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Finals > Urology > Flashcards

Urology Flashcards

1
Q

most common type of bladder cancer and risk factors

A

transitional cell carcinoma

smoking, azo dyes, rubber industry, male, cystitis

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2
Q

associations of squamous cell bladder carcinoma

A

schistosomiasis (swimming in rivers)

BCG

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3
Q

what do you do if find microscopic haematuria

A

if >60, rule out UTI and investigate

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4
Q

investigations in haematuria

A

FBC, clotting , U&E, PSA
urinalysis and cytology
flexible cystoscopy + biopsy
CT urography

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5
Q

management of a local bladder cancer

A

TURBT

intrathecal mitomycin / BCG

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6
Q

management of a locally invasive bladder cancer (i.e. muscle wall)

A

cystectomy and ileal conduit

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7
Q

monitoring of post op bladder cancer

A

regular flexi cystoscopy

high chance of recurrence

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8
Q

most common type of prostate cancer and location

A

adenocarcinoma of peripheral zone

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9
Q

where does prostate Ca metastesise to?

A

obturator and internal iliac lymph nodes

bone

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10
Q

investigations in prostate cancer

A 
DRE -hard , irregular, nodular
PSA - do before DRE
urinalysis
biopsy
TRUSS
isotope bone scan 
gleeson staging
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11
Q

what staging is used in prostate cancer

A

gleeson

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12
Q

management of local prostate cancer

A

watch and wait - active surveillance (DRE +PSA)

TURP / radical prostatectomy

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13
Q

management of metastatic prostate cancer

A

TURP / orchidectomy
RT : external beam / brachytherapy
GnRH analogues: goserelin
anti androgens

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14
Q

investigations in BPH

A

DRE - smooth, tender, nodular, >30g
PSA
urinalysis
international prostate symptom score

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15
Q

management of BPH according to international prostate symptom score

A

<7: WW
8-19 : Tamsulosin (alpha blocker - can cause P. HTN)
>19.5: finasteride (5 alpha reductase i ), TURP

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16
Q

testicular tumour in a 35-65 year old, most likely to be..?

+ associations

A

seminoma

normal AFP, high FAP, radiosensitive - RT

17
Q

testicular tumour in a young man (<30) likely to be..?

+ associations

A

non seminoma (yolk sac, teratoma, choriocarcinoma)
high beta HCG and AFP
needs chemo / orchidectomy

18
Q

risk factors for testicular cancer

A

cryptorchidism, klinefelter’s, mumps orchitis, infertility, FHx

19
Q

what is cryptorchidism and management

A

testes not descended by 3 months of age

fix by 6-18 months

20
Q

what is the most common type of kidney stone?

A

calcium oxolate

21
Q

what is in struvite stones and what causes it

A

magnesium, phosphate, ammonia

urease producing bacteria : klebsiella, proteus

22
Q

risk factors for kidney stones

A

dehydration, metabolic disturbance, congenital abnormality, structural abnormality eg. strictures, gout, obesity, immobility, hypertension, hyperparathyroidism, FHx

23
Q

which kidney stones are radio- opaque

A

calcium oxalate and calcium phosphate

24
Q

which kidney stones are associated with alkaline urine (>7)

A

struvite

25
Q

which kidney stones are associated with acidic urine and are radiolucent

A

uric acid

26
Q

investigations in kidney stones

A

FBC, U&E, eGFR, CRP, calcium, phosphate , urate
urinalysis/ MSU
NON CONTRAST CT

27
Q

management of kidney stones

A 
analgesia: PR diclofenac
tamsulosin (alpha blocker)
nifedipine (CCB)
EWSL
ureteroscopy and laser
28
Q

what is stress incontinence

A

reduced sphincter tone (S2,3,4 and pedundal nv)

29
Q

management of stress incontinence

A 
life style advice
pelvic floor exersizes
physio
ring pessary
Duloxetine
surgery - tape/ colposuspension
30
Q

what is urge incontinece

A

overactive detrusor (sympathetic NS)

31
Q

management of urge incontinence

A 
lifestyle advice
6 weeks bladder training
Oxybutynin - antimuscarinic
Mirabegron (B3 adrenergic receptor blocker)
botulinum toxin injections
32
Q

investigations in incontinence

A

neuro, vaginal and PR exam
MSU
post void residual volume
urodynamics / flow studies

33
Q

causes of unilateral hydronephrosis

A

obstruction, stones, tumours

34
Q

causes of bilateral hyrdronephrosis

A

urethral stenosis, BPH, prostate/bladder ca

35
Q

associated presentation of renal cell carcinoma

A 
haematuria
polycythaemia due to raised EPO
hypercalcaemia due to raised PTH
hypertension
raised ACTH - cushing's
lung, bone and brain mets
36
Q

presentation of testicular torsion

A

pain, change in colour, retracted, loss of cremasteric reflex

37
Q

management of testicular torsion

A

urgent surgical review

+/- doppler USS

Finals (18 decks)

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