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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?

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
What do candidates for active surveillance have?
1. At least 10 biopsies 2. At least 1 re-biopsy
26
Treatment for prostate cancer/
Active surveillance Radical prostatectomy
27
What symptoms are associated with prostate cancer?
Urinary bladder outlet obstruction Hematuria Pain in the back or testicles
28
What is the first line investigation for prostate cancer?
MRI
29
What is cryptochidism?
Undescended testes
30
What are some risk factors of testicular cancer?
1. Mumps 2. Cryptochidism 3. Klinefelters syndrome 4. Infertility
31
Why does Gynaecomastia arise in testicular cancer?
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
Which testicular tumour does alpha fetoprotein become elevated in?
Non-seminomas
33
What happens treatment wise with a low Gleason score?
Watch and wait - especially if elderley co morbidities
34
What hormonal therapy is given in prostate cancer/
Anti-androgens and LHRH
35
What is brachytherapy in prostate cancer?
Internal radiotherapy
36
What treatment is given for prostate cancer T1/2
Watch and wait Radical prostatectomy Radiotherapy - external and brachii therapy
37
What treatment is given for prostate cancer graded T3/4
hormonal therapy Radical prostatectomy Radiotherapy

UKMLA (14 decks)

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