Urology

Question 1

mgt for intermittent testicular torsion?

Answer 1

bilateral orchiopexy (preventative securing of testes)

Question 2

features of renal cell carcinoma?

Answer 2

triad:
haematuria
loin pain
abdo mass

+ pyrexia of unknown origin

Question 3

endocrine effects from renal cell carcinoma?

Answer 3

may secrete EPO - causing polycythaemia
parathyroid hormone-related protein - hypercalcaemia
Renin
ACTH

Question 4

testicular complication of RCC?

Answer 4

varicocele (left sided)
caused by tumour compressing veins

Question 5

paraneoplastic syndromes associated with RCC?

Answer 5

paraneoplastic hepatic dysfunction syndrome
stauffer syndrome - cholestasis/hepatosplenomegaly
secondary to inc IL6

Question 6

pain relief for renal colic?

Answer 6

diclofenac

Question 7

when can PSA levels not be done?

Answer 7

6 weeks of a prostate biopsy
4 weeks following a proven urinary infection
1 week of digital rectal examination
48 hours of vigorous exercise
48 hours of ejaculation

Question 8

first line ix for testicular mass?

Answer 8

testicular USS

Question 9

prostate cancer grading system?

Answer 9

gleason score (out of 10)

Question 10

what is turp syndrome?

Answer 10

caused by irrigation with glycine - hypo-osmolar and systemically absorbed
-> hyponatraemia, hyper-ammonia and visual disturbances

Question 11

how does turp syndrome present?

Answer 11

CNS, resp and systemic symptoms

Question 12

tumour marker for seminomas?

Answer 12

hcg elevated in 20%

Question 13

tumour marker in non-seminomas?

Answer 13

AFP and/or B-hcg elevated in 80-85%

Question 14

tumour marker in germ cell tumours?

Answer 14

LDH elevated in 40%

Question 15

mgt of communicating hydroceles in newborns?

Answer 15

reassure - usually resolve in first few months of life

Question 16

imaging for renal colic?

Answer 16

non contrast CT KUB

Question 17

in which condition does elevation of the testicle ease the pain?

Answer 17

epididymitis
elevation eases epididymitis (prehns sign)

Question 18

most likely organisms causing epidymo-orchitis?

Answer 18

sexually active - chlamydia and gonorrhoea
low risk STI - e.coli

Question 19

mgt for epidymo-orchitis?

Answer 19

most likely chlam/gon - IM ceftriaxone single dose plus 10-14 days doxy
most likely enteric - send MSU and treat with oral quinolone for 2 weeks

Question 20

most common type of renal stone?

Answer 20

calcium oxalate
then mixed oxalate/phosphate
then triple phosphate
then calcium phosphate

Question 21

radio lucent renal stones?

Answer 21

urate
xanthine

Question 22

first line for BPH if moderate to severe voiding sx and not significantly enlarged prostate or high risk of progression?

Answer 22

alpha 1 agonist
eg tamsulosin, alfuzosin

Question 23

first line for BPH if significantly enlarged prostate or high risk of progression?

Answer 23

5 alpha reductase inhibitors eg finasteride

Question 24

microscopic haematuria management?

Answer 24

A patient >= 60 years of age with unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test should be referred using the suspected cancer pathway (within 2 weeks) to exclude bladder cancer

Question 25

contraindication to circumcision?

Answer 25

hypospadias

Question 26

medication for overactive bladder?

Answer 26

antimuscarinic eg oxybutynin

Question 27

when is congenital hydrocele repaired if not resolved?

Answer 27

1-2 years

Question 28

Occupational exposure to which of the following is a recognised risk factor for transitional cell carcinoma of the bladder?

Answer 28

aniline dye