Urology Flashcards
What is the treatment for uric acid stones?
-alkalinize the urine with potassium citrate or bicarbonate
Which stones are radiolucent?
Uric acid stones (U=unseen)
Best imaging for kidney stones?
CT abd without contrast
What is the most common site for renal stone impaction?
ureterovesicular junction
Tx of uncomplicated cystitis?
- Nitrofurantoin x 5 days
- Bactrim x 3 days
- fosfomycin x 1
Tx for urethritis in men?
- Ceftriaxone IM x 1
- Doxycycline or Azithromycin PO
Risk for bladder cancer?
- Smoking!
- Schistosomiasis (squamous cell cancer)
Which side varicocele is more common? What should be suspected in a patient with the uncommon sided varicocele?
- Left is more common
- Right sided varicocele may indicate a renal cell carcinoma.
What can a hydrocele result from?
A patent processus vaginalis
What is the likely cause of epididymitis in a patient older than 35 yo or with a h/o anal intercourse? Tx?
- Enterobacteriaceae
- FQ x10-14 days
What is the likely cause of epididymitis in people
- GC/chlamydia
- IM ceftriaxone and doxycycline
How quickly does testicular torsion need to be addressed?
6 hours
Which testicular cancer is associated with an elevated beta-HCG?
Choriocarcinoma
Which testicular cancer is associated with an elevated alpha fetoprotein?
Yolk sac (nonseminomatous)
Which testicular cancer is associated with an elevated estrogen?
Stromal (Leydig, servoli, granulosa)
What is the most common cause of acute bacterial prostatitis?
E. coli
What is the treatment for chronic pelvic pain syndrome/chronic prostatitis?
- alpha blockers
- ABX (Cipro) x 6 weeks can help
What is the treatment for BPH?
- 1st line: alpha 1 adrenergic antagonists (tamsulosin)
- 2: 5alpha reductase inhibitors (finasteride)
- PDE5 inhibitor (tadalafil can help too)
Tx of acute bacterial prostatitis?
-Bactrim or FQ
What medication can be given to a patient with metastatic prostate cancer?
GnRH analog (leuprolide or goserelin)
Which types of HPV cause cancers?
16 and 18 (most commonly)
6 and 11 cause genital warts
Multiple vesicles on an erythematous base?
HSV
What are the 3 main findings associated with tertiary syphilis?
- Tabes dorsalis
- Argyll-Robertson pupil
- General paresis (progressive dementia)
Which cardiovascular problems can be associated with tertiary syphilis?
- Aneurysms of the ascending aorta
- aortic valve insufficiency
How can syphilis be diagnosed?
- screening: RPR and VDRL (not specific)
- Confirmatory: FTA-ABS, MHA-TP
- can sometimes see on dark-field microscopy or direct fluorescent antibody (DFA)
How does the treatment differ for primary, secondary, early tertiary, late syphilis and neurosyphilis?
- all get PCNG
- 1, 2, early 3: PCN G x1
- Late 3: 3 x weekly PCN G IM
- Neurosyphilis: PCN G IV x 10-14 days
Erythematous papule –> pustule –> painful ulcer with a purulent base with painful inguinal LAD? Bug?
Chancroid (Haemophilis ducreyi)
-Tx: ceftriaxone or Azithromycin
(gram stain shows “school of fish” pattern)
Painless dick ulcer –> resolves spontaneously –> unilateral inguinal LAD with bubo formation and “groove sign” (LAD above and below inguinal ligament)? Bug?
Lymphogranuloma venereum (C. trachomatis L1-L3)
Tx of lymphogramuloma venereum?
-doxycycline
Painless nodule(s) –> shallow, painless ulcer(s) with a beefy-red base?
Granuloma inguinale (donovanosis)
Tx of donovanosis?
Azithromycin
Gram - rods in a “school of fish” pattern?
chancroid (H. ducreyi)
