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Med Finals - Surgery > Urology > Flashcards

Urology Flashcards

1
Q

Define BPH

A

Benign prostatic hyperplasia is the benign enlargement of the prostate. Caused by hyperplasia of the stromal and epithelial cells of the prostate.

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2
Q

History of BPH

A

Hesitancy
Weak flow
Urgency
Frequency
Intermittency
Terminal dribbling
Incomplete emptying
Nocturia

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3
Q

Investigations in BPH

A

DRE
Abdo exam
Urinary frequency volume chart
Urine dip
PSA

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4
Q

Management of BPH

A

Alpha blockers
5-alpha reductase inhibitors
Surgical
TURP + variations
Prostatectomy

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5
Q

Give an example of an alpha blocker

A

Tamsulosin

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6
Q

Give an example of a 5-alpha reductase inhibitor

A

Finasteride

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7
Q

Define prostatitis

A

Inflammation of the prostate

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8
Q

History of chronic prostatitis

A

Pelvic pain - perineum, testes, penis, groin, lower back
LUTS
Sexual dysfunction
Painful bowel movement

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9
Q

History of acute prostatitis

A

Similar to chronic
Fever
Myalgia
Nausea
Fatigue
Sepsis

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10
Q

Clinical features of prostatits

A

Enlarged very tender prostate!

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11
Q

Investigations in prostatitis

A

Urine dip, microscopy, culture
STD tests

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12
Q

Management of acute prostatitis

A

Oral abx
Analgesia
Laxatives

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13
Q

Management of chronic prostatitis

A

Alpha-blockers - tamsulosis
Analgesia
Psychological treatment
Abx
Laxatives

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14
Q

Complications of prostatitis

A

Sepsis
Prostate abscess
Urinary retention
Chronic prostatitis

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15
Q

Define epididymo-orchitits

A

Inflammation of the epididymis and tests.

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16
Q

History of epididymo-orchitits

A

Testicular pain
Dragging or heavy sensation
Swelling of testes
Urethral discharge
Systemic symps - fever, sepsis

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17
Q

Investigations in epididymo-orchitits

A

Urine microscopy and culturre
STD testing
Saliva swab - mumps
Serum antibodies - mumps
Ultrasound - rule out torsion or malignancy

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18
Q

Management of epididymo-orchitits

A

IV abx
Analgesia
Supportive underwear
Reduce physical activity
Abstain from intercourse

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19
Q

Complications of epididymo-orchitits

A

Chronic pain
Chronic epididymitits
Testicular atrophy
Infertility
Scrotal abscess

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20
Q

Risk factors for prostate cancer

A

Old age
FH
Black african or caribbean
Tall stature
Anabolic steroid

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21
Q

Red flags for prostate cancer

A

LUTS
Haematuria
Erectile dysfunction
Weight loss
Bone pain

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22
Q

Investigations in prostate cancer

A

MRI
Biopsy
Bone scan

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23
Q

What is the staging system for prostate cancer?

A

TNM

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24
Q

Management of prostate cancer

A

Watchful waiting
Radiotherapy
Brachytherapy
Hormone therapy
Surgery - prostatectomy

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25
Q

Define testicular torsion

A

Twisting of the spermatic cord with rotation of the testicle.

26
Q

Clinical signs of testicular torsion

A

Unilateral testicular pain
Abdo pain
Firm swollen teste
Elevated testicle
Absent cremasteric reflex
Abnormal testicular lie - horizontal
Rotation

27
Q

Management of testicular torsion

A

Nil by mouoth
Analgesia
Urgent surgical exploration
Ochiopexy - correcting position and fixing in place
Orchidectomy - removal, if delayed or necrotic

28
Q

What sign is seen on ultrasound in testicular torsion

A

Whirlpool sign - spiral appearance to spermatic cord.

29
Q

Define hydrocele

A

Collection of fluid within the tunica vaginalis that surrounds the testes

30
Q

Cilnical signs of hydrocele

A

Testes palpable within hydrocele
Soft fluctuant
Irreducible and no bowel sounds
Transilluminates with torch

31
Q

Define varicocele

A

Occurs when the veins in the pampiniform plexus become swollen - bag of worms.

32
Q

Which side is a varicocele most common

A

Left - drains into renal vein,
(right drains to vena cava)

33
Q

Clinical signs of varicocele

A

Scrotal mass feeling like a bag of worms
More prominent on standing, may disappear on lying
Asymmetry in testicular size

34
Q

Define epididymal cyst

A

Occurs at the head of the epididymus, a fluid filled sac that may contain sperm.

35
Q

Clinical signs of epididymal cysts

A

Soft round lump
Typically at top of testes
Associated with the epididymis
Separate from the testicle
Maybe be transilluminable if large

36
Q

Risk factors for testicular cancer

A

Undescended testes
Infertility
FH
Increased height
15-35 years old

37
Q

Red flags for testicular cancer

A

Non-tender lump on testicle
Arises from testical
Hard
Irregular
Non fluctuant
No transillumination
Gynaecomastia
B symptons

38
Q

Investigations in testicular cancer

A

US
Tumour markers
Staging CT

39
Q

What are the tumour markers in testicular cancer

A

Alpha-fetoprotein
Beta-hCG
Lactate dehydrogenase

40
Q

Where are common places for testicular cancer to metastasise

A

Lymphatics
Lungs
Liver
Brain

41
Q

Management of testicular cancer

A

Surgery - orchidectomy
Chemo
Radio
Sperm bank!

42
Q

History of UTI

A

Dysuria
Suprapubic pain
Frequency
Urgency
Incontinency
Haematuria
Cloudy or foul smelling urine
Confusion - elderly

43
Q

What is seen on dip stick in UTI

A

Nitrites!
WBC
RBC - microscopic haematuria

44
Q

Define pyelonephritis

A

Inflammation of the kidneys resulting from bacterial infection

45
Q

Risk factors for pyelonephritits

A

Female
Structural abnormalities
Vesico-ureteric reflux - urine refluxing from bladder to ureters
Diabetes

46
Q

History of pyelonephritis

A

Fever
Loin to groin pain
Nausea and vomiting
Systemic illness
Loss of appetite
Haematuria
Renal angle tenderness

47
Q

Investigations in pyelonephritits

A

Urine dip - infection
MSU, culture
Bloods - CRP
US/CT rule out anything else

48
Q

Management of pyelonephritis

A

?sepsis
Abx

49
Q

Define interstitial cystitis

A

Chronic condition causing inflammation of the bladder, resulting in lower urinary tract symptoms and suprapubic pain.

50
Q

History of cystitis

A

Suprapubic pain
Frequency
Urgency
Often worse during menstruation

51
Q

Investigation in cystitits

A

Urinalysis
STD check
Cystoscopy
Prostate exam

52
Q

Management of cystitis

A

Supportive - diet, smoking, pelvic floor, bladder training, CBT, TENS
Analgesia
Antihistamine
Anticholinergic - oxybutynin
Mirebegron
Cimetidine
Pentosan
Ciclospporin
Surgical - cystectomy

53
Q

Risk factors for bladder cancer

A

Smoking
Aromatic amines in dye and rubber
Schistosomiasis

54
Q

Red flags for bladder cancer

A

Painless haematuria
LUTS
Retired dye/rubber worker

55
Q

Define kidney stones

A

They are hard stones that form in the renal pelvis. Calcium based are most common, are result from low urine output.

56
Q

History of renal stones

A

Renal colic - loin to groin pain, colicky in nature
Haematuria
Nausea or vomiting
Reduced urine output
Sepsis?

57
Q

Investigations in renal stones

A

CT KUB!
Urine dip - haematuria
Bloods - infection, calcium
Abdo xr - stones
US

58
Q

Management of renal stones

A

NSAIDs
Antiemetics
Antibiotics
Watchful waiting - if <5mm
Tamsulosin
Surgical removal - if >10mm

59
Q

Risk factors for renal cell carcinoma

A

Smoking
Obesity
Hypertension
End-stage renal failure
Von Hippel-Lindau disease
Tuberous sclerosis

60
Q

Red flags for renal cell carcinoma

A

Often adymptomatic
Haematuria
Vague loin pain
Non-specifc B symptoms
Palpable mass

61
Q

Classic metastasis of renal carcinoma

A

Cannonball metastases - lungs
fascias surrounding kidneys

62
Q

Paraneoplastic features of renal carcinoma

A

Polycythaemia
Hypercalcaemia
Hypertension
Stauffer’s syndrome

Med Finals - Surgery (7 decks)

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