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UWorld > Urology > Flashcards

Urology Flashcards

1
Q

Typical clinical presentation of acute epididymitis?

A

Unilateral scrotal pain, erythema, swelling

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2
Q

Typical cause of acute epididymitis in younger males?

A

Gonorrhea/Chlamydia infection … (sexually-transmitted)

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3
Q

Typical cause of acute epididymitis in older males?

A

E. coli infection … (non-sexually transmitted)

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4
Q

Best work-up for acute epididymitis in younger males?

A

UA, urine cultures, PCR amplification

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5
Q

DOC for acute epididymitis in younger males?

A

Ceftriaxone + Doxycycline … against Gonorrhea/Chlamydia

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6
Q

DOC for acute epididymitis in older males?

A

Fluoroquinolones … against E. coli

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7
Q

First step of workup for patient who presents with gross hematuria?

A

UA

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8
Q

Definition of secondary nocturnal enuresis?

A

New-onset bed-wetting in child > 5 yo who had previously achieved overnight dryness for 6+ months

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9
Q

Definition of primary nocturnal enuresis?

A

Nighttime urinary continence has never been established

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10
Q

First step in evaluation of secondary nocturnal enuresis?

A

UA

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11
Q

Best management of patient who presents with new-onset elevated PSA; Patient was recently admitted for acute urinary retention?

A

Repeat PSA in 4-8 weeks

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12
Q

2 medications that may cause acute urinary retention?

A

Baclofen, Anticholinergics

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13
Q

Definition of recurrent UTI?

A

2+ infections in 6 months, 3+ infections in 1 year

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14
Q

Best management of recurrent UTI?

A

Postcoital ABX prophylaxis

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15
Q

4 ABX of choice for postcoital anabiotic prophylaxis as treatment for recurrent UTI?

A

TMP-SMX, nitrofurantoin, cephalexin, ciprofloxacin

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16
Q

Definition of primary nocturnal enuresis?

A

Inability to achieve nighttime dryness by age 5 yo

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17
Q

2 aspects of initial management for primary nocturnal enuresis?

A

Behavioral modifications, motivational therapy

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18
Q

Best management for continued primary nocturnal eruresis after trials of behavioral modification and motivational therapy?

A

Enuresis alarm therapy

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19
Q

Best management of primary nocturnal enuresis that is resistant to enuresis alarm, behavioral modification, motivational therapy?

A

Desmopressin

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20
Q

AE of Desmopressin?

A

Hyponatremia

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21
Q

Most common solid tumor in men 15-35 yo?

A

Testicular CA

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22
Q

Clinical presentation for Testicular CA?

A

Painless, unilateral testicular enlargement … does not transilluminate

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23
Q

Initial test of workup for patients with suspected Testicular CA?

A

Bilateral scrotal US

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24
Q

Next step of workup for patients with suspected Testicular CA – mass seen on bilateral scrotal US?

A

Screening CT, Tumor markers

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25
Q

2 tumor markers used in workup of Testicular CA?

A

b-HCG, AFP

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26
Q

Diagnostic test for Testicular CA?

A

Radical inguinal orchiectomy

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27
Q

Which type of incontinence is characterized by involuntary leakage of urine that occurs after a strong urge to urinate?

A

Urge incontinence

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28
Q

Etiology of urge incontinence?

A

Bladder the trouser muscle overactivity, leading to intense contraction that causes leakage

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29
Q

Condition associated with the urge incontinence?

A

MS

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30
Q

Best initial management of urge incontinence?

A

Timed voids, bladder training

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31
Q

If initial management of urge incontinence fails, what is next best management?

A

Anti-muscarinic medication

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32
Q

Role of anti-muscarinic medications in setting of urge incontinence?

A

Inhibition of detrusor muscle contractions

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33
Q

3 examples of anti-muscarinic medications used to treat urge incontinence?

A

Oxybutynin, tolterodine, solifenacin

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34
Q

AEs of anti-muscarinic medications used to treat urge incontinence?

A

Anticholinergic affects … (can’t see, can’t pee, can’t spit, can’t sh*t)

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35
Q

3 ABX options for uncomplicated cystitis?

A

Nitrofurantoin, TMP-SMX, Fosfomycin

36
Q

Duration of nitrofurantoin treatment for uncomplicated cystitis?

A

5 days

37
Q

Duration of TMP-SMX treatment for uncomplicated cystitis?

A

3 days

38
Q

Duration of Fosfomycin treatment for uncomplicated cystitis?

A

Single dose

39
Q

1 ABX option for complicated cystitis?

A

Fluoroquinolones

40
Q

Duration of Fluoroquinolone treatment for complicated cystitis?

A

5-14 days

41
Q

Outpatient treatment ABX option for pyelonephritis?

A

Fluoroquinolones

42
Q

Inpatient treatment ABX option for pyelonephritis?

A

IV Fluoroquinolones or IV aminoglycoside + ampicillin

43
Q

5 ABX that are recommended for treatment of UTI in pregnancy?

A

Nitrofurantoin, amoxicillin, amoxicillin-clavulanate, cephalexin, fosfomycin

44
Q

3 ABX that are contraindicated for treatment of UTI in pregnancy?

A

Tetracyclines, Fluoroquinolones, TMP-SMX

45
Q

Etiology of overflow incontinence?

A

Decreased detrusor muscle contractility … OR … Bladder outlet obstruction

46
Q

Description of urine leakage in overflow incontinence?

A

Constant

47
Q

2 aspects of clinical presentation in overflow incontinence?

A

Decreased perineal sensation; Large post-residual volume

48
Q

3 major risk factors for bladder CA?

A

Age, male, smoking HX

49
Q

2 exposures that increase risk of bladder CA?

A

Aniline dye, HX of pelvic radiation

50
Q

Best test for visualizing lower urinary tract in patient with suspected bladder CA?

A

Cystoscopy

51
Q

Best test for visualizing upper urinary tract in patient with suspected bladder CA?

A

CT urogram

52
Q

2 alternatives to CT urogram in evaluating the upper urinary tract?

A

Renal US, MRI

53
Q

Clinical presentation of erectile dysfunction caused by psychogenic etiology?

A

NML nocturnal erections

54
Q

Clinical presentation of psychogenic erectile dysfunction?

A

Normal non-sexual nocturnal erections

55
Q

52 yo female presents for involuntary leakage of urine with cough/sneeze; Which additional test is recommended prior to recommended treatment for patient’s condition?

A

None needed

56
Q

What is needed for diagnosis before treatment of urinary incontinence?

A

History, PE, UA

57
Q

Prostate CA screening recommendation for men aged < 55 yo?

A

Not recommended

58
Q

Prostate CA screening recommendation for men aged 55-69 yo?

A

Consider PSA screening

59
Q

Prostate CA screening recommendation for men aged > 70 yo?

A

Not recommended

60
Q

Etiology of chronic prostatitis / chronic pelvis pain syndrome?

A

Unclear

61
Q

Best management of chronic prostatitis / chronic pelvis pain syndrome?

A

Combination of alpha blockers, ABX, psychotherapy, anti-inflammatory drugs

62
Q

56 yo female presents with 8mm kidney stone; Currently treated with NS at 100 mL/hr and analgesics – what is next best step of management?

A

Discharge with a blocker therapy

63
Q

Prognosis for renal stones < 5mm?

A

Will pass spontaneously

64
Q

Best management of renal stones < 10mm, no signs of infection?

A

Hydration, pain control, alpha blockers, discharge

65
Q

Best management of renal stones, with signs of infection, ARF, complete obstruction?

A

Admit, consult urology

66
Q

Best management of renal stones > 10mm?

A

Admit, consult urology

67
Q

Prognosis for renal stones >5mm?

A

Will pass spontaneously

68
Q

32 yo female presents with urine leakage while exercising and lifting weights; HX of 2 c-sections; Drinks 4-8L of water daily; PE shows leakage of urine when patient is asked to cough – diagnosis?

A

Stress incontinence

69
Q

Etiology of stress incontinence?

A

Urethral hypermobility, decreased urethral tone

70
Q

Etiology of urge incontinence?

A

Detrusor overactivity

71
Q

Etiology of overflow incontinence?

A

Impaired detrusor contractility, bladder outlet obstruction

72
Q

86 yo female presents with difficulty urinating, vaginal bulge; PE shows anterior vaginal wall prolapse of cervix through vaginal introitus – what is best management?

A

Pessary placement

73
Q

20-year-old male presents with penile lesions which began several months ago after unprotected sex; PE reveals small bumps along the corona of the penis; what is the next step in management of patient’s condition?

A

Reassurance that this is a normal variant

74
Q

20-year-old male presents with penile lesions which began several months ago after unprotected sex; PE reveals small bumps along the corona of the penis; diagnosis?

A

Pearly penile papules

75
Q

55-year-old male presents for painful, persistent erection after intracavernosal injection of alprostadil; awaken 4 hours due to persistent pain in penis; PE reveals engorgement of corpora cavernosa, tenderness to palpation, findings consistent with ischemic priapism; best next step of management?

A

Intra cavernosal phenylephrine injection

76
Q

Definition of priapism?

A

Persistent painful erection lasting more than 4 hours

77
Q

Etiology of priapism?

A

Impaired outflow from corpora cavernosa, leading to acidosis and tissue ischemia

78
Q

Medical condition that increases risk of priapism?

A

Sickle cell disease

79
Q

First-line treatment for priapism with tissue ischemia?

A

Aspiration of corpora cavernosa

80
Q

46-year-old male presents for dull, aching pain in the penis and perennial region; also reports pain with ejaculation; PE reveals mildly tender prostate; best initial step of work-up?

A

Urinalysis with culture

81
Q

46-year-old male presents for dull, aching pain in the penis and perennial region; also reports pain with ejaculation; PE reveals mildly tender prostate; UA shows 30+ leukocytes, but negative culture - diagnosis?

A

Chronic prostatitis

82
Q

Alternate name for chronic prostatitis?

A

Chronic pelvic pain syndrome

83
Q

46-year-old male presents for dull, aching pain in the penis and perennial region; also reports pain with ejaculation; PE reveals mildly tender prostate; UA shows 30+ leukocytes, with positive bacterial culture - diagnosis?

A

Chronic bacterial prostatitis

84
Q

3 hallmark aspects of clinical presentation for chronic prostatitis?

A

3+ months of dysuria, pain with ejaculation, pelvic pain

85
Q

63-year-old AA male presents for BPH, which have worsened despite doxazosin therapy; he is opted for transurethral resection of prostate -what is the most likely expected complication of this procedure?

A

Retrograde ejaculation

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