Urology

Question 1

What lobe enlarged in BPH

Answer 1

Median

Question 2

Where does prostate cancer most commonly occur

Answer 2

Posterior lobe

Question 3

First line examination for suspected prostate cancer?

Answer 3

PSA

Biopsy

Question 4

Stag-horn calculi formed of?

Answer 4

Struvite - magnesium ammonium and phosphate
Proteus infection
Urine pH >7.2

Question 5

Most common renal stone?

Answer 5

Calcium oxylate - 85% of stones
Radio-opaque
Urine pH - 6

Question 6

Other renal stones?

Answer 6

Uric acid - 5-10%
Calcium phosphate 10%
Cystine 1%
Struvite 2%

Question 7

Which stone is associated with renal tubular acidosis?

Answer 7

Calcium phosphate

Question 8

What are cystine stones?

Answer 8

Inherited recessive disorder of transmembrane cystine transport
Urine pH 6.5

Question 9

First line for renal colic?

Answer 9

Diclofenac

Question 10

Management renal colic?

Answer 10

Stones <5 mm pass spontaneously
Emergency surgery
Shockwave lithotripsy
Ureteroscopy - pregnant

Question 11

Prevention of calcium oxylate stones?

Answer 11

High fluid intake
Low animal protein diet
Low salt diet
Thiazide diuretics
Cholestyramine 
Pyridoxine

Question 12

How do cholestyramine and pyridoxine work?

Answer 12

Reduce urinary oxylate secretion

Question 13

Imaging modality for renal stone?

Answer 13

Non-contrast CT

Question 14

What stones are radiolucent?

Answer 14

Uric acid

Question 15

Risk factors for renal stones?

Answer 15

Anatomical anomalies
Hypertension
Gout
Dehydration
Drugs
Hot climates
Hyperparathyroidism

Question 16

Management of renal stones?

Answer 16

NSAIDs
Antiemetic
Rehydration
Shock wave therapy

Question 17

What is functional incontinence?

Answer 17

Unable to reach toilet in time

Question 18

What is stress incontinence?

Answer 18

Involuntary leakage of urine on effort or exertion
Incompetent sphincter
Sneezing/coughing

Question 19

What is urge incontinence?

Answer 19

Sudden desire to urinary that cannot be deferred

Detrusor instability

Question 20

What is overactive bladder syndrome?

Answer 20

Urgency that occurs with or without incontinence

Question 21

What is overflow incontinence?

Answer 21

Chronic bladder outflow obstruction

Question 22

What is a neurogenic bladder?

Answer 22

Dysfunction of bladder due to disease of the CNS
Overflow incontinence
Frequency
Urgency
Urge incontinence
Retention

Question 23

Causes of neurogenic bladder?

Answer 23

Peripheral nerve disease
Spinal cord disease
Slipped disc
Neural tube defects
Brain tumour
Stoke
Parkinsons
MS
Syphilis

Question 24

What is flaccid neurogenic bladder?

Answer 24

Large volume
Low pressure
Absent contractions
Spinal cord damage at S2-S4
Overflow incontinence

Question 25

What is spastic neurogenic bladder?

Answer 25

Involuntary contractions Brain damage or spinal cord damage above T12 Overactive bladder

Question 26

Causes of unilateral hydronephrosis?

Answer 26

``` PACT Pelvic-ureteric obstruction Aberrant renal vessels Calculi Tumours of renal pelvis ```

Question 27

Causes of bilateral hydronephrosis?

Answer 27

``` SUPER Stensosis of the urethra Urethral valve Prostatic enlargement Extensive bladder tumour Retro-peritoneal fibrosis ```

Question 28

What is acute epididymo-orchitis?

Answer 28

``` Clinical syndrome of pain, swelling and inflammation of the epididymis with or without inflammation of the testes. Most commonly occurs due to chlamydia Other causes: Gonorrhoea Mumps Coxsackie A E. coli Klebsiella Pseudomonas Syphilis ```

Question 29

Features of epididymo-orchitis?

Answer 29

``` Unilateral scrotal pain Discharge Tenderness Swelling Relief on elevation of testes ```

Question 30

What is testicular torsion?

Answer 30

Torsion of the spermatic cord Occlusion of blood vessels Left side more commonly affected

Question 31

Features of testicular torsion?

Answer 31

``` Sudden severe pain Lower abdominal pain Nausea, vomiting Red, swollen scrotum Retracted testis Absent cremasteric reflex ```

Question 32

What is the cremasteric reflex?

Answer 32

Stroking inner thigh causes retraction of testes

Question 33

What is a hydrocele?

Answer 33

Accumulation of fluid Non-tender Transilluminate

Question 34

Complications of hydrocele?

Answer 34

Wound infection Infertility Testicular atrophy Haematoma

Question 35

What is an epididymal cyst?

Answer 35

``` Smooth Multiple, bilateral Small cysts Transilluminate Can be distinguished from the testis ```