
Q

Treatment Options for prostate cancer

A

Radical prostatectomy
Radiotherapy
Brachytherapy (radio-active seeds injected directly into the prostate
For non-confined disease: pt not curable, palliation

25
Q

First line therapy for advanced prostate cancer

A

androgen deprivation therapy

26
Q

Palliative Treatment for Prostate cancer

A

HORMONE TREATMENT: androgen deprivation therapy

  1. LHRH analogues (Buserelin)
  2. Bilateral orchidectomy
  3. Oestrogens (neg Feedback on test)
  4. Anti-androgens (block androgen receptors in prostate, Flutamide)
  5. TURP (relieves bladder outlet obstruction)
27
Q

What is a common side effect of Bicalutamide (anti-androgen drug)

A

Painful gynaecomastia

28
Q

What is a medical emergency in prostate cancer

A

Spinal cord compression
>Motor dysfunction (complete paraplegia)
>Sensory loss
>Urinary Retention
>use MRI to determine Level of compression
>Treat with high dose steroids (Dexamethosone)

29
Q

Underlying sytemic conditions which predispose to necrotising fasciitis

A 
DM
AIDS
Chronic alcohol abuse
chemotherapy
Transplant Patient
Steroid therapy
30
Q

Antibiotics for necrotising fasciitis and organisms that they treat

A

Penicillin-gram + strep
Metronidazole-anaerobes (klebsiella)
Aminoglycosides - gram - (e.coli)

31
Q

Complications of catherisation in Patient with chronic urinary retention

A

Worsening of renal failure
Severe haematuria
Dehydration
diuresis

32
Q

Describe underlying cause and characteristics of female pseudohermaphroditism

A

Cause: congenital adrenal hyperplasia
congenital Enzyme deficiency in glucocorticoid
metabolic pathways
Characteristics: Salt & water wasting
Hypertension
Hyperpigmentation

33
Q

Oligospermia

A

Decreased number of spermatozoa in semen <20 Million/ml

34
Q

Asthenospermia

A

Impaired spermatozoa motility <50%

35
Q

Teratospermia

A

Increased number of abnormal spermatozoa <30% normal sperm in semen

36
Q

Define communicating hydrocoele

A

Fluid collection between viscerla and parietal layers of tunica vaginalis.
Babies- swelling larger when crying
Children-swelling larger in evening and smaller in morning

37
Q

Primary hydrocoele

A

Painless cystic scrotal swelling
testes post to fluid
transilluminates

38
Q

secondary hydrocoele

A

Primary scrotal disorder with small hydrocoele

39
Q

Epididymal cyst

A

testes anterior to fluid

40
Q

Treatment Options for condylomata acuminata

A

Salicylic acid
Interferon
Circumcision
laser and cryotherapy

41
Q

Medical conditions associated with erectile dyfunction

A 
IHD
DM
Dyslipidaemia
Depression
Hypertension
42
Q

Mechanism of Action of 5PDE inhibitors

A

inhibit and degrade Enzyme Cgmp

Inhibition of this Enzyme increases corporal cGMP and thus promotes smooth muscl erlaxation

43
Q

Treatment of 30 year old non-pregnant women with pyelonephritis

A 
Hospitilise- if toxically ill (rescuss, IV fluids)
Broad spectrum bactiricidals
 Co-amoxiclav
 cephalosporins
 gentamycin
 quinolones
44
Q

How does DM predispose to UTi

A
  1. Glucose in Urine good culture for organisms
  2. impaires WBC
  3. Autonomic neuropathy (poorly contracting bladder + urinary stasis)
45
Q

what percentage of women aged 20-40 have had an UTI

A

25-30%

46
Q

In women with UIT, what percentage will experiance recurrence within 1 year

A

40%

47
Q

Why is uti more common in older men than younger men

A

BPH

48
Q

What percentage have significant bacteriuria

A

men: 10%
women: 20%

49
Q

Haematological causes of haematuria

A

Anti-coagiulants
leukemia
haemophilia

50
Q

Medicines used to treat incontincence

A

Alpha agonists (pseudoephidrine)- increases bladder outlet obstruction
Hormone replacement theraphy (oestrogens)- increased tone in bladder neck
Anticholinergics (oxybutinin) relax detrusor muscle and increase bladder capacity

51
Q

Hesitancy

A

Person has to wait along time before Urine starts flowing

52
Q

Urgency

A

Patient feels the urge to urinate, he/she has to hurry

53
Q

Dysuria

A

Any Problem or difficulty with urination, mostly pain and discomfort

54
Q

What is the Management of retractile testes

A

Human Chorionic Gonadotropin

Uro-Preclin (4 decks)

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