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Medicine Finals: HARD STUFF ONLY > Urology > Flashcards

Urology Flashcards

1
Q

What is the management of acute prostatitis?

A

14 days ciprofloxacin

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2
Q

What is the most common type of prostate cancer?

A

Adenocarcinoma

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3
Q

What is the 2WW criteria for prostate cancer?

A

Man 50-69 with raised PSA or DRE suggestive of prostate cancer

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4
Q

Which imaging is used to diagnose prostate cancer?

A

Multi-parametric MRI

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5
Q

What hormone therapy can be used for prostate cancer? What is a complication of this?

A

GnRH agonist e.g. Goserelin
Suppresses testosterone

Can have an initial rise in testosterone (tumour flare) - this is avoided by also giving Cyproterone acetate

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6
Q

Where does prostate cancer most commonly metastasise?

A

Bone

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7
Q

What are indications for conducting a PSA?

A

Abnormal DRE
Symptoms of malignancy + LUTS
Can be done on request if >50
Can be done on request if >45 if black/family history

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8
Q

Which medications can cause erectile dysfunction?

A

Finasteride
SSRIs
Alcohol
Beta blockers

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9
Q

How is bladder cancer investigated?

A

1) urine dip
2) CT Urogram + flexible cystoscopy
3) Biopsy

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10
Q

Why does varicocele occur in renal cell carcinoma?

A

Compression of the left renal vein

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11
Q

What paraneoplastic features are associated with renal cell carcinoma?

A

Polycythaemia - increased EPO production
Hypercalcaemia - secretion of PTH mimick
Hypertension - increased renin secretion

Stauffer’s syndrome - Abnormal LFTs without liver mets

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12
Q

What are the types of testicular cancer? What marker are associated with them?

A

Main 2 are seminoma germ cell and non-seminoma germ cell

Non-seminoma highly associated with hCG and AFP

Seminoma slightly associated with bHCG

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13
Q

What is the management of renal calculi?

A

<5mm = Watch and wait
<1cm = can try medical management
1cm-<2cm = Shockwave lithiotripsy (Or uteroscopy if pregnant)
>2cm or staghorn = Percutaneous nephrolithiotomy

Causing obstruction = Nephrostomy

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14
Q

What is shockwave lithiotripsy?

A

Shockwave from outside the body fragments the stone

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15
Q

What is nephrolithotomy?

A

Invasive method of breaking down stone

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16
Q

What is a nephrostomy?

A

Decompression of the kidney if obstructed

17
Q

What score is used to grade prostate cancer?

A

Gleason score

18
Q

Prostate cancer management

A

x

19
Q

How to manage a hydrocele?

A

In children - usually resolve within a few months. refer if not resolve by 1-2 years

In adults - testicular ultrasound

20
Q

What can hydroceles develop secondary to?

A

Epididymo-orchitis
Testicular torsion
Testicular tumour

21
Q

Which renal cancer is most common in occupational exposure?

A

Renal transitional cell carcinoma

22
Q

Which malignancy are you at risk of after schistosomiasis infection?

A

Squamous cell carcinoma of the bladder

23
Q

What are risk factors of Renal cell carcinoma?

A 
Increasing age
Smoking
Obesity
Von hipel-lindau syndrome
Male
Tuberous sclerosis
24
Q

What are risk factors for prostate cancer?

A

Increasing age
Family history
Obesity
Afro-caribbean

25
Q

What are risk factors for testicular cancer?

A

Infertility
Family history
Klinefelter’s syndrome
Orchitis due to mumps

26
Q

Where do renal stones most commonly get lodged?

A

Vesico-ureteric junction
Renal pelvis
Pevi-ureteric junction

27
Q

What is priapism and what are causes? How is it investigated? How is it managed?

A

Persistent penile erection
Causes:idiopathic, sickle cell crisis, erectile dysfunction medication
Investigation: Cavernosal blood gas analysis
Management:
If ischaemic - aspiration
If non ischaemic - observe

28
Q

Which type of testicular cancer is most associated with gynaecomastia?

A

Leydig cell tumour

29
Q

What is the management of erectile dysfunction?

A

management: Phosphodiesterase type V inhibitors (Sildenafil)

30
Q

What are side effects of sildenafil?

A 
Blue discolouration of vision
Nasal congestion
Flushing
Priapism
Headache
31
Q

What are CI to sildenafil?

A

Patients taking nitrates
Hypotension
Recent stroke/MI in last 6 months

32
Q

What are risk factors for pyelonephritis?

A

Female
Structural abnormalities
Versico-ureteric reflux
Diabetes

33
Q

How is a stag horn calculus of any size managed?

A

Percutaneous nephrolithiotomy

34
Q

What is a Bell Clapper deformity?

A

The testes is not fixed to the tunica vaginalis - it hangs freely and therefore is able to rotate

Predisposes to testicular torsion

35
Q

What infection is most associated with Staghorn calculi?

A

Proteus infections

36
Q

What is vesico-ureteric reflux?

A

Abnormal backflow of urine from bladder to ureter and kidney

Common in children, predisposes to UTI

37
Q

How is vesico-ureteric reflux diagnosed?

A

Micturating cystourethrogram (MCUG)

DMSA can look for scarring

Medicine Finals: HARD STUFF ONLY (23 decks)

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