Urology

Question 1

Markers for non-seminomatous testicular cancer

Answer 1

alpha feto protein and beta HCG

Question 2

Testicular mass: biopsy is ____ via ____

Answer 2

orchiectomy via inguinal incision— never trans-scrotal (Every year)

Question 3

_________ (cancer) is very radiosensitive= even stage I gets RT (___% have occult mets)

Answer 3

seminoma; 25% w occult mets

Question 4

seminoma:

Node + gets _______; usually ages ______; most tumors are ___ (benign/malignant); ___ (rare/common) in african/americans

Answer 4

platinum chem; ages 20-35; tumors malignant; rare in african-americans

Question 5

Cryptoorchidism: ___ incr/decr cancer risk by ___ fold.

Orchiopexy does ____ but does not ____. When to operate?

Answer 5

incr testicular ca x 3-14. orchiopexy incr fertility but does not decr cancer risk; do age ~2 years

Question 6

Testicular torsion rx?

Answer 6

Rx with bilateral orchiopexy

Question 7

Varicocele: remember L gonandal vein drains to….. think about…..

Answer 7

L gonadal vein drains to L renal vein (may be obstructed by renal cell CA)

Question 8

Ureteral injury: avoid _________, use ______, rx?

Answer 8

(iatrogenic or otherwise): avoid ureteral dissection (compromise blood supply), use absorbable suture (otherwise nidus for stones as with bile duct); stent and drain

Question 9

Urethral injury: suspect with _____, ___, ____; dx with ____; 1st rx is ____

Answer 9

suspect with blood at the meatus, scrotal/penile injury, high-riding prostate. dx with retrograde urethrogram (RUG); 1st rx is DO NOT place foley-> needs suprapubic cath

Question 10

Bladder injury: when with pelvic fx, usally _____ and ____ (rx); If NO pelvic fx, is usually ____ and _____ (rx)

Answer 10

pelvic fx- extraperitoneal, generally need foley drainage only; NO pelvic fx- usually dome rupture (full bladder in MVA); needs OR, 3 layer closure, keep foley

Question 11

Prostate cancer: mets to _____ are ______

Answer 11

mets to bone are osteoblastic, radio-dense

Question 12

____________ most common (especially after small bowel resection); ______ (elements)

Answer 12

oxalate stones; Mg Am Ph 15%, urate 8%

Question 13

_____-> struvite stones, “staghorn”. Why?

Answer 13

Proteus infection; (urease producing)

Question 14

RCC triad

Answer 14

abdominal pain (capsule stretching), mass, hematuria

Question 15

RCC: can see these effects….

Answer 15

erythrocytosis due to incr erythropoetin; fever; HTN; stouffer syndrome (decr hepatic flow)

Question 16

Erythropoetin: ___% made in ____; stimulated by ___; decr production in ____

Answer 16

95% made by kidney; stimulated by hypoxia, decr production in ESRD