Urology Flashcards
Noninfective cause ofepididymiorchitis
Amiodarone
Infective cause of epididymiorchitis is
gonorrhoea or chlamydia
Ureteric Calculus pain
ureteric calculus pain radiates to Loin is classical sign due to ilio hy pogastricarea.
Diff b /w bulbar and memb urethral injury
Bulbar will be dueto fall from bike with legs apart
Memb : Pelvic# with no prostateon rectal exam
Normal PSA level
ormal upper limit for PSA is 4ng/ml
Mc site prostate Cancer is
Peripheral Zone 70%
1st node to be affected in Prostate Ca
Lymphatic spread occurs first to the internal iliac
low risk menfor Prostate Cancer
clinical stage T1c, Gleason score 3+3 and PSA density < 0.15 ng/ml/ml who have cancer in less than 50% of their biopsy cores, with < 10 mm of any core involved
SChistoma Hema tobiom causes
Bladder Calcification
-Howto asses failing kidney transplant
MAG 3 renogram
when adrenal masS is considered malignant
> 4cm in size 25% ofthem are malignant
How to exclude Bladder outflow obstruction
Uroflowmetry (a flow rate of >15ml/second helps to exclude BOO)
which test to asses renal scaring
DMSA Scan
lthough MAG 3 renograms may provide some information relating to the structural integrity of the kidney, many still consider a DMSA scan to be the gold standard for the detection of renal scarring (which is the main concern in PUJ obstruction and infections).
Improve
Testsfor these Kidney issues
1. Renal scaring
2. GFR
3. RENAL TRANSPLANT
4. Degree of reflux from bladder
5. Stones
1.DMSA
2.DTPA
.3 MAG3 renoogram
4. mcuG Scan
5. Non contrast CT
Trimethoprim in Rx of
Pyelonephritis
common sequelae of vasectomy
Sperm granulomas
Low flow vs high flow priapism
Low: dark blood on aspiration ( dangerous)
High: bright red
Clearance after vasectomy by
is usually taken after 12-16 weeks post procedure (and prefer after 24 ejaculates).
intravesical BCG therapy isgiven in
Transitional cell carcinoma of the bladder may be treated with intravesical BCG therapy.
Cysteine stones
They are radio opaque but diff from Calcium stones is their hereditary nature
child us adult surgery for hydrocele
child by inguinal approach
adult by scrotal app(Lords and Jabolay procedure)
Keypoints of RCC
Frank Hematuria
Polycythaemia
Stones after radiotherapy
uric acid stones
p H and stones
1 Low
2 High
3. Normal
4 variable
1 Uric Acid
2 Storvite, Ca phosphate
3 Cysteine, Ca phosphate
4 Ca oxalate
Nephroblastoma vs Neuroblastoma
Under 15 years vs under 4 years ofage
Rare vs common GUT tUmor
HTN vs no HTN
Surgical resection combined with chemotherapy (usually vincristine, actinomycin D and doxorubicin) vsSurgical resection, radiotherapy and chemotherapy
Diagnosis of neuroblastoma
MI BIG Scam
Antidote of cyclophosphamide
Mesna
Torsion fixation
. This can be achieved using sutures or by placement of the testis in a Dartos pouch.
Clear Cells is found in
Kidney and canbe found as metastasis
Lobe enlargement in BPH vs Tumor
BPH Median lobe
Tumor Post lobe
Whatfirst test to get after an adrenal incidentaloma on CT
Get blood workup 1st and nothing else
Varicocele is more common at which side
Leftside dueto 90° position ofthe testicular vein to renal vein
Angiomyolipoona is associated with
Tuberous sclerosis typeof RCC
TCC of Renal
Pink in color on appearance
Drugs causing Pseudo hemetUria
Rifampicin, phenytoin, levodopa, methyldopa, and quinine all cause pseudohaematuria
High riding urethra
Membranous urethral rupture
Renal Mass with epilepsy and learning disability
Tuberous Sclerosis which is due to Angiongolipoma
APKD features
APKD is associated with liver cysts (70%), berry aneurysms (25%) and pancreatic cysts (10%). Patients may have a renal mass, hypertension, renal calculi and macroscopic haematuria.
Which Cele is present in testicular tumor vS RCC
TT: Hydrocele
RCC Varicocele
low flow priapismneeds surgical intervention after
> 4 hours
Recurrent priapism seen in
Typically seen in sickle cell disease, most commonly of high flow type.
Risk factor for bladder ca
Smoking
Schistosomiasis
cyclophosphamide
Anilinedye( textile industry)
First time renal transplant occurs in
First time renal tranplants are typically implanted in the left or right iliac fossae.
Which vessels are anastomoses to Kidney during transplant
The vessels are usually joined to the external iliac artery and vein as these are the most easily accessible. The Rutherford Morison incision provides access to the external iliac vessels.
LUTS include
frequency, urgency, or feeling of incomplete voiding.
aide memoire for upper PSA limit
(age - 20) / 10
Normal levels of PSA
Age. PSA level (ng/ml)}
50-59 years: 3.0
60-69 years: 4.0
> 70 years: 5.0
PSA levels may also be raised by these procedures apart from tumor
benign prostatic hyperplasia (BPH)
prostatitis and urinary tract infection (NICE recommend to postpone the PSA test for at least 1 month after treatment)
ejaculation (ideally not in the previous 48 hours)
vigorous exercise (ideally not in the previous 48 hours)
urinary retention
instrumentation of the urinary tract
PSA levels can be raised after UTI till
1 month
These 2 can cause raised PSA levels after 48 hours
Vigorous exercise
Ejaculation
Biopsy of which cancer shouldn’t be done
Testicular cancer
What swellings transilluminates
Hydrocoeles and large epididymal cysts will classically transilluminate.
A scrotql swelling descibred as bag of worms” or with a “dragging sensation”, and may disappear on lying flat.
Varicocle
Epididymal cust vs hydrocele
Both transilluminates and fluctuant
but H isn’t separated from testes while E is found above and is Separable from cyst.
Classically, testicular tumours are described as
painless lumps arising from the testis
Rx of testicular cancer
radical inguinal orchidectomy
Loss of cremasteric reflex
Testicular torsion
Cannot get above the swelling in testes
Dx?
Hernia or
Infant hydocele due to patent processus vaginalis
Nerve supply of scrotum
The anteriolateral aspect of the scrotum is supplied by branches of the genitofemoral and the ilioinguinal nerve, whilst the posterior scrotum is supplied by the perineal branches of the pudendal nerve and posterior femoral cutaneous nerve.
If Abdominal lesion >1cm post chemo of GUT tumors
Perform retroperitoneal lymph node dissection
Rx of bony metastasis of prostate gland
Radiotherapy+Bisphosphoates+androgen suppression
Which gleason score shows Worst prognosis
10
