Urology

Question 1

By what age should the testes have descended?

Answer 1

3 months

Question 2

What is gold standard for investigating bladder cancer?

Answer 2

cystoscopy

Question 3

what would prompt a 2ww referral for bladder cancer?

Answer 3

aged >/= 45 and unexplained visible haematuria without UTI or visible haematuria that persists or recurs after successful treatment of UTI
aged >/= 60 and have unexplained nonvisible haematuria or either dysuria or a raised white cell count on a blood test?

Question 4

what is testicular torsion?

Answer 4

twist of the spermatic cord resulting in testicular ischaemia and necrosis
most common in males aged between 10 and 30, with peak incidence 13-15

Question 5

what are the features of testicular torsion?

Answer 5

• pain is usually severe and of sudden onset
• pain may be referred to lower abdomen
• nausea and vomiting may be present
• on examination: there is usually swollen, tender testes retracted upwards, skin may be reddened
• cremasteric reflex is lost
• elevation of the testis does not ease the pain

Question 6

How is testicular torsion managed?

Answer 6

treatment is with urgent surgical exploration - if a torted testes is identified then both testis should be fixed

Question 7

What is the most common type of bladder cancer?

Answer 7

transitional cell carcinoma

Question 8

what can cause raised PSA levels?

Answer 8

BPH
prostatitis and urinary tract infection
ejaculation (ideally not in the previous 48 hrs)
vigorous exercise (ideally not in the previous 48 hrs)
urinary retention
instrumentation of the urinary tract

Question 9

What is tardive dyskinesia?

Answer 9

onset of choreoathetoid movements, anormal, involuntary - most common is chewing and pouting of jaw

Question 10

what should be done in men presenting with UTI symptoms?

Answer 10

a urine culture should be sent in all cases before antibiotics are started

Question 11

what drugs can cause erectile dysfunction?

Answer 11

SSRIs, beta-blockers

Question 12

what is the cause of epididymo-orchitis in older, low risk sexual acitivty men?

Answer 12

e. coli

Question 13

what are epididymal cysts?

Answer 13

most common scrotal swelling seen in primary care - affect 30% of men
most are asymptomatic
separate from body of testicle
found posterior to testicle
larger cysts can be transilluminated - will be separate from testicle
can sometimes cause pain and discomfort
can very rarely cause torsion - acute pain and swelling

Question 14

What is TURP syndrome and how does it present?

Answer 14

rare and life-threatening complication of transurethral resection of prostate surgery - pathophysiology is venous destruction and absorption of the irrigation fluid
- hyponatraemia
- fluid overload
- glycine toxicity

Question 15

what imagine should be done if you suspect renal stones?

Answer 15

unenhanced CT-KUB

Question 16

what are the symptoms of genital herpes?

Answer 16

painful genital ulceration
may be associated with dysuria and pruritus
the primary infection is often more severe than recurrent episodes
systemic features such as headache, fever and malaise are more common in primary episodes
tender inguinal lymphadenopathy
urinary retention may occur

Question 17

what is the incubation period of gonorrhoea?

Answer 17

2-5 days

Question 18

how can renal stones be prevented?

Answer 18

calcium stones may be due to hypercalciruia - thiazide diuretics can be given to increase distal tubular calcium resorption