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Renal > Urology > Flashcards

Urology Flashcards

1
Q

Haemospermia may be a presentation of what?

A
  • prostate cancer
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2
Q

What is non-visible haematuria

A
  • microscopic
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3
Q

Potential symptoms of non-visual haematuria

A
  • LUTS (Hesitancy, frequency, urgency, dysuria)

- UUTS (Renal colic)

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4
Q

What does LUTS stand for?

A
  • Lower urinary tract symptoms
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5
Q

What is important in a history for a patient with haematuria?

A
  • smoking
  • age > 40yrs
  • occupational exposure
  • travel (schistoma)
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6
Q

Causes of haematuria?

A
  • stones
  • infection
  • malignancy
  • trauma
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7
Q

What are some infective causes of haematuria?

A
  • uretritis
  • prostatisis
  • cystitis
  • pyelonephritis
  • glomerulonephritis
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8
Q

Tumours of the urinary tract may have what symptoms?

A
  • haematuria
  • loin pain
  • renal colic
  • urinary retention
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9
Q

Penile cancer symptoms?

A
  • itching
  • burning
  • haematuria
  • mass
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10
Q

Potential contaminants that may appear like haematuria?

A
  • menstural
  • food (beetroot, blackberries)
  • myoglobin (rhabdomyolysis)
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11
Q

Biggest risk factor for bladder cancer?

A
  • smoking
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12
Q

Schistosoma may lead to what?

A
  • chronic cystitis

- squamous cell carcinoma

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13
Q

Describe joggers haematuria?

A
  • stress - hypoxic damage to nephrons

- no underlying cause

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14
Q

Blood visible at the start of urination?

A
  • urethra?
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15
Q

Blood visible at end of urination?

A
  • bladder

- prostate

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16
Q

Blood visible throughout urination?

A
  • bladder
  • kidney
  • ureters
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17
Q

Investigations for haematuria?

A
  • dip stick
  • PR examination
  • Gold standard = CT urogram
  • USS
  • MRI
  • flexible cytoscopy
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18
Q

All patients aged > ____ years with asymptomatic non-visible haematuria should be___

A
  • 40yrs

- referred

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19
Q

Gold standard investigation for visible haematuria?

A
  • CT urogram
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20
Q

When might an MRI be done over a CT in a haematuria case?

A
  • allergy to contrast dye in CT
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21
Q

Causes of a bladder obstruction

A
  • benign prostatic hyperplasia
  • urethral stricture
  • prostatic cancer
  • bladder stones
  • extrinsic (cystocoele)
  • drugs
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22
Q

What drugs may cause a bladder outflow obstruction?

A
  • anti-cholinergic

- nasal decongestants

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23
Q

What is a cystocoele?

A
  • prolapsed bladder
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24
Q

What composes Hald diagram?

A
  • LUTS
  • BOO (Bladder outflow obstruction)
  • BPE (Benign prostatic enlargement)
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25
Q

LUTS can be divided into?

A
  • storage

- voiding

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26
Q

What are some voiding LUTS symptoms?

A
  • hesitancy
  • poor flow
  • intermittent flow
  • sensation of incomplete emptying
  • post-micturition dribbling
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27
Q

Red flags in urology?

A
  • haematuria
  • supra-pubic pain
  • recurrent UTI
  • Back pain/sciatica
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28
Q

What scoring system can be used in bladder obstruction?

A
  • international prostate symptom scale
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29
Q

What investigations for bladder outflow obstruction should be conducted?

A
  • frequency-volume chart
  • urinalysis
  • serum creatinine
  • PSA
  • Renal USS
  • Cytoscopy
  • TRUS (Transrectal ultrasound)
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30
Q

Surgical treatments of bladder outflow obstructions?

A
  • transurethral resection of prostate gland

- holmium laser of prostate

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31
Q

Medical management of bladder outflow obstruction

A
  • alpha blockers (tamsulosin)
  • 5 a reductase inhibitors (testosterone inhibitors)
  • anticholinergic
  • beta agonist
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32
Q

Mainly voiding symptoms suggests?

A
  • bladder outflow obstruction
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33
Q

How do alpha blockers work?

A
  • act on smooth muscle of prostate
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34
Q

What is the function of 5-alpha reductase inhibitors?

A
  • shrinks prostate
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35
Q

Surgical treatment of prostate obstruction to bladder flow

A
  • transurethral resection of prostate gland
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36
Q

What is a risk factor for testicular cancer?

A
  • cryptorchidism
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37
Q

Main cell type in testicular cancer

A
  • mixed germ cell
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38
Q

Investigations for testicular cancer

A
  • USS
  • CT chest/abdo
  • blood tests (alpha feto protein)
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39
Q

Name a testicular cancer tumour marker?

A
  • alpha-feto protein
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40
Q

Most common cell type of penile cancer

A
  • squamous cell carcinoma
41
Q

What are risk factors for penile cancer?

A
  • AGE >50YRS
  • Asia/africa
  • hPV 16 & 18
42
Q

What HPV is associated with penile cancer

A

16 and 18

43
Q

Most common site for penile cancer

A
  • the glans
44
Q

20% of angiomyolipoma patients may have what condition?

A
  • tuberous sclerosis
45
Q

Appearance of oncocytoma?

A
  • stellate scar
46
Q

Genetic link to clear cell carcinoma?

A
  • VHL
47
Q

Commonest renal cancer

A
  • clear cell
48
Q

Treatment of renal cancer less than 4cm

A
  • leave alone
49
Q

Treatment of renal tumour greater than 7cm

A
  • radical nephropathy
50
Q

Causes of acute urinary retention

A 
o	Prostate infection
o	Bladder overdistention
o	Excessive fluid intake
o	Alcohol
o	Prostatic infarction
51
Q

Name some triggering events of acute urinary retention?

A

o Non-prostate related surgery
o Catheterization
o Urethral instrumentation
o Medications - sympathomimetic or anticholinergic

52
Q

What is paraphimosis

A
  • painful swelling of the foreskin distal to phimotic ring
53
Q

When does paraphimosis occur?

A
  • after catheterisation or cystoscopy
54
Q

Treatment of paraphimosis?

A
  • multiple punctures on foreskin
  • under penile block, manual compression of glands
  • dorsal slit
55
Q

Define priapism

A
  • prolonged unwanted erection >4hrs, painful and not associated with sexual arousal
56
Q

Causes of priapism

A
  • idiopathic
  • intracorporeal injection for ED
  • Trauma
57
Q

Risk in priapism?

A
  • vascular ischaemia
58
Q

Investigations for priapism

A
  • aspiration of blood from corpus cavernosum

- colour doppler USS

59
Q

Treatment of priapism

A
  • aspiration
  • injection of alpha agonist
  • surgical shunt
  • non-ischaemic = may resolve spontaneously
60
Q

Define fournier’s gangrene

A
  • form of necrotising fasciitis occurring about the male genitalia
61
Q

Predisposing factors for fournier’s gangrene

A
  • diabetes

- local trauma

62
Q

Treatment of fournier’s gangrene

A
  • antibiotics and surgical debridement
63
Q

Symptoms of fournier’s gangrene

A
  • swelling
  • crepitus
  • dark purple
64
Q

Treatment of acute urinary retention

A
  • catheter

- a blockers

65
Q

What organisms are involved in mourners gangrene

A
  • anaerobes and areobes
66
Q

What causes a perinephric abscess

A
  • rupture of an acute cortical abscess into perinephric space
67
Q

What are the blood results for a perinephric abscess

A
  • raised WCC

- raised creatinine

68
Q

Treatment of perinephric abscess

A
  • CT guided drain and antibiotics
69
Q

Describe emphysematous pyelonephritis

A
  • an acute necrotising parenchymal and perinal infection
70
Q

What organism usually causes emphysematous pyelonpehritis

A
  • e.coli
71
Q

What is seen on CT of emphysematous pyelonephritis

A
  • gas formation
72
Q

Treatment of emphysematous pyelonephritis

A
  • antibiotics

- potential nephrectomy

73
Q

Causes of an acute renal trauma

A
  • RTA

- sporting injury

74
Q

Symptoms of renal trauma

A
  • frank haematuria

- loin pain

75
Q

Investigations of renal trauma

A
  • CT with contrast
76
Q

Bladder trauma is associated with what injury?

A
  • pelvic fractures
77
Q

Symptoms of bladder trauma

A
  • suprapubic tenderness
  • lower abdo bruising
  • gross haematuria
78
Q

Treatment of bladder trauma

A
  • large bore catheter
  • antibiotics
  • surgery
79
Q

Urethral trauma is associated with what injury?

A
  • pubic rami fracture
80
Q

Symptoms of urethral trauma

A
  • butterfly haemangioma

- blood at meatus

81
Q

Treatment of urethral trauma

A
  • suprapubic catheter

- reconstruction >3mnths

82
Q

Describe post-obrustive diuresis

A
  • prolonged urine production after relief of urinary retention
83
Q

What should be monitored in post-obstructive diuresis?

A
  • fluid balance
84
Q

Blue dot sign?

A
  • torsion of appendage
85
Q

Cremasteric reflex lost?

A
  • torsion of spermatic cord
86
Q

Treatment of torsion of spermatic cord?

A
  • prompt exploration
87
Q

Symptoms of epididymitis

A
  • dysuria
  • pyrexia
  • cremasteric reflex
88
Q

Treatment of epididymitis?

A
  • analgesia

- ofloxacin

89
Q

2 main divisions of urinary incontinence

A
  • stress urinary incontinence

- urge urinary incontinence

90
Q

What causes stress urinary incontinence

A
  • intrinsic sphincter deficiency

- raised intra abdo pressure - cough sneeze

91
Q

What causes urge urinary incontinence

A
  • bladder overactivity

- detrusor instability

92
Q

Nocturia incontinence in males may suggest

A
  • chronic high pressure retention
93
Q

Explain post-micturition dribble

A
  • due to urine pooling in bulbar urethra
94
Q

Constant leak of urine consider?

A
  • fistula
95
Q

Investigations for urinary incontinence

A
  • bladder diary
  • flow rate and post void residue
  • cystometry
96
Q

Treatment of incontinence

A
  • lifestlyle
  • pelvic floor muscles
  • injection therapy - bulking
  • retropubic suspension
  • artificial urinary sphincter
97
Q

Symptoms of overactive bladder

A
  • urgency with or without incontinence

- increased frequency

98
Q

Treatment of an overactive bladder

A
  • pelvic floor exercises
  • anticholinergics
  • botox
  • augmentation ileocytoplasty
99
Q

Last resort for an overactive bladder

A
  • ileal conceit urinary diversion

Renal (14 decks)

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