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
Epididymis cyst
``` 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
Hydrocele
``` Painless, soft fluctuant swelling Can get above it Clear fluid Transilluminate May be presenting feature of testicular cancer ```
27
Testicular torsion
Sudden severe pain Testis tender and pain not eased by elevation Urgent surgery Cremasteric reflex lost
28
Varicocele
Bag of worms Left Bilateral may affect fertility Can be presenting feature of renal cell carcinoma
29
Testicular cancer Most common type
Seminoma
30
Seminoma
Age 40 AFP normal HCG elevated in 10% Lactate elevated in 10-20%
31
Non seminomatous
Age 20-30 AFP elevated in 70% HCG elevated in 40%
32
Risk factors for testicular cancer
``` Cryptorchidism Infertility Family history Klinefelters syndrome Mumps orchitis ```
33
First line in diagnosing testicular cancer
USS then CT for staging Tumour markers
34
Most common histoligical type malignant renal cancer
Clear cell carcinoma
35
Common side effects of ureteric stents in situ
Haematuria | Loin pain
36
Diagnosing bladder cancer - first line
Cystoscopy
37
Stag horn calculi
Struvite - ammonium magnesium phosphate | Form in alkaline urine
38
How long before finasteride makes difference in BPH
6 months
39
Renal stones on X Ray
Cystine - semi opaque Urate and xanthine stones - radiolucent
40
Overactive bladder - drugs
Antimuscarinics
41
Complications of transurethral resection
TURP Tur syndrome Urethral stricture/UTI Retrograde ejaculation Perforation of prostate
42
Why does trimethoprim not work in upper UTI
Doesn't penetrate renal parenchyma
43
Rectal exam too sore
EUA
44
Haematuria after travel abroad
Schistosomiasis
45
Best treatment for urethrocele
Pelvic floor exercises
46
Learn hernias
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