Urology Flashcards

1
Q

What are the most common organisms involved in epididymo-orchitis?

A

Youn and sexually active- Niseirria Gonorrhoea or Chlamydia

Old- E-coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the mx in epididymo-orchitis?

A

STI- treat
E-coli- MSU dependent/oral quinolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the RFs for transitional cell carcinoma of the bladder?

A

SMOKING!!
Exposure to dyes
Rubber manufacture
Cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the RFs for squamous cell carcinoma of the bladder?

A

Schistomiosis
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the Ix indicated in renal stones?

A

FBC, CRP, U&Es
Coagulation studies
Urine dipstick and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most appropriate imaging for renal stones?

A

Non contrast CT KUB
In pregnancy and children- USS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most appropriate initial mx of renal stones?

A

Analgesia (NSAIDs)
+/- Alpha blocker if distal uteric stone <10mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the mx of renal stones?

A

<5mm- watchful waiting
5-10mm- Shockwave lithotripsy
10-20mm- Shockwave lithotripsy/Uteroscopy
>20mm- Percutaneous nephrolithotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

List the obstructive and storage sx of BPH?

A

Obstructive: (SHIP)
Straining
Hesitancy
Dribbling
Incomplete emptying
Poor flow

Storage- (FUN)
Frequency
Urgency
Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the 1st line of mx for BPH?

A

Alpha 1 antagonist e.g. Tamsulosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the MOA of alpha 1 antagonist in BPH?

A

Decreases smooth muscle tone of bladder and prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the 2nd line of mx in BPH?

A

5 alpha reductase Inhibitors
e.g. Finasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How long does it take for finasteride to take effect?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the MOA of Finasteride?

A

Blocks the conversion of testosterone to DHT, causing a decrease in prostate volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the SE of alpha 1 antagonists?

A

Dizziness
Postural Hypotension
Dry mouth
Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

List the causes of acute urinary retention (AUR)?

A

BPH**
Urethral obstruction- strictures, calculi, constipation
Medications- anticholinergics, TCAs, Opioids, Benzos
Neurological cause
UTI
Post operative

17
Q

List the sx of AUR?

A

Inability to pass urine
Lower abdominal discomfort
Considerable pain or distress
an acute confusional state may also be present in elderly patients

18
Q

What Ix are indicated in AUR?

A

Urine MCS
U&Es, FBC, CRP

19
Q

How should a diagnosis of AUR be confirmed?

A

Bladder USS- A volume of >300 cc confirms the diagnosis

Bladder scans have its inaccuracies

20
Q

What is the mx of AUR?

A

Decompressing the bladder via catheterisation- measure urine in bag in 15 mins

A volume of <200 confirms that a patient does not have acute urinary retention, and a volume over 400 cc means the catheter should be left in place. In between these volumes, it depends on the case.

21
Q

What is a complication of AUR?

A

Post-obstructive diuresis

The Kidneys may increase diuresis due to the loss of their medullary concentration gradient. This can take time re-equilibrate
this can lead to volume depletion and worsening of any acute kidney injury
some patients may therefore require IV fluids to correct this temporary over-diuresis

22
Q

List the causes of unilateral hydronephrosis?

A

PACT
Pelvic-ureteric obstruction
Aberrant renal vessels
Calculi
Tumours of the renal pelvis

23
Q

List the causes of BL hydronephrosis?

A

SUPER
Stenosis of the urethra
Urethral valve
Prostatic enlargement
Extensive bladder tumour
Retro-peritoneal fibrosis

24
Q

What is the 1st line Ix for hydronephrosis?

A

USS- Identifies presence of hydronephrosis and can assess the kidneys

25
Q

What other Ix can be conducted in hydronephrosis?

A

IVU- assess the position of the obstruction
Antegrade or retrograde pyelography- allows treatment
if suspect renal colic: CT scan

26
Q

What is the mx of hydronephrosis?

A

Remove the obstruction and drainage of urine

Acute upper urinary tract obstruction: nephrostomy tube

Chronic upper urinary tract obstruction: ureteric stent or a pyeloplasty

27
Q

List the classic triad of sx associated with renal cell cancer?

A

haematuria
loin pain
abdominal mass

28
Q

List the paraneoplastic syndrome associated with renal cell cancer?

A

Stauffer syndrome
a paraneoplastic disorder associated with renal cell cancer
typically presents as cholestasis/hepatosplenomegaly
it is thought to be secondary to increased levels of IL-6

29
Q

What is the management of renal cell cancer?

A

For confined disease- partial or total nephrectomy

Alpha-interferon and interleukin-2 have been used to reduce tumour size and also treat patients with metatases

30
Q

What are the complications associated with TURPs sx?

A

TURP Syndrome (Hyponatraemia, Fluid overload, Glycine toxicity)
Urethral strictue/UTI
Retrograde ejaculation
Perforation of the prostate

31
Q

When is circumcision CI?

A

in Hypospadias

32
Q

What is the tell-tale sx of a epididymal cysts?

A

Separate from the body of the testicle found posterior to the testicle

33
Q
A