Urology Flashcards
Narrowest 3 points of ureters
Uteropelvic junction
Pelvic brim
Vesicoureteric junction
Types of renal stones
Calcium oxalate (75%), magnesium ammonium phosphate (15%), urate, hydroxyapatite
Presentation of renal stones
Renal colic, n+v, bladder irritation, pain in genitals, dysuria, UTI symptoms, haematuria, proteinuria, sterile pyuria, anuria
Investigation of renal stones
FBC, U+E, urine dip, MSU for MC+S, spiral non contrast CT, XR KUB, USS for hydronephrosis
Management of renal stones
Analgesia - diclofenac
stones <5mm pass with increased fluid intake
>5mm - nifedipine/tamsulosin,
Extracorporeal shockwave lithotripsy, uteroscopy, percutaneous nephrolithotomy
Causes of urinary tract obstruction
Luminal - stones, blood clots, tumour
Mural - stricture, neuromuscular problem
Extramural - abdominal/pelvic mass/tumour, peritoneal fibrosis
Causes of acute urinary retention
Prostatic, urethral strictures, anticholinergics, alcohol, constipation, neurological
What is BPH?
Benign nodular or diffuse proliferation of musculofibrous and glandular layers of the prostate. Inner transition zone enlarges
Presentation of BPH
Storage symptoms - frequency, urgency, nocturne
Voiding symptoms - Hesitancy, Intermittent/incomplete emptying, post void dribbling, poor flow
Investigations for BPH
PR exam, FBC, U+Es, TRUSS, PSA
Treatment of BPH
lifestyle - avoid alcohol, caffeine
alpha blockers first line - tamsulosin (decrease smooth muscle tone, s/e - drowsy, dizzy, dry)
5a-reductase inhibitors - finasteride
Surgical - TURP, TUIP
Features of RCC
haematuria, loin pain, abdo mass, anorexia, malaise, weight loss
Investigations of RCC
BP (raised from renin), FBC (polycythaemia from increase in EPO), ESP, U+Es, ALP, urine rbcs, US, CT, MRI, CXR (cannonball metastases)
Management of RCC
Radical nephrectomy, biologics
Most common prostate cancer
Adenocarcinoma arising from peripheral prostate
