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Revision lectures > Urology > Flashcards

Urology Flashcards

1
Q

Most common type of kidney stone

A

Calcium oxalate

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2
Q

Pain relief in renal colic

A

IM Diclofenac

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3
Q

Imaging in renal stones

A

Initially USS

Diagnostically non contrast CT KUB

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4
Q

Stone management

<5mm

A

Usually pass spontaneously within 4 weeks

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5
Q

Stone management

Stone burden of less than 2cm in aggregate

A

Lithotripsy

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6
Q

Stone management

Stone burden of less than 2cm in aggregate in pregnant

A

Ureteroscopy

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7
Q

Stone management

Complex renal calculi and staghorn calculi

A

Percutaneous nephrolithotomy

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8
Q

Prevention of renal stones

A

Reducing calcium stones

  • High fluid
  • Thiazides diuretics

Reducing oxalate stones

  • cholestyramine
  • pyridoxine

Reducing uric acid stones

  • allopurinol
  • urinary alkalisation eg oral bicarbonate
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9
Q

Causes of unilateral hydronephrosis

A

PACT

Pelvic ureteric obstruction
Aberrant renal vessels
Calculi
Tumours of renal pelvis

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10
Q

Causes of bilateral hydronephrosis

A

SUPER

  • Stenosis of the urethra
  • Urethral valve
  • Prostatic enlargement
  • Extensive bladder tumour
  • Retro peritoneal fibrosis
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11
Q

Investigation of hydronephrosis

A

USS

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12
Q

Management of hydronephrosis

A

Remove obstruction and drainage of urine

Acute upper - nephrostomy
Chronic upper - ureteric stent or pyeloplasty

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13
Q

Renal cell cancer associations

A

More common in middle aged men
Smoking
Von Hippel Lindau syndrome
Tuberous sclerosis

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14
Q

Features of renal cell cancer

A

Classical Triad - haematuria, loin pain, abdo mass

Pyrexia 
Left varicocele
Endocrine effects (polycythaemia, hypercalcaemia, renin, ACTH)
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15
Q

Bladder cancer risk factors

A

Transitional

  • smoking
  • aniline dyes
  • rubber
  • cyclophosphamide

Squamous

  • schistosomiasis
  • BCG treatment
  • smoking
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16
Q

BPH ethnicity

A

Black > white > Asian

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17
Q

First line for BPH

A

Alpha 1 antagonists - tamsulosin, alfuzosin

Decrease smooth muscle tone

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18
Q

Second line BPH

A

5 alpha reductive inhibitors eg finasteride

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19
Q

Side effects of alpha-1 antagonists

A

Dizziness, postural hypotension, dry mouth, depression

20
Q

Side effects of 5 alpha reductive inhibitors

A

Erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia

21
Q

PSA levels may be raised by

A 
BPH
Prostatitis and UTI
Ejaculation in last 48hrs
Vigorous exercise in last 48hrs
Urinary retention
Instrumentation of the urinary tract
22
Q

Inguinal hernia

A

Inguinoscrotal swelling
Cannot get above it
Cough impulse may be present
May be reducible

23
Q

Testicular tumours

A

Often discrete nodule

USS scrotum and serum AFP and BHCG

24
Q

Acute epididymo-orchitis

A

Often history of dysuria and discharge
Swelling may be tender and eased by elevating testes
Most cases due to chlamydia

Non infective cause - amiodarone

25
Q

Epididymis cyst

A 
Single or multiple
Usually occur over 40
Painless
Lie above and behind testes
Usually possible to get above lump

Associated - PKD, CF, Von Hippel Lindau

Confirm diagnosis with USS

26
Q

Hydrocele

A 
Painless, soft fluctuant swelling
Can get above it
Clear fluid
Transilluminate
May be presenting feature of testicular cancer
27
Q

Testicular torsion

A

Sudden severe pain
Testis tender and pain not eased by elevation
Urgent surgery
Cremasteric reflex lost

28
Q

Varicocele

A

Bag of worms
Left
Bilateral may affect fertility
Can be presenting feature of renal cell carcinoma

29
Q

Testicular cancer

Most common type

A

Seminoma

30
Q

Seminoma

A

Age 40

AFP normal
HCG elevated in 10%
Lactate elevated in 10-20%

31
Q

Non seminomatous

A

Age 20-30

AFP elevated in 70%
HCG elevated in 40%

32
Q

Risk factors for testicular cancer

A 
Cryptorchidism
Infertility
Family history 
Klinefelters syndrome
Mumps orchitis
33
Q

First line in diagnosing testicular cancer

A

USS

then CT for staging

Tumour markers

34
Q

Most common histoligical type malignant renal cancer

A

Clear cell carcinoma

35
Q

Common side effects of ureteric stents in situ

A

Haematuria

Loin pain

36
Q

Diagnosing bladder cancer - first line

A

Cystoscopy

37
Q

Stag horn calculi

A

Struvite - ammonium magnesium phosphate

Form in alkaline urine

38
Q

How long before finasteride makes difference in BPH

A

6 months

39
Q

Renal stones on X Ray

A

Cystine - semi opaque

Urate and xanthine stones - radiolucent

40
Q

Overactive bladder - drugs

A

Antimuscarinics

41
Q

Complications of transurethral resection

A

TURP

Tur syndrome
Urethral stricture/UTI
Retrograde ejaculation
Perforation of prostate

42
Q

Why does trimethoprim not work in upper UTI

A

Doesn’t penetrate renal parenchyma

43
Q

Rectal exam too sore

A

EUA

44
Q

Haematuria after travel abroad

A

Schistosomiasis

45
Q

Best treatment for urethrocele

A

Pelvic floor exercises

46
Q

Learn hernias

A

Write this card pls

Revision lectures (15 decks)

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