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Medicine Year 5 > Urology > Flashcards

Urology Flashcards

1
Q

can you get above an inguinal hernia

A

no

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2
Q

severe and sudden onset testicular pain radiating to the abdomen in a young male with a unilaterally swollen and retracted testicle

A

testicular torsion

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3
Q

what is testicular torsion

A

twisting of the spermatic cord

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4
Q

what is prehns sign in torsion

A

elevation of the testicle does NOT ease the pain

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5
Q

what happens to the cremasteric reflex in torsion

A

it is lost

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6
Q

management of testicular torsion

A

orchidopexy to BOTH testicles

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7
Q

abnormal enlargement of the testicular veins which feels like a bag of worms

A

varicocele

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8
Q

which side is most common to get a varicocele

A

left (due to vessel drainage)

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9
Q

complications of varicocele

A

infertility
renal cell carcinoma

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10
Q

management of varicocele

A

generally conservative but if unresolving in left then USS for RCC

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11
Q

soft, non tender fluctuant swelling that is confined to the scrotum and TRANSILLUMINATES

A

hydrocele

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12
Q

can you get above a hydrocele on examination

A

yes

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13
Q

two types of hydrocele and management

A

communicating: self resolve in newborns
non communicating: adults, USS to exclude cancer

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14
Q

painless cysts above and behind the testis in over 40’s which do NOT transilluminate

A

epididymal cysts

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15
Q

can you get above epididymal cysts on examination

A

yes

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16
Q

tender and swollen testis with dysuria and discharge
pain eased by elevating testis

A

epididymo-orchitis

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17
Q

investigations for epididymo-orchitis

A

young sexually active male: NAAT for chlamydia
older male: MSUS for e.coli

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18
Q

management of prostatitis in young man

A

screening for STI
14 day ciprofloxacin

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19
Q

main histology for renal cell cancer

A

adenocarcinoma/clear cell

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20
Q

cause of transitional cell renal cancer

A

textile industry

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21
Q

paraneoplastic syndrome, cholecystitis and hepatosplenomegaly in renal cell cancer

A

stauffer syndrome

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22
Q

staging for renal cell cancer

A

1: less than 7cm
2: more than 7cm
3: to gerota
4: beyond

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23
Q

management of renal cell cancer

A

nephrectomy
tyrosine kinase - NIB

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24
Q

RF for renal cell and bladder cancer

A

smoking

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25
Q

presentation of bladder cancer

A

painless frank haematuria

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26
Q

most common histology for bladder cancer

A

transitional

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27
Q

management of bladder cancer

A

cystoscopy/biopsy/TURB/chemo/radio

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28
Q

RF for prostate cancer

A

afrocaribbean

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29
Q

most common histology for prostate cancer

A

adenocarcinoma

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30
Q

how is prostate cancer graded

A

gleason score (10 is aggressive)

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31
Q

1st line investigation for prostate cancer

A

MRI

32
Q

medical management of prostate cancer

A

goserelin (GnRH)

33
Q

TURP

A

transurethral resection of the prostate

34
Q

complications of TURP

A

Tur syndrome (irrigation fluid enters circulation causing fluid overload, low Na and glycine toxicity - treat with fluid restriction)

Urethral stricture / UTI
Retrograde ejaculation
Perforation of the prostate

35
Q

most common histology of penile cancer

A

SCC

36
Q

discrete testicular nodule with hydrocele or gynaecomastia

A

testicular cancer

37
Q

4 RF for testicular cancer

A

mumps, kleinfelters, infertility, FHx

38
Q

histology of testicular cancers

A

Germ cell tumours
- seminomas in over 35 (hCG)
- non-seminomas e.g. teratoma in 25 (AFP)

39
Q

investigation for testicular cancer

A

beta hCG and AFP
USS

40
Q

management of testicular cancer

A

orchidectomy / chemo /radio

41
Q

1st and 2nd line management for BPH

A

1st: Tamsulosin (alpha 1 antagonist)
2nd: Finasteride (5 alpha reductase inhibitor)

42
Q

which drug causes the side effects of dizziness, hypotension, depression and dry mouth

A

tamsulosin

43
Q

which drug causes the side effects of ED, reduced libido, gynaecomastia and can take 6m to take effect

A

finasteride

44
Q

investigation for erectile dysfunction

A

morning testosterone

45
Q

most common organic cause of ED

A

vascular issues

46
Q

2 drugs which can cause ED

A

SSRI and BB

47
Q

investigation after vasectomy

A

2 semen analysis

48
Q

complication after vasectomy

A

5% left with chronic pain

49
Q

2 medication indications for circumcision

A

phimosis and balantitis

50
Q

1 contraindication for circumcision

A

hypospadias in infancy as foreskin used in the repair

51
Q

loin to groin pain

A

renal stones

52
Q

dipstick in renal stones

A

blood and leukocytes

53
Q

main investigation for renal stones

A

non contrast CTKUB

54
Q

pain relief for renal stones

A

IM diclofenac

55
Q

management of renal stones under 5mm

A

pass spontaneously

56
Q

management of obstructive renal stones

A

decompress with nephrostomy

57
Q

management of renal stones in pregnancy

A

ureteroscopy

58
Q

which stones are radio opaque

A

calcium oxalate
calcium phosphate
struvite

59
Q

which stones are radio dense

A

cystine (sulphur)

60
Q

which stones are radio lucent

A

uric acid
xanthine

61
Q

prevention of oxalate stones

A

cholestyramine and pyridoxine

62
Q

which stone does increased citrate increase the risk of

A

calcium oxalate

63
Q

cause of cystine stones

A

inherited disorder causing reduced cystine absorption

64
Q

prevention of urate stones

A

allopurinol
uric acid is a product of purine metabolism

65
Q

staghorn calculus due to urease producing bacteria causes which stones

A

struvite

66
Q

what does periureteric fat stranding indicate

A

recent stone passage

67
Q

investigation for bladder voiding

A

urodynamic studies

68
Q

post void volumes in over 65’s

A

under 50 is normal

69
Q

diagnosis of urinary incontinence in man with a history of gonorrhoea

A

urinary stricture

70
Q

2 things which retention can precipitate

A

AKI and delirium

71
Q

what can retention be precipitated by

A

LUTI

72
Q

management of overactive bladder

A

antimuscarinics (oxybutynin, tolterodine, darifenacin)

73
Q

catheter in a pelvic fracture

A

suprapubic

74
Q

pelvic fracture and highly displaced prostate

A

membranous urethral rupture

75
Q

scan for hydronephrosis

A

USS

76
Q

what is priapism

A

persistent penile erection not associated with sex commonly caused in sickle cell and requiring cavernous blood gas analysis

Medicine Year 5 (27 decks)

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