Urology

Question 1

kidney stones management by size

Answer 1

<0.5cm: expectant treatment +/- tamsulosin
<2cm: lithotripsy
<2cm +pregnant: uteroscopy
>2cm: nephrolithotomy

Question 2

how to treat kidney stones if hydronephrosis/infection

Answer 2

percutaneous nephrostomy and antibiotics

Question 3

localised prostate cancer management (T1/T2) options

Answer 3

1. conservative with active monitoring
2. radical prostatectomy
3. radiotherapy

Question 4

treatment of metastatic prostate cancer disease

Answer 4

hormonal therapy only

Question 5

what is hormonal therapy in prostate cancer?

Answer 5

synthetic GnRH agonist
+ 3 week anti-androgen cover

Question 6

tumours find in Von-Hippel-Lindau

Answer 6

phaeo
neuroendocrine
pancreatic
clear cell renal

Question 7

investigations in testicular Ca

Answer 7

1. USS
2. AFP, hCG, LDH
3. CT TAP
   NO BIOSPY

Question 8

what is the cremasteric reflex?

Answer 8

stroking of skin of inner thigh
cremaster muscle contracts and pulls up ipsilateral testicle towards inguinal canal

Question 9

investigations in erectile dysfunction

Answer 9

Q risk
free testosterone
if this is low = FSH, LH, prolactin (if abnormal = refer to Endo)

Question 10

when to refer men to urology in UTI

Answer 10

if 2 or more uncomplicated UTIs

Question 11

what are the symptoms of prostatitis?

Answer 11

referred pain
obstructive voiding sx
fevers, rigors

Question 12

management of prostatitis

Answer 12

STI screen
quinolone 14/7

Question 13

management options for hydrocele

Answer 13

watch and wait
aspiration for symptomatic relief
surgical = Lloyd’s repair

Question 14

varicocele management

Answer 14

conservative (scrotal support)
surgical (radiological embolisation operation)

Question 15

treatment of hypercalcuria and recurrent Ca renal stones

Answer 15

thiazide-like diuretics

Question 16

Urinary retention causes

Answer 16

Obstructive (BPH, stones)
Neurological (DM, MS)

Question 17

What do you need to remember once you correct an obstruction?

Answer 17

Post obstruction diuresis
Replace fluids

Question 18

Risk factors for transitional cell cancer

Answer 18

Smoking
Drugs

Question 19

Squamous cell carcinoma of bladder RFs

Answer 19

Schistosomiasis

Question 20

Bladder storage symptoms

Answer 20

Nocturia
Frequency
Urgency
Overflow incontinence

Question 21

Voiding storage symptoms

Answer 21

Hesitancy
Straining
Poor stream
Terminal dribbling
Incomplete emptying

Question 22

MoA of tamsulosin

Answer 22

Alpha blocker

Question 23

When is hormonal treatment for prostate Ca used and what is it ?

Answer 23

Metastatic or node positive
LnRH analogues and anti-androgen

Question 24

What are most testicular tumours (95%)?

Answer 24

Germ cell

Question 25

Germ cells tumour types and treatment

Answer 25

1. Seminoma (radiosensitive )
2. Non seminoma (mixed, Teratoma, yolk sac, chorioCa)