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MRCS - Part A > Urology > Flashcards

Urology Flashcards

1
Q

What is paraphimosis?

A

Inability to return retracted foreskin of penis

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2
Q

What is priapism?

A

Prolonged rigid erection

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3
Q

What is the commonest cause of hesitancy and poor stream in young children?

A

Posterior urethral valves

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4
Q

Simple differences between neuroblastoma and nephroblastoma

A

Neuroblastoma - originates from adrenal gland, calcified
Nephroblastoma - Originates from the renal apex, non-caclified. Associated with hypertension. More common

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5
Q

What part of the kidney does a renal cell carcinoma arise from?

A

It is an adenocarcinoma of the proximal convoluted tubule

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6
Q

What type of renal tumour appears pink?

A

Transitional cell carcinoma

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7
Q

What type of renal stone occurs with raised urinary pH and is associated with recurrent infections?

A

Struvite

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8
Q

What are struvite renal stones made up of?

A

magnesium, ammonium and phosphate

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9
Q

What type of stone precipitates in acidic conditions?

A

Uric acid

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10
Q

What type of renal stone is most common?

A

Calcium oxalate

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11
Q

Which type of stone is associated with an inherited metabolic disorder?

A

cystine stone

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12
Q

What bacteria is associated with struvite stones?

A

proteus mirabilis

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13
Q

What is the surgical procedure for testicular cancer?

A

Orchidectomy via inguinal approach

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14
Q

Which lobe of the prostate does carcinoma usually occur and which lobe tends to be enlarged in BPH?

A

Carcinoma - posterior
BPH - median

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15
Q

What are the features of a seminoma?

A

Age = 40
AFP normal
HCG mostly normal, elevated in 10%
LDH mostly normal, elevated in 10-20%

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16
Q

What are the feature of non-seminomatous germ cell carcinomas?

A

Age 20-30
Worse prognosis
May need retroperitoneal lymph node dissection
AFP elevated in 70%
HCG elevated in 40%

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17
Q

Risk factors for testicular cancer?

A

Cryptorchidism
Infertility
Family history
Klinefelter’s syndrome
Mumps orchitis

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18
Q

Features of an acute haematocele?

A

Tender
Non transilluminating
Testis not palpable
Secondary to trauma

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19
Q

Difference between a bulbar urethral rupture and a membranous urethral rupture?

A

Bulbar - More common, due to straddle type injuries, Triad signs: urinary retention, perineal haematoma, blood at the meatus

Membranous - Associated with pelvic fractures, penile/perineal oedema or haematoma, prostate displaced upwards

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20
Q

What type of renal stones are radiolucent?

A

Uric acid stones

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21
Q

Hydrocele in children is most commonly due to what?

A

Persistant processus vaginalis

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22
Q

Which type of testicular cancer is most likely to cause gynaecomastia?

A

Leydig cell tumours

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23
Q

Why should an abdominal ultrasound be done when a varicocele is diagnosed?

A

Because it might be a symptom of a renal tumour occluding the left renal vein, in which the left testicular vein drains

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24
Q

Which type of stone is due to a familial disorder?

A

Cysteine
Inherited recessive disorder of transmembrane cystine transport leading to decreased absorption of cystine from intestine and renal tubule

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25
Q

Which nerves cause erection and which cause ejacultation?

A

Parasympathetic = points = erection = S2-S4
Sympathetic = shoots = ejaculation = T11-L2 (inferior mesenteric ganglion)

26
Q

Where does the testicular artery arise from?

A

Aorta

27
Q

What is the primary site of venous drainage of the urinary bladder?

A

vesicoprostatic venous plexus

28
Q

What nerves innervate the skin of the scotum?

A

Anterior scrotum - ilioinguinal L1 and genitofemoral L1-L2
Posterior scrotum - posterior scrotal branches -> perineal nerve -> pudendal nerve S2-S4

29
Q

What is the lymphatic drainage of the male spongy urethra?

A

deep inguinal nodes

30
Q

Features of nephroblastoma

A

AKA Wilm’s Tumour
Mass, lethargy, loin pain, haematuria
Pyrexia in 50%
Metastasise early to lung
Usually affect children aged 2-5 years

31
Q

Assuming the renal function is normal, what proportion of calcium filtered at the glomerulus will be reabsorbed by the renal tubules?

A

95%

32
Q

What type of bladder malignancy is due to chronic inflammation from schistosomiasis?

A

SCC

33
Q

What is transurethral resection syndrome?

A

TUR syndrome occurs when irrigation fluid enters the systemic circulation. The triad of features are:

  1. Hyponatraemia: dilutional
  2. Fluid overload
  3. Glycine toxicity
34
Q

What is the most common cause of a hard painless ulcer of the penis?

A

Syphilis - Treponema Pallidum

35
Q

What is the blood supply of the ureters?

A

Blood supply is segmental; renal artery, aortic branches, gonadal branches, common iliac and internal iliac

36
Q

What type of epithelium lines the urethra?

A

Stratified columnar

37
Q

What is the blood supply of the urethra?

A

Prostatic - Inferior vesical artery, branch of internal iliac artery
Membranous - Bulbourethral artery, branch of the internal pudendal artery
Spongey - Branches of the internal pudendal artery

38
Q

Where is most resistance felt when inserting a male catheter?

A

Membranous urethra

39
Q

What is the lymphatic drainage of the urethra?

A

Prostatic and membranous portions - internal iliac lymph nodes
Spongey urethra - Deep inguinal lymph nodes

40
Q

What is the histology of a seminoma?

A

Sheet like lobular patterns of cells with fibrous septae. Fibrous septa contain lymphocytic infiltration +/- granulomas

41
Q

Where do the left and right testicular veins drain into?

A

Left testicular vein - Left renal vein
Right testicular vein - IVC

42
Q

How does prostate cancer metastasise to vertebral column and brain?

A

Prostate venous drainage is to the vesicoprostate venous plexus which communicates with inferior vesicular vein and the internal vertebral venous plexus posteriorly.
The internal venous plexus of baston communicate with the intracranial venous sinuses.

43
Q

Which renal stone contains sulphur

A

Cysteine

44
Q

Which stones are most radio dense and radiolucent?

A

Very radio dense - Calcium phosphate
Relatively radio dense - Cysteine
Radio-opaque - Calcium Oxalate
Slightly radio-opaque - Struvite
Radiolucent - Uric acid

45
Q

What type of renal cancer is associated with long term staghorn calculus?

A

SCC

46
Q

What is the management of an infant with a hydrocele?

A

Likely due to persistent processus vaginalis so management is surgical ligation of persistent processus vaginalis via inguinal approach

47
Q

What is the most common paratesticular tumour?

A

Rhabdomyosarcoma

48
Q

What antibody is involved with hyperacute rejection of renal transplant?

A

IgG

49
Q

What conditions are associated with adult polycystic kidney disease?

A

Liver cysts
Berry aneurysms
Pancreatic cysts
Renal calculi
Hypertension
Haematuria
Mitral valve prolapse
Recurrent UTIs

50
Q

What type of epithelium lines the ureter?

A

Transitional

51
Q

What bony landmark do the ureters lie over?

A

Tips of transverse processes L2-5

52
Q

Which of the renal artery, renal vein and ureter lies most anteriorly and most posteriorly?

A

Anterior - renal vein
Posterior - ureter

53
Q

Which nerve is most likely to be damaged during resection of bladder?

A

Obturator

54
Q

What genetic condition is associated with renal angiomyolipomata?

A

Tuberous sclerosis

55
Q

What anatomical plane separates the prostate from the rectum?

A

Denonvilliers fascia

56
Q

Polycythaemia is a recognised feature of which urinary tract cancer?

A

Renal cell carcinoma (adenocarcinoma of the kidney)

57
Q

What are the contents of the deep perineal pouch in a male

A
  • Urethral sphincter
  • Transversus perinei
  • Dorsal nerve of penis, muscular branches of the perineal nerve
  • Deep and dorsal arteries of penis, stem of origin of artery to the bulb of penis, urethral artery.
58
Q

What is onuf’s nucleus?

A

Located in anterior horn of S2
It is the origin of the nerves that supply the external urethral sphincter

59
Q

What renal lesion is associated with tuberous sclerosis?

A

Angiomyolipoma.

60
Q
A

MRCS - Part A (16 decks)

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