Urology

Question 1

Patient with: acute urinary retention, LUTS, reduced renal fx

Answer 1

Lower urinary tract obstruction - BPH, prostate cnx,

ureter/urethra strictures, neurogenic bladder

Question 2

Complications of urinary tract obstruction

Answer 2

AKI (postrenal)
CKD
infection
dilated kidney/ureters/bladder
pain

Question 3

What is the most common type of kidney tumour and characteristic

Answer 3

Renal cell carcinoma,

cannon ball mets in the lungs are typical

Question 4

What’s the most common RCC type?

Answer 4

clear cell, then papillary, chromophobe, collecting duct carcinoma
Kids - Wilm’s tumour

Question 5

abnormal LFTs with obstructive jaundice picture without localised liver/biliary mets

Answer 5

Stauffer syndrome - RCC

Question 6

Most common type of bladder cancer

Answer 6

90% transitional

–> smoking

Question 7

What are key risk factors for TCC of bladder

Answer 7

aromatic amines, polycyclic aromatic hydrocarbons, arsenic and tetrachloroethylene.

Question 8

Treatment of BPH

Answer 8

alpha blockers eg tamsulosin
5-a-reductase inhibitors eg finasteride

TURP
TUVP
HoLEP
open prostactectomy

Question 9

What does a benign prostate feel like

Answer 9

smooth, symmetrical and slightly soft

vs firm, asym, craggy or irregular with loss of central sulcus

Question 10

Risk factors for prostate cancer

Answer 10

agem fhx, being black, tall and using anabolic steroids

Question 11

Which test is used for progression of prostate cnx and success of tx surveillance?

Answer 11

PSA

Question 12

Causes of Epididymo-orchitis

Answer 12

E. coli
chlamydia trachomatis
neisseria gonorrhea
mumps

Question 13

Important differential to EO

Answer 13

Testicular torsion.

think chlamydia/gonorrhoea with urethral discharge.

Question 14

How long before ischaemia after testicular torsion is irreversible

Answer 14

6hr window

Question 15

Pt - no fixation of testicle to tunica vaginalis

Answer 15

Bell-clapper deformity

Question 16

Types of testicular cancers?

Answer 16

Germ cell cancers:
Seminoma, teratoma
50:50

Question 17

Where does testicular cnx metastasise to?

Answer 17

Lymphatics, lungs, liver brain

Question 18

Most common cause of pyelonephritis?

Answer 18

E. coli

Question 19

Pt with high fever & rigours, loin to groin pain, dysuria and haematuria

Answer 19

pyelonephritis

Question 20

What type are the majority of renal stones?

Answer 20

calcium oxalate 80%

ca phosphate
uric acid (not on xray)
struvite.

Question 21

Dx of renal stones

Answer 21

urine dipstick
bloods for infection and kidney fx
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