Urology

Question 1

What is the management of acute prostatitis?

Answer 1

14 days ciprofloxacin

Question 2

What is the most common type of prostate cancer?

Answer 2

Adenocarcinoma

Question 3

What is the 2WW criteria for prostate cancer?

Answer 3

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

Question 4

Which imaging is used to diagnose prostate cancer?

Answer 4

Multi-parametric MRI

Question 5

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

Answer 5

GnRH agonist e.g. Goserelin
Suppresses testosterone

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

Question 6

Where does prostate cancer most commonly metastasise?

Answer 6

Bone

Question 7

What are indications for conducting a PSA?

Answer 7

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

Question 8

Which medications can cause erectile dysfunction?

Answer 8

Finasteride
SSRIs
Alcohol
Beta blockers

Question 9

How is bladder cancer investigated?

Answer 9

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

Question 10

Why does varicocele occur in renal cell carcinoma?

Answer 10

Compression of the left renal vein

Question 11

What paraneoplastic features are associated with renal cell carcinoma?

Answer 11

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

Stauffer’s syndrome - Abnormal LFTs without liver mets

Question 12

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

Answer 12

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

Non-seminoma highly associated with hCG and AFP

Seminoma slightly associated with bHCG

Question 13

What is the management of renal calculi?

Answer 13

<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

Question 14

What is shockwave lithiotripsy?

Answer 14

Shockwave from outside the body fragments the stone

Question 15

What is nephrolithotomy?

Answer 15

Invasive method of breaking down stone

Question 16

What is a nephrostomy?

Answer 16

Decompression of the kidney if obstructed

Question 17

What score is used to grade prostate cancer?

Answer 17

Gleason score

Question 18

Prostate cancer management

Answer 18

x

Question 19

How to manage a hydrocele?

Answer 19

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

In adults - testicular ultrasound

Question 20

What can hydroceles develop secondary to?

Answer 20

Epididymo-orchitis
Testicular torsion
Testicular tumour

Question 21

Which renal cancer is most common in occupational exposure?

Answer 21

Renal transitional cell carcinoma

Question 22

Which malignancy are you at risk of after schistosomiasis infection?

Answer 22

Squamous cell carcinoma of the bladder

Question 23

What are risk factors of Renal cell carcinoma?

Answer 23

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

Question 24

What are risk factors for prostate cancer?

Answer 24

Increasing age
Family history
Obesity
Afro-caribbean

Question 25

What are risk factors for testicular cancer?

Answer 25

Infertility Family history Klinefelter’s syndrome Orchitis due to mumps

Question 26

Where do renal stones most commonly get lodged?

Answer 26

Vesico-ureteric junction Renal pelvis Pevi-ureteric junction

Question 27

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

Answer 27

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

Question 28

Which type of testicular cancer is most associated with gynaecomastia?

Answer 28

Leydig cell tumour

Question 29

What is the management of erectile dysfunction?

Answer 29

management: Phosphodiesterase type V inhibitors (Sildenafil)

Question 30

What are side effects of sildenafil?

Answer 30

``` Blue discolouration of vision Nasal congestion Flushing Priapism Headache ```

Question 31

What are CI to sildenafil?

Answer 31

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

Question 32

What are risk factors for pyelonephritis?

Answer 32

Female Structural abnormalities Versico-ureteric reflux Diabetes

Question 33

How is a stag horn calculus of any size managed?

Answer 33

Percutaneous nephrolithiotomy

Question 34

What is a Bell Clapper deformity?

Answer 34

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

Question 35

What infection is most associated with Staghorn calculi?

Answer 35

Proteus infections

Question 36

What is vesico-ureteric reflux?

Answer 36

Abnormal backflow of urine from bladder to ureter and kidney | Common in children, predisposes to UTI

Question 37

How is vesico-ureteric reflux diagnosed?

Answer 37

Micturating cystourethrogram (MCUG) DMSA can look for scarring