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Phase 2a > Urogenital > Flashcards

Urogenital Flashcards

1
Q

What are non-malignant scrotal diseases?

A

Epididymal cyst, hydrocele, varicocele, adenomatoid tumour

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2
Q

What are the causes of urinary tract obstruction?

A

Urinary stones, urothelial tumours, extrinsic compression by abdominal masses, prostatic hyperplasia, urinary tract malformations, strictures

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3
Q

How does obstruction of the urinary tract present?

A

Pain, impaired renal function, recurrent UTIs
Upper tract obstruction - loin pain radiating to groin
Lower tract obstruction - urinary retention, severe suprapubic pain, urinary frequency, poor stream, terminal dribbling

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4
Q

How is obstruction of the urinary tract diagnosed?

A

US: hydronephrosis (swelling of the kidney due to a build-up of urine)
CT scan: level of obstruction

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5
Q

How is obstruction of the urinary tract managed?

A

Upper - nephrostomy or ureteric stent

Lower - urethral or suprapubic catheter

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6
Q

What causes haematuria?

A

Malignancy, calculi, IgA nephropathy, polycystic kidney disease

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7
Q

What is benign prostatic hyperplasia?

A

Enlargement of the prostate gland due to an increase in cell number

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8
Q

How does benign prostatic hyperplasia present?

A

LUTS - frequency, urgency, nocturia, hesitancy, poor flow, terminal dribbling

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9
Q

What are differential diagnoses of benign prostatic hyperplasia?

A

Overactive bladder, prostatitis, prostate cancer, UTI

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10
Q

How are benign prostatic hyperplasias diagnosed?

A

Ultrasound, PSA test, biopsy

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11
Q

How are benign prostatic hyperplasias managed?

A

Lifestyle - avoid caffeine, alcohol to reduce urgency. Void twice in a row to aid emptying
Drugs - alpha blockers 1st line
Surgery - transurethral resection/incision of prostate, prostatectomy

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12
Q

What are the complications of benign prostatic hyperplasia?

A

Urinary retention, recurrent UTIs, bladder stones, obstructive nephropathy

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13
Q

How do renal carcinomas present?

A

Painless haematuria, loin pain, abdominal mass, anorexia, malaise, weight loss

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14
Q

How are renal carcinomas managed?

A

Radical nephrectomy, radio frequency ablation is an option for patients unfit or willing to undergo surgery

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15
Q

What is a Wilm’s tumour?

A

Nephroblastoma - a malignant childhood renal neoplasm. Present with abdominal mass and haematuria

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16
Q

How do bladder carcinomas present?

A

Painless haematuria, LUTS, recurrent UTIs, voiding irritability

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17
Q

How are bladder carcinomas managed?

A

Depends on the stage
T1 - diathermy via transurethral resection
T2-3 - radical cystectomy
T4 - palliate chemo/radiotherapy

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18
Q

How do prostate cancers present?

A

Majority asymptomatic, LUTS may be present

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19
Q

How are prostate cancers diagnosed?

A

Needle biopsy performed after a raised serum PSA level is found
DRE - hard, irregular prostate

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20
Q

How are prostate cancers managed?

A

Prostatectomy, radiotherapy, analgesia, treat hypercalcaemia

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21
Q

What is a seminoma?

A

Germ cell tumour of the testicle

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22
Q

What is a teratoma?

A

Non-germ cell tumour of the testicle

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23
Q

How do testicular tumours present?

A

Painless testis lump, secondary hydrocele, dyspnoea, abdominal mass

24
Q

How are testicular tumours managed?

A

Radical orchidectomy, seminomas are radiosensitive, use chemotherapy for teratomas

25
Q

How are GU tract tumours generally diagnosed?

A

CT of abdomen and pelvis
CXR, biopsies
Urine cytology

26
Q

What is urolithiasis?

A

Urinary tract calculi - the formation of stony concretions in the bladder or urinary tract

27
Q

What can urinary tract calculi be formed from?

A

Calcium, phosphate, oxalate, urate

28
Q

What are the causes of urinary calculi?

A

Anatomical factors e.g. obstruction
Urinary factors e.g. calcium, oxalate, urine, cystine
Calcium stones associated with hypercalciuria, uric acid stones with hyperuricaemia

29
Q

How does urolithiasis present?

A

Triad: fever, vomiting, flank pain.

Nausea, urinary frequency/ urgency, Haematuria, tachycardia

30
Q

Where would pain be felt if urinary calculi caused obstruction of the kidney?

A

Loin

31
Q

What are the 3 most common sites of urinary tract calculi?

A

Pelviureteric junction, pelvic brim, vesicoureteric junction

32
Q

What are the risk factors for calculi?

A

High protein/ high salt intake
Male, white
Obesity, dehydration, medications e.g. antacids

33
Q

Where would pain be felt if urinary calculi caused obstruction of the bladder or urethra?

A

Pelvic pain

34
Q

How is urolithiasis diagnosed?

A

CT - helps exclude differentials
Urine dipstick - positive for blood
24hr urine sample for stone biochemistry - calcium, phosphate, oxalate, urate
US - hydronephrosis

35
Q

How is urolithiasis managed?

A

Acute - NSAIDs, antiemetics, IV fluids

Surgical - nephrostomy, ureteric stent, endoscopic treatment, extracorporeal shock waves

36
Q

Which clinical syndromes are caused by lower urinary tract infections?

A

Cystitis, prostatitis, epididymitis, urethritis

37
Q

Which clinical syndromes are caused by upper urinary tract infections?

A

Pyelonephritis

38
Q

What is the main organism that causes UTIs?

A

Escherichia coli

39
Q

How are UTIs diagnosed?

A

Urinalysis - leucocytes/ nitrates
Microscopy
Microbiological culture is gold standard - midstream urine specimen

40
Q

How are UTIs managed?

A

Treat with antibiotics

41
Q

What is prostatitis?

A

Inflammation of the prostate gland

42
Q

How does prostatitis present?

A

Pain, fever, malaise, nausea, urinary symptoms

43
Q

What is cystitis?

A

Inflammation of the bladder caused by an infection (usually E.coli)

44
Q

How does cystitis present?

A

Frequency, dysuria, urgency, suprapubic pain, polyuria, haematuria

45
Q

What is pyelonephritis?

A

Infection of the renal parenchyma and soft tissues of renal pelvis/ upper ureter

46
Q

How does pyelonephritis present?

A

Classic triad of loin pain, fever, pyuria

Associated cystitis symptoms

47
Q

How is pyelonephritis managed?

A

Fluid replacement, broad spectrum IV antibiotics, drain obstructed kidney, analgesia

48
Q

What is urethritis?

A

Sexually transmitted inflammation of the urethra

49
Q

What can causes urethritis?

A

Gonorrhoea, chlamydia

50
Q

How is urethritis managed?

A

Gonorrhoea - ceftriaxone
Chlamydia - doxycycline
Bacteria - oflaxacin

51
Q

What is epididymo-orchitis?

A

Sexually transmitted inflammation of the epididymis +/- testes

52
Q

What causes epididymo-orchitis?

A

Chlamydia, E.coli, mumps, gonorrhoea

53
Q

What are the features of epididymo-orchitis?

A

Swelling, dysuria, sweats, UTI symptoms, urethral discharge.

Warn of possible infertility

54
Q

How is epididymo-orchitis managed?

A

Doxycycline, analgesia, scrotal support, sexual abstinence

55
Q

What are the male symptoms of STIs?

A

Urethral discharge, dysuria, genital skin problems, testicular pain/ swelling, peri-anal or anal symptoms

56
Q

What are the female symptoms of STIs?

A

Unusual vaginal discharge, vulval skin problems, abdominal pain, unusual vaginal bleeding

Phase 2a (16 decks)

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