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academic days > Urology > Flashcards

Urology Flashcards

1
Q

How might the position of patient differ in someone with renal colic versus abdominal pain?

A

renal colic- cannot find comfortable position therefore rolling around

abdo pain- staying still in one position

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2
Q

List two sites of stone impaction

A

PUJ
Pelvic brim
VUJ

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3
Q

How can struvite stone present?

A

recurrent UTIs
malaise
weakness
loss of appetite

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4
Q

List three differential diagnoses for renal colic

A

Acute abdo- gallstones, pancreatitis, AAA
Pyelonephritis
Bacterial cystitis
Gynae
Referred pain- orchitis
Chest- lobar pneumoni, rib fractures

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5
Q

Which imaging do you do for renal colic? (the most sensitive investigation)

A

Non-contrast CT KUB

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6
Q

What does radio-opaque mean?

A

presence of calcium within the stone

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7
Q

List one radioopaque stone

A

ca phosphate
ca oxalate

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8
Q

List one radiolucent stone= transparent

A

uric acid
(struvite stone= infection, cystine are relatively radiolucent)

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9
Q

Which co-infection is indinavir stones associated with?

A

HIV

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10
Q

What is the treatment for renal stones?

A

Analgesia- NSAIDs, opiates
Alpha blockers
Stent or percutaneous nephrostomy tube
surgery

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11
Q

List two indications for intervention to remove stone?

A

pain unresponsive for analgesia
related fever
renal function impairment
obstruction unrelieved >4 weeks

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12
Q

What is the first intervention for kidney stone?

A

shock wave therapy- ESWL

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13
Q

If ESWL fails, what is the next option?

A

PCNL- percutaneous nephrolithonomy

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14
Q

What is one indication for ESWL?

A

pregnancy
pacemaker
distal obstruction
uncorrected coagulopathy

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15
Q

Name one indication for PCNL

A

staghorn calculi
stone >2cm
multiple stones

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16
Q

Which surgical treatment for kidney stones is safe in pregnant women?

A

ureterenoscopy

17
Q

Which treatment is safe for coagulopathies?

A

ureterenoscopy

18
Q

List three surgical treatments for stones

A

cystoscopy
open surgery
ureterenoscopy
nephrectomy!!

19
Q

List two complications of urinary retention

A

infection, AKI, haematuria

20
Q

List two complications of chronic urinary retention

A

hydronephrosis
CKD
bladder detrusor hypertrophy

21
Q

List three risk factors for acute urinary retention

A

BPH
Constipation
Cancer- prostate, pelvic
Infection- cystitis
Trauma
Medications

22
Q

List one medication that can lead to urinary retention

A

antimuscarinics (decreased bladder sensation and detrusor contractility)
sympathomimetics
opioids (decreased bladder sensation)

23
Q

Signs of acute urinary retention when palpating and percussing bladder?

A

dull to percussion
enlarged palpable bladder

24
Q

List two aspects of examination in acute urinary retention

A

abdo exam- suprpubic tenderness and palpate/percuss bladder
PR exam
vaginal exam
neuro exam- neuro impairment

25
Q

List three investigations for acute urinary retention

A

bladder USS
urinary catheterisation
urinalysis
U+Es
FBC- infection, haematuria

26
Q

What is the treatment for acute urinary retention?

A

urethral catheterisation
suprapubic catheter
treat underlying cause

27
Q

Red flags for malignancy with haematuria

A

old age
male
cigarette smoking
chemical exposure- benzenes
history of pelvic radiation

28
Q

List two differentials for glomerular haematuria

A

IgA nephropathy- Berger’s disease
Thin glomerular basement disease
hereditary nephritis- Alport syndrome

29
Q

List two causes for non-glomerular haematuria

A

urinary obstruction
transitional cell carcinoma
pyelonephritis
renal cell cancer
UTI
BPH
Strenuous exercise

30
Q

List two causes for pseudo haematuria

A

food- beetroot, blackberries
menses
drug related

31
Q

Painless haematuria. What MUST you rule out

A

transitional cell carcinoma

32
Q

List three differentials for the acute scrotum

A

testicular torsion
acute epididymitis
acute orchitis
abscess
hernia
hydrocele

academic days (8 decks)

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