Urology

Question 1

hydroceles features

Answer 1

transilluminate
distinct in size changes

softer /less tense when the patient is lying down (supine)

Question 2

what cyst can you get above the lump of?

Answer 2

epidymal cysts

single / multiple cysts
painless

lie above and behind the cysts

Question 3

which infections predispose to formation of stag horn calculi?

Answer 3

renal pelvis

at least 2 calyces
alkalise urine - proteus infections

Question 4

which drug class is quickest to act in BPH?

Answer 4

alpha 1 antagonist like tamsulosin

Question 5

why does finesteride take 6 month to work?

Answer 5

5-alpha reductase inhibitors take longer to show effects

reduce prostate volume rather than symptom relief

Question 6

most common form of prostate cancer?

Answer 6

adenocarcinoma

Question 7

if a scrotal swelling is separate from testicle then it can’t be?

Answer 7

epididymal cyst
epididymo-orchitis

testiculor tumour

Question 8

most common type of renal cancer?

Answer 8

renal cell carcinoma

• adenocarcinoma

Question 9

spread of RCC?

Answer 9

direct extension

OR

haematogenous
> lung
>bone
>brain

Question 10

LUTs symptoms and pmhx of gonorrhoea?

Answer 10

urethral stricture

Question 11

epididymal cyst presentation?

Answer 11

separate form the body of the testicle

does not transilluminate
separate from body of testes

Question 12

what can help differentiate between ischaemic and non ischaemic priaprism?

Answer 12

cavernosal blood gas analysis

Question 13

in ischaemic priapism

Answer 13

pO2 and pH would be reduced whilst pCO2 would be increased

Question 14

mx of ischaemic priaprism?

Answer 14

aspiration of blood from cavernosa

injection of saline flush

intracavernosal injection of phenylepinephrine

surgery

Question 15

organic causes of erectile dysfunction

most common cause?

Answer 15

vascular

neurogenic
structural / hormonal

Question 16

slidenefil moa?

Answer 16

pde-5 inhibitor

Question 17

when is a referral to urology in the first instance appropriate?

ED

Answer 17

always an issue with achieving erections

absence of morning erections

Question 18

prostatitis

Answer 18

fever and pain in perineum and scrotom

dysuria
urinary frequency

Question 19

acute urinary retention

Answer 19

can happen secondary to UTI

due to swelling
> urethritis

Question 20

acute urinary retention

Answer 20

BPH

stricture/constipation / mass (fibroids)

Question 21

medication to commonly cause urinary retention?

Answer 21

anticholinergics
tricyclic antidepressants
antihistamines
opiods
benzos

Question 22

adults presenting with hydrocele?

Answer 22

refer immediately

for USS to exclude tumour

Question 23

what does hydronephrosis mean?

Answer 23

ureter is completely occluded

urgent decompression needed

JJ stent

Question 24

mx of hydronephrosis?

Answer 24

USS - image

IVU
nephrostomy tube

Question 25

anti androgen treatment needs to be prescribed with?

Answer 25

goserelin synthetic GnRH agonist > give with crproterone acetate

Question 26

seminomas have a better prognosis than teratomas T/F?

Answer 26

true germ cell tumour > more sensitive to radiation and chemo less aggressive

Question 27

cremasteric reflex

Answer 27

genitofemoral nerve carries afferent genital branch carries efferent

Question 28

chronic urinary retention

Answer 28

high pressure presents with impaired renal function and bilateral hydronephrosis

Question 29

if there is a mix storage and voiding symptom issue how to manage?

Answer 29

1st line is tamsulosin ( alpha blocker0 2nd line is alpha blocker with antimuscarinic like tolterodine / darifenac

Question 30

best investigation for hydronephrosis?

Answer 30

USS renal tract

Question 31

prostate cancer co morbid 1st line

Answer 31

watchful waiting

Question 32

hormonal therapy for prostate cancer?

Answer 32

androgen deprivation therapy with radiotherapy > grade 2 and above

Question 33

when is urethral catheter contraindicated?

Answer 33

pelvic trauma urethral stricture hx resistance to passage high riding prostate blood at meatus

Question 34

prostitis management?

Answer 34

14 days of ciprofloxacin

Question 35

bacterial prostitis?

Answer 35

gram negative prostate gland via urethra E.Coli most common isolated pathogen

Question 36

digital rectal examination findings for prostatitis?

Answer 36

tender boggy prostate gland

Question 37

what is a normal post void volume in ptrs >65

Answer 37

<100ml

Question 38

what is a normal post void volume in <65?

Answer 38

50ml

Question 39

vasectomy as contraception

Answer 39

use additional contraception until semen analysis reveals azoospermia > twice > usually atkes 12 weeks