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4th year passmed > Urology > Flashcards

Urology Flashcards

1
Q

True or false; prostate cancer always presents with a raised PSA

A

False - can be normal

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2
Q

State whether the following renal stones are opaque or radiolucent

1 Calcium oxalate
2 Mixed oxalate/phosphate
3 Triple phosphate
4 Urate
5 Cysteine
6 Xanthine
A 
1 Opaque
2 Opaque
3 Opaque
4 Radiolucent
5 Semiopaque
6 Radiolucent
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3
Q

What is the cremasteric reflex and when is it lost?

A

Stroking the inner thigh causes ipsilateral testicular retraction.

Absent in torsion

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4
Q

Which drugs commonly cause erectile dysfunction?

A

SSRIs

Beta blockers

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5
Q

What is the best investigation for hydronephrosis?

A

Ultrasound of the renal tract

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6
Q

What is the first line management of hydronephrosis?

A

Nephrostomy

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7
Q

What are the causes of hydronephrosis?

A 
Unilateral - PACT
Pelvic ureteric obstruction
Aberrant vessels
Calculi
Tumour
Bilateral - SUPER
Stenosis of urethra
Urethral valve
Prostate
Extensive bladder tumour
Retroperitoneal fibrosis
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8
Q

WHat are staghorn calculi typically composed of?

A

Mangeium ammonium phosphate (triple phosphate Struvite) stones

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9
Q

Which infection is most commonly associated with staghorn calculi?

A

Proteus mirabilis

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10
Q

Renal cancer with exposure to textiles industry?

A

TCC

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11
Q

What type of renal cancer is associated with Tuberous Sclerosis?

A

Angiomyolipoma

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12
Q

How might a lower UTI precipitate urinary retention?

A

Urethritis _> oedema -> retention

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13
Q

What is the use of a PSA in urinary retention?

A

None - it is generally raised due to compression

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14
Q

How do you diagnose acute retention?

A

Bladder scan with >300ml volume

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15
Q

What is the first line investigation in suspected prostate cancer?

A

Multiparametric MRI (NOT TRUS guided biopsy)

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16
Q

What is the most common type of prostate cancer?

A

Adenocarcinoma

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17
Q

What is the first line investigation for any testicular lump?

A

Ultrasound

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18
Q

What complication may occur after acute urinary retention, and how should it be monitored for?

A

AKI

Cr

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19
Q

What should be done for a patient with an unresolved varicocele?

A

Renal tract USS

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20
Q

What is the commonest infective agent of epididimo orchitis in a patient with a low vs. high STI risk?

A

E coli in low risk

Chlamydia in high risk

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21
Q

What is the commonest cause of scrotal swelling seen in primary care, and what are its features?

A

Epididymal cysts

Separate from body of testicle on the posterior aspect

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22
Q

What are the features of a hydrocele?

A

Soft non tender swelling antero-inferior to the testicle
You can get above the mass
Transluminates

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23
Q

What are the side effects of tamsulosin?

A

Dizziness
Postural hypotension
Dry mouth
Depression

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24
Q

What are the side effects of finestaride?

A

ED
Reduced libido
Ejaculation problems
Gynaecomastia

25
Q

What is the first step in the management of patients with chronic urinary retention and hydronephrosis?

A

Intermittent self catheterisation

26
Q

WHich has the better prognosis, seminoma or teratoma?

A

Seminoma

27
Q

What investigation should be done in the event of priapism and why?

A

Cavernosal blood gas analysis to distinguish between ischaemic and non ischaemic priapism

28
Q

Which type of renal calculus is associated with an inherited metabolic disorder?

A

Cystine

29
Q

What type of renal stone would you see in a patient undergoing chemo?

A

Urate (radiolucent)

30
Q

What are the features of a nephroblastoma (WIlm’s tumour)

A

Early (first 4 years)
Haematuria with mass
50% have pyrexia
Lung mets

31
Q

What does periureteric fat stranding indicate?

A

Recent stone passage

32
Q

What testicular pathology may occur after a urological intervention?

A

Epidydimo orchitis

33
Q

WHat are some common complications following radical prostatectomy?

A

Incontinence
ED
Urethral stenosis

34
Q

What might occur in the early stages of treatment with 5alha reducatas inhibitors, and how can this be prevented?

A

A transient rise of prostate symptoms known as the ‘flare effect’ due to increase in LH production prior to receptor down regulation

Flutamide is a synthetic antiandrogen which can be used to attenuate this flare

35
Q

Measurement of PSA should be deferred for how long after prostatitis?

A

1 month

36
Q

True or false, the cremasteric reflex is present in torsion of the testicular appendage

A

True

37
Q

What is the commonest type of renal carcinoma?

A

Adenocarcinoma

38
Q

Which urological malignancy (other than RCC) metastasises to the lungs?

A

Teratoma - common in younger males

39
Q

What are the prophylactic benefits of circumcision?

A

Reduced risk of penile cancer
Reduced risk of UTI
Reduced risk of STIs including HIV

40
Q

What is the strongest risk factor for testicular cancer?

A

Infertility (3x higher)

41
Q

Manageme4nt of renal calculi with signs of infection?

A

Surgical decompression

42
Q

What is a contraindication to circumcision?

A

Hypospadias

43
Q

A 75-year-old man presents with a swelling in his right scrotum. On examination a large, non-tender swelling is found in the scrotum. You cannot palpate above the swelling during the examination.

A

Inguinal hernia, as you cannot palpate above the swelling

44
Q

WHat are the commonest causes of organic erectile dysfunction?

A

Vascular - e.g. CVD, HTN, DM etc

45
Q

What cancer are patients with schistosomiasis at risk of?

A

Squamous cell carcinoma of the bladder

46
Q

What is the preferred management of urolithiasis in pregnant women?

A

Ureteroscopy

47
Q

What is the management of a stone burden <2cm?

A

Shock wave lithotripsy with urinary alkalinization

48
Q

Prostate cancer radiotherapy puts patients at increased risk of which cancers?

A

Bladder
Colon
Rectal

49
Q

How long does finestaride take to work?

A

6 months

50
Q

AFP and HCG are typically normal and raised in whicy types of t esticular cancer?

A

Normal in seminomas

Raised in teratomas and yolk sac tumours

51
Q

WHich type of testicular lump is associated with infertility?

A

Varicoceles

52
Q

What is recommended as pain management in renal colic?

A

75 IM diclofenac

53
Q

What should be prescribed in the first 3 weeks of goserelin treatment?

A

Cyproterone acetate (anti-androgen)

54
Q

Balanitis xerotica obliterans may cause…?

A

Phimosis

55
Q

Schistosomiasis is a risk factor for which type of renal cancer?

A

Squamous cell carcinoma of the bladder

56
Q

What are the complciations of TURP?

A

TURP

Turp syndrome:
Dilutional hyponatraemia
Fluid overload
Glycine toxicity
Occurs due to irrigation fluid entering the systemic circulation

Urethral stricture/UTI
Retrograde ejaculation
Perforation of the prostate

57
Q

What is a normal post void bladder volume in under and over 65 year olds?

A

<65 - <50ml

>65 - <100ml

58
Q

What is the mechanism of Goserelin?

A

GnRH agonist

4th year passmed (28 decks)

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