Urology Flashcards
hydrocele
serous fluid
tunica vaginalis
surrounds testes - non palpable
most common type of renal stones?
calcium oxalate
which renal stones are radio lucent
xanthine
urate
men with ED?
bloods
Hba1c
lipids
testosterone
> DM, CVD, Hypogonadism
if free testosterone is low or borderline?
repeat
measure FSH/LH and prolactin
prehns sign?
elevation of testis does no ease the pain
epididymitis
elevation eases the pain
in testicular torsion how do you manage?
both testes are fixed as both sides have future risk
testicular lump suspicious of tumour
Ix?
referral to 2WW urgent urology
USS
Bloods > LDH, bHCG, FBC, AFP
BPH
mx?
tamsulosin and finesteride
alpha1 antagonist and 5alpha reductase inhibitor
LUTS
voiding symptoms?
weak / intermittent flow
strain
dribble
incomplete emptying
LUTS storage
urgency
frequency
urgency incontinence
nocturia
Ix BPH?
dipstick urine
u&E
PSA
IPSS
5 alpha-reductase inhibitors
finesteride
alpha-1 antagonists
tamsulosin
surgical mx of BPH?
TURP
first line Ix for bladder cancer?
flexible cystoscopy
Bladder cancer subtypes?
which one associated w schistosomiasis?
SCC
suspected testicular torsion?
urgent surgical exploration
what is testicular torsion surgery called?
bilateral orchidopexy
Testing PSA
refrain from exercise and ejaculation - how long?
48 hours
how long after prostate biopsy can you test PSA?
6 weeks
prostate cancer findings?
weight loss
systemic features
exam findings hard, irregular / unsmooth
suspected epididymo-orchitis mx?
ceftriaxone 500mg IM
oral doxycycline 100mg twice daily 10-14 days
causative agents of epididymo-orchitis?
Chlamydia trachomatis
Neisseria gonorrhoea
E.coli - if not STI
S/E of tamsulosin?
alpha 1 adrenergic receptor antagonist
> dizziness
postural hypotension
systemic vasodilation
S/E
5-alpha reductase inhibitors?
block the conversion of testosterone to dihydrotestosterone
ED
reduced libido
ejaculation problems
gynaecomastia
Bladder Cancer RF?
smoking
aniline dyes
rubber
normal age-appropriate range
PSA
3ng/ml
NICE guidelines for suspecting prostate cancer?
‘If a hard, irregular prostate felt on examination 2WW’
PSA high
prostate cancer
Dx
PSA measurement
DRE
transrectal USS / biopsy
MRI /CT and bone scan to stage
normal upper limit for PSA?
4ng/ml
lymphatic spread of prostate cancer is usually to?
obturator nodes
seminal vesicles
suspected renal colic IX?
non contrast CT KUB
Mx of renal colic?
diclofenac
alpha blocker
>
watchful waiting
active management >5mm
5-10mm renal stones?
shockwave lithotripsy
10-20mm?
shockwave lithotripsy / uretroscopy
why is varicocele a sign of malignancy?
compression of renal vein between abdo aorta and superior mesenteric artery
RCC - most common subtype?
clear cell > arises in proximal renal tubular epithelium
first line investigation for prostate cancer?
multiparameteric MRI
TURP syndrome?
venous destruction and absorption of the irrigation fluid
resultant hypernatraemia