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SHU > Urology > Flashcards

Urology Flashcards

1
Q

What are the three sites of anatomical ureteric narrowing?

A
  1. Ureteropelvic junction
  2. Ureteral crossing of iliac veins
  3. Ureterovesicular junction
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2
Q

What are the indications for outpatient treatment of ureteric stones?

A

First episode
Pain free (or managed with oral NSAIDs)
No evidence of infection
Stone <4mm diameter (90% spontaneously pass)

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3
Q

What is the first-line treatment for the removal or ureteric stones?

A

Ureteroscopy and laser lithotripsy

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4
Q

What are the differentials for frank haematuria?

A

Transitional cell carcinoma (bladder or ureters)
Renal cell carcinoma
Trauma (catheter, procedure)
Prostatitis

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5
Q

What are the symptoms of urinary obstruction?

A 
Hesitancy
Poor stream & intermittent flow
Terminal dribbling
Incomplete emptying
Overflow incontinence (if severe)
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6
Q

What are the irritative or filling urinary symptoms?

A

Increased frequency (including nocturia)
Urgency
Painful urination

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7
Q

Which zone of the prostate is affected by prostate cancer?

A

Peripheral

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8
Q

Which zone of the prostate is affected by BPH?

A

Transitional

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9
Q

What pharmacological management is available for the treatment of BPH?

A 
Andrenoreceptor blockers (e.g. prazocin)
5-alpha reductase inhibitors (e.g. finasteride)
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10
Q

What pharmacological management is available for the treatment of prostate cancer?

A

Androgen deprivation therapy (chemical castration)

= LHRH agonist (goserelin), covered with anti-androgen for first 7 days during the flare

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11
Q

How does TCC typically present?

A

Painless haematuria or recurrent UTIs

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12
Q

What are the components of the spermatic cord?

A

3 arteries: cremasteric, deferential, testicular
3 nerves: genital branch of genitofemoral, autonomic + visceral afferent fibres
3 fascial layers: external + external spermatic, cremasteric
3 others: pampiniform plexus (venous), vas deferens (sperm), lymphatics

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13
Q

What is the lymph drainage of the testes?

A

Para-aortic lymph nodes

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14
Q

What are the testicular germ cell tumours

A

Seminomas (40%)
Non-seminomas/teratomas (10%)
Mixed (40%)

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15
Q

Which testicular tumours can secrete beta-HCG and alpha-fetoprotein?

A

Non-seminoma germ cell tumours (teratomas)

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16
Q

What are the non-germ cell tumours?

A

Leydig cell tumour
Sertoli cell tumour
Lymphoma

17
Q

Which is the more common testicular malignancy: germ cell or non-germ cell tumour?

A

Germ cell tumour

18
Q

What is the biggest risk factor for testicular torsion?

A

Bell-clapper deformity (congenital inadequate testis fixation)

19
Q

What type of incontinence is tension-free vaginal tape used to treat?

A

Stress incontinence

20
Q

What type of incontinence can be treated with antimuscarinics?

A

Urge and mixed incontinence

21
Q

Positive alpha-fetoprotein makes which testicular tumour type much less likely?

A

Seminoma

22
Q

Are varicocele’s more common in the left or right testicle?

A

Left (drains to renal vein at a right angle)

23
Q

What may be the cause of a scrotal lump that becomes more prominent on standing?

A

This is the classical presentation of a varicocoele

24
Q

What is the most appropriate treatment for a renal cell carcinoma that does not show any signs of spread?

A

Nephrectomy

25
Q

What is the investigation of choice for gross haematuria?

A

Abdomen + pelvis CT

26
Q

Why is a pelvic CT indicated before catheterising a patient with a pelvic fracture?

A

To identify any urethral damage that may have resulted from the fracture

27
Q

What are the types of urinary incontinence?

A 
Storage Problems:
- Urge / Overactive Detrusor
- Stress
Emptying Problems (overflow):
- Obstruction
- Underactive Detrusor
Functional Problems:
- Impaired Mobility
- Mental Disorder
28
Q

What are the potential complications of recurrent UTIs?

A

Renal scarring and failure (from pyelonephritis)
Staghorn calculi
Perinephric abscess
Prostatitis (males)

29
Q

What is the definition of recurrent UTIs?

A

3+ episodes of culture-confirmed UTI in past 12 months OR

2+ episodes of culture-confirmed UTI in past 6 months

30
Q

Which urological tumour is found in a greater frequency amongst workers in aniline dye industries?

A

Urothelial tumours

SHU (10 decks)

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