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UKMLA > Urology > Flashcards

Urology Flashcards

1
Q

What is BPH

A

Benign prostate hyperplasia

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2
Q

What is BPH caused by?

A

Increased testosterone converting to DHT (dihydrocortisone) causing prostate enlargement

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3
Q

What are the symptom of BPH?

A
  1. Voiding
    - intermittent or weak flow
    - terminal dribbling
    - hesitancy
    - straining
  2. Storage
    -urgency
    - frequency
    - nocturia
    - urge incontinence

Lower urinary tract infection

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4
Q

Investigations for BPH?

A

Urine dip - proteins for renal function, blood for cancer, WCC for infections

U&E - renal and electrolyte imbalances

PSA - cancer?

Urinary frequency-volume chart

IPSS (international prostate symptoms score)

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5
Q

What is the IPSS broken down?

A

Mild 0-7
Moderate 8-19
Severe 20-35

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6
Q

Management for BPH?

A
  1. Watch and wait
  2. Alpha-1antagonist (tamsulosin)
    - decreases smooth muscle tone of the prostate and bladder
    - first line for NICE
    - hypotension, dizziness, dry mouth and depression caused by
  3. 5 alpha-reductase (finasteride)
    - block testosterone to DHT conversion = slows progression
  4. Mixed therapy
  5. Anticholinergics (tolterodine or daeifenacin)
  6. Surgery - TURP
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7
Q

Urinary incontinence causes?

A
  1. Women
  2. Increasing age
  3. Previous pregnancy and birth
  4. Hysterectomy
  5. Family history
  6. BPH
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8
Q

Classification of urinary incontinence (women)?

A
  1. Urge/overactive bladder
    - detrusor muscle overstimulation = leakage from small to complete bladder emptying
  2. Stress incontinence
    - coughing, laughing, sneezing = weak pelvic floor muscles
  3. Mixed incontinence
  4. Overflow incontinence- BPH/bladder obstruction
  5. Functional incontinence - dementia
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9
Q

Initial investigations?

A
  1. Bladder diaries
  2. Vaginal exam for prolapse
  3. Urine dip/culture
  4. Urodynamics studies
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10
Q

Management of urge incontinence?

A
  1. Bladder retraining programme 6 weeks
  2. Bladder stabilising antimuscarinics (oxybutynin for young, mirabegron for old)
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11
Q

Stress incontinence management?

A

Pelvic floor muscle training
Surgical procedure
Duloextine can be used if decline surgery

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12
Q

Where does testicular cancer come from?

A

Germ cells in the testes

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13
Q

What are germ cells?

A

The cells that produce sperm

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14
Q

What are the 2 types of causes of testicular cancer?

A

Seminoma

Non-seminoma

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15
Q

Epidemiology of testicular cancer?

A

20-35

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16
Q

What are type of tumour makes up most of non-seminoma testicular cancer?

A

Teratoma

17
Q

4 risk factors of testicular cancer?

A
  1. Undescended testes
  2. Male infertility
  3. Family history
  4. Increased height
18
Q

Symptoms of testicular cancer?

A
  1. Painless lump
  2. Non tender/reduced/numb lump
  3. Hard irregular non trasnilluminating
  4. Gynaecomastia
19
Q

What tumour in testicular cancer can usually cause Gynaecomastia?

A

Leydig cell

20
Q

What investigations are done for testicular cancer>

A

Scrotal ulrasound

Beta-hCG

Alpha-feta protein in teratomas
LDH (non-specific)

Staging CT

21
Q

Management for testicular cancer?

A

Orchidectomy

Chemo and radiation

22
Q

What scale is used to grade prostate cancer?

A

Gleason scale

23
Q

What is the most common type of cancer of prostate cancer?

A

Adenocarcinoma

24
Q

What does in-situ malignancy (prostate cancer) need?

A

Multiple biopsies

25
Q

What do candidates for active surveillance have?

A
  1. At least 10 biopsies
  2. At least 1 re-biopsy
26
Q

Treatment for prostate cancer/

A

Active surveillance
Radical prostatectomy

27
Q

What symptoms are associated with prostate cancer?

A

Urinary bladder outlet obstruction
Hematuria
Pain in the back or testicles

28
Q

What is the first line investigation for prostate cancer?

A

MRI

29
Q

What is cryptochidism?

A

Undescended testes

30
Q

What are some risk factors of testicular cancer?

A
  1. Mumps
  2. Cryptochidism
  3. Klinefelters syndrome
  4. Infertility
31
Q

Why does Gynaecomastia arise in testicular cancer?

A

In germ-cell tumours there is a release of bHCG this then causes leydig cell dysfunction which increases both oestradiol and testosterone levels but more so oestradiol

32
Q

Which testicular tumour does alpha fetoprotein become elevated in?

A

Non-seminomas

33
Q

What happens treatment wise with a low Gleason score?

A

Watch and wait
- especially if elderley co morbidities

34
Q

What hormonal therapy is given in prostate cancer/

A

Anti-androgens and LHRH

35
Q

What is brachytherapy in prostate cancer?

A

Internal radiotherapy

36
Q

What treatment is given for prostate cancer T1/2

A

Watch and wait
Radical prostatectomy
Radiotherapy - external and brachii therapy

37
Q

What treatment is given for prostate cancer graded T3/4

A

hormonal therapy
Radical prostatectomy
Radiotherapy

UKMLA (11 decks)

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