Urology Flashcards
Nervous system causing erection
PS - s2/3
Nervous system causing ejaculation
Sympathetic - l1
causes of ED
SSRI, cauda equina, MS
Treatment of ED
PDE5i (viagra)
How do PDE5i work
Causes vasodilatation in penis
Which lobe of the prostate is enlarged in BPH
Median
Which lobe the prostate is enlarged in cancer?
Posterior - peripheral zone
Sx BPH
L UTI sx
Polyuria
Retention
Smooth prostate on DRE
Tx BPH
a-blockers like alfuzosin
What is urge incontiennce?
Involuntary detrusor contractions cause uncontrollable bladder emptying
Tx urge incontinence
Exercises
What is stress incontinence?
Increased abdominal pressure e.g. coughing/laughing causes small but frequent loss of urine
Tx stress incontinence
Duloxetine
Where do you find renal cell carcinomas
Proximal tubular epithelium - adenocarcinomas
Sx RCC
haematuria, loin pain, weight loss, anaemia
Spread of RCC
para-aortic LNs
Paraneoplastic syndromes with RCC
PTh secretion and EPO secretion (polycythemia)
Trimethoprim MOA
Inhibits dihydrofolate reductase - interacts with methotrexate
When should you not give trimethoprims
teratogenic in first trimester
Sx UTI
Polyuria and dysuria
Smelly urine
Cause of UTI
E coli
Ix UTI
Increased nitrites caused by gram neg bacteria
Tx UTI
Cystitis = trimethoprim
If pregnant = nitrofurantoin
Sx acute pyelonephritis
fever, loin pain, vomiting
Tx acute pyelonephritis
Ciprofloxacin
What does insulin and salbutamol do to potassium
Move from ECF to ICF
Calcium glutinate function
Stabilises myocardium
Which compounds remove potassium rom body
Calcium resonium
Loop diuretics
Pre-renal causes of AKI
Ischaemia and stenosis
Renal causes of AKI
Damage to kidneys - glomerulonephritis
Post-renal causes of AKI
Kidney stones/BPH
Sx AKI
Decreased urine output, increased K+/urea
Which compounds have increased risk of toxicity in AKI
Metformin, digoxin, lithium
Which compounds should be stopped in AKI as they worsen renal function
ACEi, NSAIDs, angiotensin ii blockers, diuretics, aminoglycosides
E.g. quinolone
Ciprofloxacin
Quinolones MOA
Inhibit DNA synthesis by DNA gyros
C/I quinolones
Pregnancy/BF
Side effects quinolones
Seizures, tendon damage, long QT
Causes of prostatitis
UTI/STI -> e.coli or chlamydia/gonorrhoea
Chronic non-bacterial prostatitis
Pelvic pain for 3+ months, -ve urine culture, pain without urinary sx
Chronic bacterial prostatitis
gradual onset, e.coli cause
Acute bacterial prostatitis
Tender, boggy prostate
UTI sx, lymphadenopathy
Treat with quinolones
Which LN does bladder cancer spread to first
Internal and external iliac
At which level do the renal arteries branch from the aorta?
l2
Where is glucose reabsorbed in the nephron?
PCT
Why does alcohol cause polyuria?
It is a diuretic and inhibits posterior pituitary and therefore ADH secretion
Epididymo-orchitis
- Inflammation of epididymis, often caused by bacterial infection
- Infection spreads from bladder - usually chlamydia or gonorrhoea
idiopathic cause of epididymo-orchitis
amiodarone
which structure is twisted in testicular torsion
spermatic cord
mass that trans-illuminates
hydrocele
why does hydrocele occur?
patent processus vaginalis
Most common type of testicular cancer
seminoma
blood tests seminoma
AFP and HCG normal
Types of germ cell tumours
teratoma, yolk sac tumour, choriocarcinoma
blood results germ cell tumour
AFP and HCg elevated
AKI + harmolytic anaemia + thrombocytopenia
haemolytic uraemia syndrome
what is haemolytic uraemia syndrome caused by
e.coli
Which nephrotic syndrome has high levels of C3 but not IgM
membranoproliferazive glomerulonephritis
Main risk factor for renal cancer
smoking
renal cell carcinoma lung metastases key word
cannonball appearance on CXR
What is a Wilm’s tumour
Common in children < 5 years
- Arises from transformation of persistent metanephric cells
Sx Wilm’s tumour
- Loin mass
- Abdo pain
- Haematuria
- fever
- HTN
- Weight loss
Mx Wilm’s tumour
Nephrectomy and radiotherapy
Ix renal colic
CT KUB
treatment for simple lower UTI in women
3 days trimethoprim or nitrofurantoin
treatment for UTI in men or pregnant women
Nitrofuranoitn 7 days
Grading system for prostate cancer
Gleason
FIGO staging system
gynaecological cancer
how do you treat chronic prostatitis
trimethoprim for 4 weeks
how to treat acute bacterial prostatitis
ciprofloxacin for 2 weeks
androgen insensitivity syndrome
phenotypically female but inside have testes
pre-disposing factor for testicular torsion
bell-clapper deformity
Treatment for persistent haematuria
ACEi