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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
First line therapy for advanced prostate cancer
androgen deprivation therapy
26
Palliative Treatment for Prostate cancer
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
What is a common side effect of Bicalutamide (anti-androgen drug)
Painful gynaecomastia
28
What is a medical emergency in prostate cancer
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
Underlying sytemic conditions which predispose to necrotising fasciitis
``` DM AIDS Chronic alcohol abuse chemotherapy Transplant Patient Steroid therapy ```
30
Antibiotics for necrotising fasciitis and organisms that they treat
Penicillin-gram + strep Metronidazole-anaerobes (klebsiella) Aminoglycosides - gram - (e.coli)
31
Complications of catherisation in Patient with chronic urinary retention
Worsening of renal failure Severe haematuria Dehydration diuresis
32
Describe underlying cause and characteristics of female pseudohermaphroditism
Cause: congenital adrenal hyperplasia congenital Enzyme deficiency in glucocorticoid metabolic pathways Characteristics: Salt & water wasting Hypertension Hyperpigmentation
33
Oligospermia
Decreased number of spermatozoa in semen <20 Million/ml
34
Asthenospermia
Impaired spermatozoa motility <50%
35
Teratospermia
Increased number of abnormal spermatozoa <30% normal sperm in semen
36
Define communicating hydrocoele
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
Primary hydrocoele
Painless cystic scrotal swelling testes post to fluid transilluminates
38
secondary hydrocoele
Primary scrotal disorder with small hydrocoele
39
Epididymal cyst
testes anterior to fluid
40
Treatment Options for condylomata acuminata
Salicylic acid Interferon Circumcision laser and cryotherapy
41
Medical conditions associated with erectile dyfunction
``` IHD DM Dyslipidaemia Depression Hypertension ```
42
Mechanism of Action of 5PDE inhibitors
inhibit and degrade Enzyme Cgmp | Inhibition of this Enzyme increases corporal cGMP and thus promotes smooth muscl erlaxation
43
Treatment of 30 year old non-pregnant women with pyelonephritis
``` Hospitilise- if toxically ill (rescuss, IV fluids) Broad spectrum bactiricidals Co-amoxiclav cephalosporins gentamycin quinolones ```
44
How does DM predispose to UTi
1. Glucose in Urine good culture for organisms 2. impaires WBC 3. Autonomic neuropathy (poorly contracting bladder + urinary stasis)
45
what percentage of women aged 20-40 have had an UTI
25-30%
46
In women with UIT, what percentage will experiance recurrence within 1 year
40%
47
Why is uti more common in older men than younger men
BPH
48
What percentage have significant bacteriuria
men: 10% women: 20%
49
Haematological causes of haematuria
Anti-coagiulants leukemia haemophilia
50
Medicines used to treat incontincence
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
Hesitancy
Person has to wait along time before Urine starts flowing
52
Urgency
Patient feels the urge to urinate, he/she has to hurry
53
Dysuria
Any Problem or difficulty with urination, mostly pain and discomfort
54
What is the Management of retractile testes
Human Chorionic Gonadotropin

Uro-Preclin (4 decks)

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