Urology

Question 1

risk factors for testicular cancer

Answer 1

cryptorchidism
fhx
mumps orchitis
infertility
klinefelters syndrome

Question 2

What are they types of testicular cancer
Which are most common and at what age

Answer 2

95% are Germ cell - seminomas (35yrs) and non-seminomas (25yrs) (teratomas, yolk sac etc)

Non germ cell - Leydig, Sarcoma

Question 3

presentation of testicular cancer

Answer 3

young
painless lump
may have gynaecomastia
hydrocele

Question 4

tumour markers for testicular cancer

Answer 4

bHCG - seminomas
bHCG and AFP - non seminomas

Question 5

gold standard ix for urethritis

Answer 5

NAAT - gonorrhoea or chlamydia

Question 6

rx of urethritis

Answer 6

one dose IM ceftriaxones + azithromycin if gonnococcal
no sex for 7 days
contact tracing

Question 7

common organism causing Fournier gangrene

Answer 7

e coli

Question 8

rx of fournier

Answer 8

surgical debridement, abx

Question 9

renal stones types

Answer 9

calcium oxalate
uric acid
struvite

Question 10

what foods are high in oxalate

Answer 10

chocolate and crisps

Question 11

gold standard ix or renal stones

Answer 11

CT KUB non contrast

Question 12

RF for stones

Answer 12

dehydration, high oxalate diet. high calcium eg hyperparathyroidism, loop diuretics, infection, sarcoidosis, diabetes, PCKD

Question 13

3 locations of stone lodging

Answer 13

uretopelvic junction
vesicoureteric
mid way where iliac vessels cross

Question 14

rx of stones

Answer 14

jj stent
nephrostomy

lithotripsy - <2cm but CI if on anti coags

Question 15

if stone <10mm and distal what drug do you give to help smooth muscle relaxation

Answer 15

alpha blocker

Question 16

pain med of choice for stones

Answer 16

NSAIDs

Question 17

rx of renal stones if:
- <5mm and asymptomatic
- 5-10mm
-10-20mm
->20mm

Answer 17

Renal stones
watchful waiting if < 5mm and asymptomatic
5-10mm shockwave lithotripsy
10-20 mm shockwave lithotripsy OR ureteroscopy
> 20 mm percutaneous nephrolithotomy

Question 18

rx of ureteric stones

Answer 18

shockwave lithotripsy +/- alpha blockers>
< 10mm shockwave lithotripsy +/- alpha blockers
10-20 mm ureteroscopy

Question 19

which stone type is radio lucent

Answer 19

uric acid

Question 20

renal stone prevention

Answer 20

avoid dehydration
low oxalate diet
allopurinol
thiazides - calcium oxalate
low salt diet

Question 21

acute vs chronic urinary retention

Answer 21

chronic drains > 1.5L and is painlesss
acute is painful and drains less

Question 22

how does tamsulosin work
how does finasteride work

Answer 22

Tamsulosin - alpha blocker that relaxes smooth muscle in the prostate

Finasteride - 5alpha reductase. Inhibits conversion of testosterone into dihydrotestosterone which is more potent.

Question 23

causes of acute urinary retention

Answer 23

BPH
constipation
drug induced
UTI
CES
post anaesthesia

Question 24

ix o acute urinary retention

Answer 24

bladder scan - confirm retention
Real USS - hydronephrosis
U&Es - renal impairement
Urine MCS once catheterised - infection
FBC, CRP - infection
If signs of CES - MRI wholes spine

Question 25

how may acute urinary retention present in a pt with chronic retention

Answer 25

painless overflow incontinence

Question 26

voiding sx of BPH

storage sx of BPH

Answer 26

voiding - hesitancy, poor flow, strain, post micturition dribble

storage - frequency, incontinence, nocturne

Question 27

initial ix for BPH

Answer 27

post voiding scan
urine MC&S and urine dip
DRE
PSA

Question 28

ddx of BPH

Answer 28

prostate cancer
prostatitis
UTI

Question 29

rx of BPH

Answer 29

tamsulosin, finasteride + lifestyle mods (as seen in nitty gritty)
TURP

Question 30

side effects of tamsulosin and finasteride

TURP complications

Answer 30

Tamsulosin - postural hypotension, dizines
finasteride - reduced libido and impotence

TURP - impotence, incontinence