Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CP3 Surgery > Urology > Flashcards

Urology Flashcards

1
Q

List the DDx for ureteric obstrn (3; 11)

A 
Luminal:
Calculus
Blood clot
TCC / Bladder tumour
Papillary necrosis (sloughed e.g. from DM/NSAIDs)
Intramural:
Acquired stricture (Post-TB/Op/Calculus)
Congenital neuromusc dysfunc
Structural abn (megaureter) (1o/2o to e.g. post valves)
Extramural:
External tumour
Retroperitoneal fibrosis
Diverticulitis
AAA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the features of ureteric obstrn (4)

A

Loin pain (worsens with ↑ urine e.g. alc/diuretics)
Palpable hydronephrotic kidney
Infection
Anuria (bilateral) / Polyuria (in chronic, impaired conc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What Ix should be done if suspecting ureteric obstrn (4+3)

A 
Bloods: U+Es inc Creatinine
Urine: dip + MCS
Imaging: 
USS
CT (if USS+ve; determines obstrn level)

AXR (?stones)
VCUG (contrast + AXR)
Radionucleotide (functional)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is ureteric obstrn managed? (2)

A

Stent (idiopathic)

Nephrostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List some RFs for kidney stones (4)

A

Obesity
Dehydration
PMH/FH
Structural abn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 diff ways in which kidney stones may present?

A

Renal Colic
Dull loin pain (if in calyx)
2º UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What Ix should be done if suspecting kidney stones (5)

A

Bloods:
U+Es inc Ca/Phos/Gluc/HCO3/Urate

Urine:
Dip + MCS
bHCG

Imaging:
CT (non-contrast)
AXR (80% show)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Outline the immediate management of kidney stones (4)

A 
A–E inc. IV fluids
IM diclofenac (if not CI)
IM metoclopramide (if severe N+V)
IV Abx (if s/o infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the indications for admission/active tx with renal stones (5)

A 
Severe pain after 1hr
Ongoing obstrn/ low chance spont. passing
Renal insufficiency / Risk AKI
Dx uncertain
S/o shock/infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the medical tx options for renal stones (2)

What are the surgical options (3)

A

Tamulosin (a-blocker) (1st line - stops ureteric spasms)
Nifedipine

ESWL (shock-wave) ± nephrostomy (if hydronephrosis)
Uretoscopy
Percutaneous nephrolithiotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What advice should be given if sending someone home with renal stones (6)

A 
Most (80%) pass naturally
Drink plenty fluids
Return if pain ↑
Return if s/o infection
If 1st stone – try sieve/collect so can analyse
Urology clinic 1wk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the causes of bladder stones (3)

A

BOO
F.O. e.g. prolonged catheter
Upper tract stone passing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How may bladder stones present? (3)

How are they treated? (2)

A 
Anuria / bladder distention
Perineal pain (trigonitis)
UTI Sx (DDx - males penis tip not general pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the RFs for renal cell carcinoma (5 common; 4 rare)

A 
Middle-aged male
Smoking
Obesity
HTN
Prolonged haemodialysis

ADPKD (slight ↑ risk)
Tuberous sclerosis
Occupational exposures
von Hippel-Lindau

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the classic triad of features of renal cell carcinoma
List some other possible features (3)

A

Loin pain
Abdo mass
Haematuria (+ vague B Sx)

Varicocele
Polycythaemia (EPO)
HTN (renin)
Hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What Ix should be done for RCC?(7)

A

Bloods: FBC / UEs / Ca
Urine: cytology

Imaging
USS: solid vs cystic
CT/MRI
CXR (cannon ball mets)
Renal angiography

Invasive: Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In RCC, when may a partial nephrectomy be done instead of radical? (3)

A

If tumour <5cm
If bilateral tumours
If contralateral poor kidney func

18
Q

What are the RFs for TCC (4)

A

Smoking
Chronic cystitis
Previous radiation
Aromatics industry (rubbers/plastics/dye)

19
Q

What Sx may be seen in TCC (4)

A

Painless haematuria ± clots
Recurrent UTI
Voiding Sx
Pain (local invasion) (e.g. suprapubic/buttock/perineal)

20
Q

What Ix are done for TCC (3)

A

Urine MCS + Cytology (sterile pyuria)
Cystoscopy + Biopsy
CT/MRI / Lymphangiography (assess extent)

21
Q

Outline the different managements for different T levels of TCC (in-situ/T1; T2/3/high-grade; T4)

A

in-situ/T1: TURBT (trans-urethral resection bladder tumour) + intra-vesical chemo

T2/3/High-Grade:
Pre-Op chemo + Radical cystectomy w. ileal conduit

T4: Palliative

Pts cured all need long-term FU w. cystoscopy

22
Q

List some intra/extraperitoneal causes of bladder trauma

A

Intraperitoneal trauma:
Laparotomy
Suturing

Extraperitoneal:
Prolonged urethral/suprapubic catheter

23
Q

List some intra/extraperitoneal causes of bladder trauma

A

Intraperitoneal trauma:
Laparotomy
Suturing

Extraperitoneal:
Prolonged urethral/suprapubic catheter

24
Q

List the DDx causes for bladder outlet obstrn (3;7)

A

Luminal:
Bladder stones
Bladder tumour

Mural:
Neuropathic bladder
Congenital abn
Urethral stricture

Extramural:
BPH/Cancer
Para/Phimosis

25
What are the possible features of BOO (4) | What may be seen O/E (3)
Hesitancy / Poor flow / Post-void dribble Suprapubic pain Overflow incontinence S/o infection Enlarged prostate on PR Palpable bladder Palpable hydronephrotic kidney / loin tenderness
26
What Ix should be done for BOO (4) | How is it managed?
``` Bedside: PR Bloods: FBC (infection) / UEs / PSA Imaging: USS (distended/hydronephrosis) CT/MRI ```
27
What tissue is involved in BPH?
Glandular layers of inner transitional zone | Can be nodular/diffuse prolif
28
What are the symptoms of BPH (3 groups)
Storage Sx: Freq/Noct/Dysuria Voiding Sx: hesitancy / incomplete voiding / strangury / poor stream / post-void dribble Complication Sx: Haematuria / Haematospermia UTI Overflow incontinence
29
What Ix should be done into BPH (7)
Bedside: Urine diary (freq/vol) PR Bloods: FBC (exclude UTI) / UEs / PSA Urine: Dip + MCS Uroflowmetry Imaging: USS bladder (pre/post-void) USS transrectal ± biopsy
30
List some complications of BPH (5)
``` UTI Overflow incontinence Bladder calculi Bladder diverticulae Renal failure (bilateral hydronephrosis) ```
31
Outline the lifestyle management of non-acute urinary retention (4)
Dietary: avoid alc/caffeine Voiding: relax + do twice Referral: bladder retraining therapy Watch and wait (for mild sx)
32
What are the medical tx options for BPH (2) + SEs What are the surgical options (2)
Medical: a-Blockers (e.g. tamulosin, doxazosin) SEs inc: hypotension / dizzy / drowsy / depression 5a-reductase inhibitors (e.g. finasteride) SEs inc: impotence / reduced libido Surgical: TURP Holmium laser prostatectomy (endoscopic, for v large)
33
List the post-op risks of a TURP (5)
``` Retrograde ejaculation (100%) Recurrence (repeat in 10yrs) (20%) Impotence (10%) Bleeding TURP syndrome: hyponat/seizures ```
34
List some causes for a raised PSA (7)
``` Prostate cancer (>10 highly suggestive) BPH Vigorous exercise / mountain biking (48hrs) Intercourse (48hrs) Infection (prostatitis) Cystoscopy Urinary retention ```
35
How does Gleason scoring of prostate cancer work? What does D'Amico Risk Stratification of prostate cancer include?
Most prevalent pattern + 2nd most prevalent (both/5) =/10 | D'Amico = Gleason + Clinical stage + PSA more accurate prog
36
Outline the management of prostate cancer in: Localised (T1/2) Advanced (T3/4) Metastatic
Localised: Surveillance (reg PSA/PR/Re-biopsy) Surgery: radical prostatectomy Radio/Brachytherapy Advanced: Surgery / Radio (no diff in outcomes) Metastatic: Hormonal therapy
37
What hormonal therapy is used in prostate cancer? How does it work When is it used?
``` GnRH agonists (inhib pituitary LH ∴ ↓ Testosterone + Anti-androgen (otherwise initial testosterone rise) ``` Used as adjunct / palliative
38
Outline the management of prostate cancer in: Localised (T1/2) Advanced (T3/4) Metastatic
Localised: Surveillance (reg PSA/PR/Re-biopsy) Surgery: radical prostatectomy Radio/Brachytherapy Advanced: Surgery / Radio (no diff in outcomes) / Hormonal Metastatic: Hormonal therapy ± Orchidectomy
39
What hormonal therapy is used in prostate cancer? How does it work When is it used?
``` GnRH agonists (inhib pituitary LH ∴ ↓ Testosterone + Anti-androgen (otherwise initial testosterone rise) ``` Used as adjunct / palliative
40
List the differentials for erectile dysfunction
``` Neurogenic: SC lesion Post-Op nn damage Hypothalamus lesion Cerebral infarct (stroke) ``` Vascular: HTN Arterial disease (Leriche) Psychogenic Endocrine: DM (neuropathy) Pituitary failure ``` Drugs: Alc Tranquilisers Anti-HTNs Oestrogens ```

CP3 Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions