Urology

Question 1

can you get above an inguinal hernia

Answer 1

no

Question 2

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

Answer 2

testicular torsion

Question 3

what is testicular torsion

Answer 3

twisting of the spermatic cord

Question 4

what is prehns sign in torsion

Answer 4

elevation of the testicle does NOT ease the pain

Question 5

what happens to the cremasteric reflex in torsion

Answer 5

it is lost

Question 6

management of testicular torsion

Answer 6

orchidopexy to BOTH testicles

Question 7

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

Answer 7

varicocele

Question 8

which side is most common to get a varicocele

Answer 8

left (due to vessel drainage)

Question 9

complications of varicocele

Answer 9

infertility
renal cell carcinoma

Question 10

management of varicocele

Answer 10

generally conservative but if unresolving in left then USS for RCC

Question 11

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

Answer 11

hydrocele

Question 12

can you get above a hydrocele on examination

Answer 12

yes

Question 13

two types of hydrocele and management

Answer 13

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

Question 14

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

Answer 14

epididymal cysts

Question 15

can you get above epididymal cysts on examination

Answer 15

yes

Question 16

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

Answer 16

epididymo-orchitis

Question 17

investigations for epididymo-orchitis

Answer 17

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

Question 18

management of prostatitis in young man

Answer 18

screening for STI
14 day ciprofloxacin

Question 19

main histology for renal cell cancer

Answer 19

adenocarcinoma/clear cell

Question 20

cause of transitional cell renal cancer

Answer 20

textile industry

Question 21

paraneoplastic syndrome, cholecystitis and hepatosplenomegaly in renal cell cancer

Answer 21

stauffer syndrome

Question 22

staging for renal cell cancer

Answer 22

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

Question 23

management of renal cell cancer

Answer 23

nephrectomy
tyrosine kinase - NIB

Question 24

RF for renal cell and bladder cancer

Answer 24

smoking

Question 25

presentation of bladder cancer

Answer 25

painless frank haematuria

Question 26

most common histology for bladder cancer

Answer 26

transitional

Question 27

management of bladder cancer

Answer 27

cystoscopy/biopsy/TURB/chemo/radio

Question 28

RF for prostate cancer

Answer 28

afrocaribbean

Question 29

most common histology for prostate cancer

Answer 29

adenocarcinoma

Question 30

how is prostate cancer graded

Answer 30

gleason score (10 is aggressive)

Question 31

1st line investigation for prostate cancer

Answer 31

MRI

Question 32

medical management of prostate cancer

Answer 32

goserelin (GnRH)

Question 33

TURP

Answer 33

transurethral resection of the prostate

Question 34

complications of TURP

Answer 34

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

Question 35

most common histology of penile cancer

Answer 35

SCC

Question 36

discrete testicular nodule with hydrocele or gynaecomastia

Answer 36

testicular cancer

Question 37

4 RF for testicular cancer

Answer 37

mumps, kleinfelters, infertility, FHx

Question 38

histology of testicular cancers

Answer 38

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

Question 39

investigation for testicular cancer

Answer 39

beta hCG and AFP USS

Question 40

management of testicular cancer

Answer 40

orchidectomy / chemo /radio

Question 41

1st and 2nd line management for BPH

Answer 41

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

Question 42

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

Answer 42

tamsulosin

Question 43

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

Answer 43

finasteride

Question 44

investigation for erectile dysfunction

Answer 44

morning testosterone

Question 45

most common organic cause of ED

Answer 45

vascular issues

Question 46

2 drugs which can cause ED

Answer 46

SSRI and BB

Question 47

investigation after vasectomy

Answer 47

2 semen analysis

Question 48

complication after vasectomy

Answer 48

5% left with chronic pain

Question 49

2 medication indications for circumcision

Answer 49

phimosis and balantitis

Question 50

1 contraindication for circumcision

Answer 50

hypospadias in infancy as foreskin used in the repair

Question 51

loin to groin pain

Answer 51

renal stones

Question 52

dipstick in renal stones

Answer 52

blood and leukocytes

Question 53

main investigation for renal stones

Answer 53

non contrast CTKUB

Question 54

pain relief for renal stones

Answer 54

IM diclofenac

Question 55

management of renal stones under 5mm

Answer 55

pass spontaneously

Question 56

management of obstructive renal stones

Answer 56

decompress with nephrostomy

Question 57

management of renal stones in pregnancy

Answer 57

ureteroscopy

Question 58

which stones are radio opaque

Answer 58

calcium oxalate calcium phosphate struvite

Question 59

which stones are radio dense

Answer 59

cystine (sulphur)

Question 60

which stones are radio lucent

Answer 60

uric acid xanthine

Question 61

prevention of oxalate stones

Answer 61

cholestyramine and pyridoxine

Question 62

which stone does increased citrate increase the risk of

Answer 62

calcium oxalate

Question 63

cause of cystine stones

Answer 63

inherited disorder causing reduced cystine absorption

Question 64

prevention of urate stones

Answer 64

allopurinol uric acid is a product of purine metabolism

Question 65

staghorn calculus due to urease producing bacteria causes which stones

Answer 65

struvite

Question 66

what does periureteric fat stranding indicate

Answer 66

recent stone passage

Question 67

investigation for bladder voiding

Answer 67

urodynamic studies

Question 68

post void volumes in over 65's

Answer 68

under 50 is normal

Question 69

diagnosis of urinary incontinence in man with a history of gonorrhoea

Answer 69

urinary stricture

Question 70

2 things which retention can precipitate

Answer 70

AKI and delirium

Question 71

what can retention be precipitated by

Answer 71

LUTI

Question 72

management of overactive bladder

Answer 72

antimuscarinics (oxybutynin, tolterodine, darifenacin)

Question 73

catheter in a pelvic fracture

Answer 73

suprapubic

Question 74

pelvic fracture and highly displaced prostate

Answer 74

membranous urethral rupture

Question 75

scan for hydronephrosis

Answer 75

USS

Question 76

what is priapism

Answer 76

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