Urology Flashcards
1
Q
Acute bacterial prostatitis
A
- e.coli
- obstructive voiding symptoms
- tender, boggy prostate
- 14 day course of quinolone
- screen for STI
2
Q
Acute tubular necrosis
A
- most common cause of AKI
- causes: ischaemia, nephotoxins (aminoglycosides, myoglobin secondary to rhabdomyolysis.
- muddy brown casts in urine
- phases: oliguric, polyuric, recovery phase
3
Q
Acute urinary retention
A
- secondary to BPH
- decompress bladder via catheterisation
- complication: post-obstructive diuresis
4
Q
Balanitis
A
- inflammation of glans penis
- candidiasis, bacterial (staph)
- gentle saline washes, 1% hydrocortisone for serve discomfort.
- candidiasis - topical clotrimazole
- staph - oral flucloxacillin
- anaerobic - oral metronidazole
- circumcision can help in lichen sclerosus
5
Q
BPH
A
- voiding symptoms, storage symptoms, post-micturation
- complications: UTI, retention, obstructive uropathy
- urinary frequency-volume chart (done for 3 days)
- IPSS: international prostate symptom score
- Rx: alpha-1 antagonists e.g. tamsulosin, alfuzosin. Decrease smooth muscle tone of the prostate and bladder
- Rx 2: 5 alpha-re-educates inhibitors e.g. finasteride. Use if very large prostate or high risk of progression. Symptoms might take up to 6 months to improve.
- combination therapy if severe
- refractory symptoms: alpha blocker and antimuscurinic
- surgery: TURP
6
Q
Bladder cancer
A
- 2nd most common urological cancer
- urothelial (TCC) 90% = papillary growth pattern usually superficial and better prognosis)
- SCC (affected by schistosomiasis) 7%
- adenocarcinoma (2%)
- painless macroscopic haematuria
- cystoscopy Ix
- Rx superficial: TURBT. High grade- intravesical chemotherapy . T2: radical cystectomy or radical radiotherapy
7
Q
Chronic urinary retention
A
- painless and insidious
- high pressure retention: impaired renal function and bilateral hydronephrosis, typically due to bladder outflow obstruction
- low pressure retention: normal renal function no hydronephrosis
- decompression haematurial occurs commonly after catheterisation - no further Rx
8
Q
Medical indications for circumcision
A
- phimosis
- recurrent balanitis
- balanitis xerotica obliterans
- paraphimosis
**important to exclude hyposadias prior
9
Q
Epididymis cyst
A
- most common cause of scrotal swelling in primary care
- separate from the body of the testicle. Found posterior to testicle
- associated w PKD, CF, Von-hippel Lindau syndrome
- diagnosis confirmed w USS
10
Q
Epididymis-orchitis
A
- infection of the epididymis +/- testes
- pain swelling
- Chlamydia trachomatis or gonorrhoeae
- DD is testicular torsion needs to be excluded
11
Q
ED
A
- RF: CVD, alcohol, SSRIs, beta blockers
- Ix universal measurement of testosterone
- Rx PDE-5 inhibitors (sildenafil (viagra))
12
Q
Hydrocele
A
- accumulation of fluid within tunica vaginalis
- communicating hydroceles (common in new born usually resolve within first few months of life)
- non-communicating
- develop secondary to testicular problems
- soft, non-tender swelling of the hemi-scrotum. Usually anterior to and below the testicle
the swelling is confined to the scrotum, you can get ‘above’ the mass on examination
transilluminates with a pen torch. the testis may be difficult to palpate if the hydrocele is large - USS is exclude tumour
13
Q
Hydronephrosis
Causes
A
Unilateral PACT Pelvic-ureteric obstruction (congenital or acquired) Aberrant renal vessels Calculi Tumours of renal pelvis
Bilateral SUPER Stenosis of the urethra Urethral valve Prostatic enlargement Extensive bladder tumour Retro-peritoneal fibrosis
14
Q
Hydronephrosis
Ix and Rx
A
- USS 1st line
- IVU - assess position of obstruction
- remove obstruction and drainage of urine
- acute upper urinary tract obstruction: nephrostomy tube
- chronic upper urinary tract obstruction: ureteric stent or pyeloplasty
15
Q
Priapism
A
- > 4hr penile erection
- cavernosal blood gas analysis to differentiate between ischaemic and non-ischaemic
- Rx aspiration of blood from cavernosa
