Urology

Question 1

Bacterial causes for epididymitis nmeumonic

Answer 1

CENT
Chlamydia trachomatis
E. coli
Neisseria gonorrhoeae
TB

Question 2

Rate of ED after TURP

Answer 2

~10%

Question 3

% of non retractable foreskin at 0, 3, 5 and 10 years old

Answer 3

100%
30%
10%
1%

Question 4

Mechanism of action of Viagra

Answer 4

phosphodiesterase inhibitors
Normal physiological process is NO release, causing cGMP, leading to smooth muscle relaxation in B vessels around corpus cavernosum
PDE inhibitors prevent breakdown of cGMP so maintain erection

Question 5

Lifetime recurrence rate following kidney stone and dietary advice

Answer 5

70%

Question 6

Patient treated for BPH going for cateracts operation…what do you need to consider

Answer 6

Tamsulosin must be stopped prior to cateracts surgery due to risk of floppy iris syndrome

Question 7

Mechanism of action of loop diuretics

Answer 7

Eg furosemide
Competitively inhibit Na+ K+ 2Cl- symporter in thick ascending limb, preventing reabsorption.
Calcium and magnesium reabsorption in thick ascending limb is dependent on a positing lumen gradient, from K+
So there is decreased calcium and mag reab
–> so exacerbate renal stones

Question 8

Enlarged kidney causes……..mnemonic

Answer 8

SHAPE

Scleroderma
HIV Nephropathy
Amyloidosis
PKD 
Endocrinopathy (diabetes)

Question 9

Drugs that can predispose renal stones and mechanism

Answer 9

Loop diuretics (decrease calcium reab)
Aspirin (increases uric acid formation – same as contra in gout)
Lithium (TFT effect? Hyperthy can cause stones)
Vit D

Question 10

Risks of prostate biopsy

Answer 10

Main risks are bleeding, infection, urinary retention. ~10% have one of these
Give Ciprofloxacin before procedure but still ~3% go to hospital after

Question 11

Cancer types of ureter

Answer 11

Transitional cells

Obstruction from other cancers

Question 12

Bladder cancer types

Answer 12

Transitional cell
Adenocarcinoma
Sqaumous

Question 13

Prostate cancer types

Answer 13

Adenocarcinoma usually

Question 14

Urethra cancer, what cells does it involve?

Answer 14

Squamous cell Carcinoma (Lined by squamous cells distal to prostate)

Question 15

Why is varicocele more common in left testi

Answer 15

R testicular vein generally joins the IVC
L testicular vein, unlike the right one, joins the left renal vein
Testicular arteries arise from the AA descending through inguinal canal

Question 16

Complication of urostomy

Answer 16

In ileal conduits (urostomy) the urine passes through an ileal segment.
Therefore gut bacteria may colonise the ureters
Resulting in ascending UTIs and renal infection

Question 17

LN drainage of testis

Answer 17

paraaortic lymph nodes (scrotum is inguinal)

Question 18

New hydrocele in young man, investigation

Answer 18

USS as sometimes secondary to testicular Ca

Question 19

Testicular cancer blood tests requested

Answer 19

Serum markers are AFP (75% of teratomas, 0% seminomas) 
HCG (60% teratomas, 7% seminomas)
USS 
CXR
CT abdo (paraaortic LN)

Question 20

Finasteride SE

Answer 20

ED and deceased libido and gynaecomastia

Question 21

Causes of Hydronephrosis unilateral

Answer 21

Unilateral PACT
Pelvic uteric obstruction
Aberrant renal vessels
Calculi
Tumours of renal pelvis

Question 22

Causes of bilateral hydronephrosis

Answer 22

SUPER
stenosis of urethra
Urethral valve
prostatic enlargement
extensive bladder tumour
retroperitoneal fibrosis