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Surgeory > Urology > Flashcards

Urology Flashcards

1
Q

Alpha1 adrenergic blockers

A

Relax the smooth muscles of the bladder neck and the prostate capsule and inhibits hypertrophy of these tissues
Useful in treating urinary retention

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2
Q

Alpha 1 adrenergic blockers

A 
Selective TSA:
Are specific and have less side effects
-Tamsulosin
- Silodosin
- Alfuzosin

Non selective PDT

  • Prazosin
  • Docazosin
  • Terazosin
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3
Q

Alpha1 adrenergic side effects

A 
DIZZINESS
●POSTURAL HYPOTENSION
●HEADACHE
●RHINITIS or nasal congestion 
●DECREASED EJACULATION
●ASTHENIA abnormal physical weakness or lack of energy.
●OTHERS: RAre
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4
Q

5 alpha reductase inhibitors

A

Shrinks an enlarged prostate gland in order to prevent urinary retention and improved the flow of urine. These drugs block the conversion of testosterone to dihydrotestosterone. No DHT no prostate gland emlagement

Eg: Finasteride: proscar, propecia
Episteride
Dutasteride : completely inhibits both isomer 1(20%) and 2(80%): avodart

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5
Q

5 alpha reductase inhibitors

A

LOSS/REDUCED LIBIDO
●EJACULATORY DISORDER
●ERECTILE DYSFUNCTION
●GYNAECOMATIA

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6
Q

Phosphodisterase 5 inhibitors

A

Relaxes the smooth muscle of the bladder neck for the patient to urinate
Enhances prologed erection
Controls BP

Eg: Sildenafil (Viagra)
       Tadalafil (Cialis)
       Verdenafil
       Avanafil
       Lodenafil
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7
Q

Phototherapy

A 
Plant derived medication that are used to treat and manage UT symptoms 
Eg: Prostacure
Prostamax
Prostacare
Prostafit
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8
Q

DRE in prostate cancer

A
  • rectal mucosa is fixed
  • consistency is hard
  • median sulcus is obliterated
  • prostate shrinks due to anaplastic tumor
  • Ill defined edges
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9
Q

DRE for BPH

A
  • rectal mucosa is flexible
  • consistency is firm
  • median sulcus is palpable and prostrate symmetrical
  • prostate is enlarged
  • well defined edges
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10
Q

Exclusion criteria IPSS

A
  • people in urethral catheter will be relieved of all the four voiding symptoms since the catether will remove all
  • when symptoms have not lasted for thirty days
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11
Q

Obstructive or voiding symptoms

A 
WISE
Weak or poor stream
Intermittency
Straining
Incomplete emptying of the bladder
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12
Q

Irritative and storage symptoms

A

FUN

  • Frequency
  • Urgency
  • Nocturia
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13
Q

Appendages around the urethra

A
  • seminal vesicles
  • epididymis
  • prostate
  • testes
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14
Q

Organs around the prostate

A
  • seminal vesicles: hemospermia
  • rectum: constipation
  • lumbar vertebrae: causes low back pain, para- paresis/ plegia(if compressing the nerve root)
    Urethra: urinary retention
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15
Q

Urethral stricture hx

A
  • age: less than 50 years old
  • pc : difficulty in voiding 3-6 months duration
    Hpc: Do you have splitting or forked stream when urinating
    Have you had any discharge from your penis in the past? How many years ago
    Have you had an STI ( gonococcal urethritis) 8to 15 years ago likely to develop urethral stricture
    Does straining improve stream when urinating
    Is there are a decrease in the width of your stream
    Has a catheter being passed through your urethra or suprapubic region? Are you still having the catether
    Have you had a trauma to your pelvis or pelvic fracture
    Have you had a straddle injury
    Are you able to urinate now
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16
Q

Urethral stricture cont

A

PMSH: has a catheter being passed in your urethra or suprapubic area? Are you still having the catether in you
- has a urethral instrument being passed in you
Past surgical operations
- are you diabetic, asthmatic, hypertensive, sickle cell, syphyllis, tuberculosis DASST Her
- DH: are you on any medications at the moment
Do you take herbal medications
Any food or drug allergies
FH: Has anyone had a urethral stricture in your family
Anyone with DASST Her
SH: tobacco and cigarette smoking don’t put you at risk

17
Q

Prostate cancer hx

A
  • age greater than 60
  • hometown; where are you from- patient has to be from an African descent since it is common amongst Africans
  • residence: schistosoma
    PC : difficulty in voiding 3 to 6 months of duration
    Hpc: have you lost weight, feel dizzy, have palpitations, pedal swelling, itching
    RSP- do you cough, feel chest pain, hemoptysis
    eyes: jaundice
    Musculoskeletal: hip joint pain, waist pains, weak limbs, paralysis, back ache
    Have you fractures any bone
    CNS: Diplopia, visual disturbance, headache,loss of consciousness
    GU: hematospermia, abdominal distension
    Are you able to pass out urine
18
Q

Prostate cancer hx cont

A

PMSH: have you had the cancer before
Has your prostate being biopsied before
Have you done a urethral surgery
Have you urinated a stone before
DH: current medication and side effects ( erectile dysfunction)
Any Food and drug allergies
Do you take herbal medications
FH: do the males in your family have prostate or colorectal cancer
Do the females in your family have ovarian, breast, endometrial and colorectal cancer
SH: have you smoked before

19
Q

Benign prosper hyperplasia hx

A

Age : 40-60 yrs old
Pc: difficulty in voiding
Hpc: do you have a urethral or suprapubic catherization. Is it still there
For BPH, urethral catetherization is done mostly
Do you strain when urinating
Prior to catetherization did you experience WISE FUN
This is a disease of exclusion

20
Q

For history ask

A

Demographics: NASIMORA
Pc: please what brought you to the hospital? Difficulty in voiding- 3 to 6 months duration
LUTS of a duration
Inability to pass out urine two to three months ago
HPC: how did it start
How did it progress
What symptoms did you experience before this
What did you do to relieve yourself before coming to the hospital
What was done for you in the hospital

21
Q

Diagnosis

A

Lower urinary tract symptom: no catether
Lower urinary tract obstruction: catether present

Lower urinary tract obstruction secondary to urethral stricture/ BPH/ prostate cancer

22
Q

In catetherization

A

Urethral catether: Lidocaine + KY Gel acting as anaesthesia to decrease the patient’s pain

Suprapubic catetherization: Lidpcaine

23
Q

If a catether cannot be passed

A
  • poor technique
  • lack of anesthesia
  • traumatization of the urethra or urethral stricture
  • in advanced prostate cancer
24
Q

A prostate can be

A
  • organ confined: age, familial
  • symptomatic or asymptotic:
  • locally advanced or metastatic

Surgeory (7 decks)

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