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Boards 2 > Urology > Flashcards

Urology Flashcards

1
Q

What are common complaints of retinal detachment?

A
  • scotoma
  • curtain-like blindness
  • sudden onset of floaters.
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2
Q

Clinical findinds suggesting Huntington’s

A

Chorea

mood changes

cognitive dysfunction

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3
Q

What disorder presents with the triad of cognitive impairment, urinary incontinence, abnormal gait?

A

Normal pressure hydrocephalus

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4
Q

Causes of calcium oxalate stones.

A

Hypercalciuria, Hyperoxaluria, ethylene glycol ingestion

Most common renal stone, Hydration to help minimize.

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5
Q

Calcium phosphate stones d/t

A

Hyperparathyroidism and renal tubular acidosis

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6
Q

Cystine renal stones

A

Due to cystinuria.

(+) staghorn calculi.

Hereditary form, and therefore difficult to treat

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7
Q

What is the most appropriate approach to renal stone treatment.

A
  • < 5mm: IVF and analgesia
  • < 7mm = medication expulsive tx
    • CCB - amlodipine
    • a-blocker - terazosin.
  • <1.5 cm = requires break down.
    • ureteroscopy - distal stone
    • Lithotripsy - proximal stone
  • > 1.5 cm = surgical retrieval
  • If obstructive sepsis is present = emergent decompression
    • stent for distal disease
    • nephrostomy for proximal disease
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8
Q

Cystitis

Pt, Dx, Tx

A
  • Pt
    • suprapubic pain, dysuria, frequency, urgency.
  • Dx
    • UA:
      • E.coli, S.saprophyticus, Enterobacter, Klebsiella, Proteus,
      • (+) cather = pseudomonas.
  • Tx
    • Uncomplicated:
      • nitrofurantoin, TMP-SMX, Fosfomycin
    • Complicated
      • Ciprofloxacin, levofloxacin.
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9
Q

Urge incontinence Tx

A

Darifenacin

Fesoterodine

Oxybutynin

solifenacin

tolterodine

trospium.

ADR: constipation, dry mouth, cognitive deficits in elderly.

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10
Q

Stress incontinence

Tx

A
  1. Kegel exercises
  2. Weight loss
  3. Pessary
  4. Duloxetine
  5. Midurethral sling surgery
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11
Q

Overflow incontinence

Tx

A
  1. Dx
    1. post-void residual volume > 50mL
  2. Tx
    1. decompress via catheter
    2. assess for obstruction
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12
Q

Most common form of bladder cancer in the US?

A
  1. Transitional cell carcinoma
  2. SCC - typically not in US. Associated w/ schistosoma heamatobium
  3. Adenocarcinoma- typically along dome of the bladder, via the urachal remnant.
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13
Q

What is the Tx for epididymitis in following age groups:

< 35.

>35.

A
  • < 35 = GC/chlamydia
    • ceftriaxone IM + doxycycline x10d
  • > 35 = enterobacteriaceae
    • fluoroquinolone x 10-14d.
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14
Q

Testicular cancer

A
  • 95% are germ cell
    • seminomatous, nonseminomatous
  • 5% are stromal
    • leydig cells
    • Sertoli cell
    • Granulosa cell
  • Pt
    • painless, firm testicular mass.
    • Metastasis along: retroperitoneal to mediastinal LN.
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15
Q

Testicular cancer lab work and treatment

A
  • Labs
    • high B-hCG = choriocarcinoma
    • AFP = yolk sac tumor
    • Estrogen = stromal cell tumor
  • Tx
    • seminoma - stage 1 = radical orchiectomy
    • seminoma - Stage 2 = chemotherapy
    • Nonseminoma early = surveillance
    • Nonseminoma late = retroperitoneal LN dissection +/- chemotherapy
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16
Q

Medical management for erectile dysfunction

A
  1. phosphodiesterase inhibitors
    1. sildenafil
    2. vardenafil
    3. tadalafil
  2. self injection penile
    1. papaverine, phentolamine, alprostadil
  3. Vacuum/ constriction device.
  4. penile prosthetic implants
17
Q

Most common cause of acute prostatitis

A
  • E. coli
  • proteus, klebsiella, serratia, pseudomonas, enterobacter
  • gonorrhea, chlamydia w/ urethritis

Tx: bactrim(1st), Fluoroquinolone (2nd)

18
Q

Chronic pelvic pain syndrome

A

>3 mon pain in perineum, back, and testes.

  • Dx of exclusion
  • Tx
    • a-blocker (tamsulosin)
    • Ciprofloxacin (6wk)
    • 5a-reductase inhibitor: mostly for older men only.
19
Q

Treatment for BPH

A
  1. A1 antagonist
    1. terazosin, doxazosin, tamsulosin
    2. relaxes smooth mm in bladder neck
    3. risk of postural hypotension.
  2. 5a-reductase inhib
    1. finasteride, dutasteride.
    2. blocks testosterone to DHT conversion. Reduces prostate size.
    3. ADR of low libido, ED, lower PSA
  3. Phosphodiesterase inhib: tadalafil
    1. improve urinary symptoms.
  4. anticholinergics
    1. reduce urgency/frequency.
  5. Surgery
    1. TURP, radiofrequency ablation (best outcome)
20
Q

Classic symptoms of BPH

A
  • increase frequency
  • reduced urine stream strength
  • (+) end dribbling
  • (+) urinary retention
21
Q

Which two classes are used to treat BPH most often?

A
  • A1-antagonist
    • tamsulosin, terazosin
  • 5a-reductase inhibitor
    • finasteride, dutasteride.

Boards 2 (10 decks)

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