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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
2 tumor markers used in workup of Testicular CA?
b-HCG, AFP
26
Diagnostic test for Testicular CA?
Radical inguinal orchiectomy
27
Which type of incontinence is characterized by involuntary leakage of urine that occurs after a strong urge to urinate?
Urge incontinence
28
Etiology of urge incontinence?
Bladder the trouser muscle overactivity, leading to intense contraction that causes leakage
29
Condition associated with the urge incontinence?
MS
30
Best initial management of urge incontinence?
Timed voids, bladder training
31
If initial management of urge incontinence fails, what is next best management?
Anti-muscarinic medication
32
Role of anti-muscarinic medications in setting of urge incontinence?
Inhibition of detrusor muscle contractions
33
3 examples of anti-muscarinic medications used to treat urge incontinence?
Oxybutynin, tolterodine, solifenacin
34
AEs of anti-muscarinic medications used to treat urge incontinence?
Anticholinergic affects … (can’t see, can’t pee, can’t spit, can’t sh*t)
35
3 ABX options for uncomplicated cystitis?
Nitrofurantoin, TMP-SMX, Fosfomycin
36
Duration of nitrofurantoin treatment for uncomplicated cystitis?
5 days
37
Duration of TMP-SMX treatment for uncomplicated cystitis?
3 days
38
Duration of Fosfomycin treatment for uncomplicated cystitis?
Single dose
39
1 ABX option for complicated cystitis?
Fluoroquinolones
40
Duration of Fluoroquinolone treatment for complicated cystitis?
5-14 days
41
Outpatient treatment ABX option for pyelonephritis?
Fluoroquinolones
42
Inpatient treatment ABX option for pyelonephritis?
IV Fluoroquinolones or IV aminoglycoside + ampicillin
43
5 ABX that are recommended for treatment of UTI in pregnancy?
Nitrofurantoin, amoxicillin, amoxicillin-clavulanate, cephalexin, fosfomycin
44
3 ABX that are contraindicated for treatment of UTI in pregnancy?
Tetracyclines, Fluoroquinolones, TMP-SMX
45
Etiology of overflow incontinence?
Decreased detrusor muscle contractility … OR … Bladder outlet obstruction
46
Description of urine leakage in overflow incontinence?
Constant
47
2 aspects of clinical presentation in overflow incontinence?
Decreased perineal sensation; Large post-residual volume
48
3 major risk factors for bladder CA?
Age, male, smoking HX
49
2 exposures that increase risk of bladder CA?
Aniline dye, HX of pelvic radiation
50
Best test for visualizing lower urinary tract in patient with suspected bladder CA?
Cystoscopy
51
Best test for visualizing upper urinary tract in patient with suspected bladder CA?
CT urogram
52
2 alternatives to CT urogram in evaluating the upper urinary tract?
Renal US, MRI
53
Clinical presentation of erectile dysfunction caused by psychogenic etiology?
NML nocturnal erections
54
Clinical presentation of psychogenic erectile dysfunction?
Normal non-sexual nocturnal erections
55
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?
None needed
56
What is needed for diagnosis before treatment of urinary incontinence?
History, PE, UA
57
Prostate CA screening recommendation for men aged < 55 yo?
Not recommended
58
Prostate CA screening recommendation for men aged 55-69 yo?
Consider PSA screening
59
Prostate CA screening recommendation for men aged > 70 yo?
Not recommended
60
Etiology of chronic prostatitis / chronic pelvis pain syndrome?
Unclear
61
Best management of chronic prostatitis / chronic pelvis pain syndrome?
Combination of alpha blockers, ABX, psychotherapy, anti-inflammatory drugs
62
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?
Discharge with a blocker therapy
63
Prognosis for renal stones < 5mm?
Will pass spontaneously
64
Best management of renal stones < 10mm, no signs of infection?
Hydration, pain control, alpha blockers, discharge
65
Best management of renal stones, with signs of infection, ARF, complete obstruction?
Admit, consult urology
66
Best management of renal stones > 10mm?
Admit, consult urology
67
Prognosis for renal stones >5mm?
Will pass spontaneously
68
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?
Stress incontinence
69
Etiology of stress incontinence?
Urethral hypermobility, decreased urethral tone
70
Etiology of urge incontinence?
Detrusor overactivity
71
Etiology of overflow incontinence?
Impaired detrusor contractility, bladder outlet obstruction
72
86 yo female presents with difficulty urinating, vaginal bulge; PE shows anterior vaginal wall prolapse of cervix through vaginal introitus – what is best management?
Pessary placement
73
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?
Reassurance that this is a normal variant 
74
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?
Pearly penile papules
75
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?
Intra cavernosal phenylephrine injection
76
Definition of priapism?
Persistent painful erection lasting more than 4 hours
77
Etiology of priapism?
Impaired outflow from corpora cavernosa, leading to acidosis and tissue ischemia
78
Medical condition that increases risk of priapism?
Sickle cell disease
79
First-line treatment for priapism with tissue ischemia?
Aspiration of corpora cavernosa
80
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?
Urinalysis with culture
81
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?
Chronic prostatitis 
82
Alternate name for chronic prostatitis?
Chronic pelvic pain syndrome 
83
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?
Chronic bacterial prostatitis 
84
3 hallmark aspects of clinical presentation for chronic prostatitis?  
3+ months of dysuria, pain with ejaculation, pelvic pain
85
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?
Retrograde ejaculation

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