Urology

Question 1

What investigation is done for refluc?

Answer 1

MCU

Question 2

Is Creatinine an early or late sign of renal impairment?

Answer 2

Late

Question 3

What does RAAS activation cause?

Answer 3

Vasoconstrictoin
Fluid retention (aldosterone)

Question 4

Does para or sympa make you pee?

Answer 4

Para makes you pee

S2-4- muscarinics

Question 5

What is used to manage urge incontinence?

Answer 5

Antimuscarinics

Oxybutynin

Question 6

What part of prostate is affected in BPH?

Answer 6

transitional zone

Smooth and enlarged

Question 7

What are red flags for LUTs for prostate cancer/

Answer 7

Haematuria
Persistant UTI
Decreased renal function
Saddle anaethesia
Abnormal neurology

Question 8

How is BPH investigated?

Answer 8

U&E
PSA
Urine dip
Bladder scan for retention volume
USS for hydronephrosis
Plain film Xray

Question 9

How is BPH managed conservatively?

Answer 9

Limit caffeine

Stop diuretics

Question 10

What is medical management of BPH?

Answer 10

ALPHA blockers- Tamulosin to relax smooth muscle

5alpha reductase inhibitors- FINASTERIDE to stop hyperplasia of the gland

Question 11

What are side effects of alpha blockers?

Answer 11

headache
postural hypotension
swollen legs and hands
delayed ejaculation

Question 12

What are side effects of finasteride?

Answer 12

whole body affected as all organs testosterone works on

Question 13

How is BPH surgically managed?

Answer 13

TURP

Core out middle of prostate

Question 14

What are side effects of TURP?

Answer 14

Incontinence
Bleeding
Infection
Erectile dysfunction
Impotence
Penis size change
Retrograde ejaculation

Question 15

What is TUR syndrome?

Answer 15

Fluid oberload and hyponatreamia during TURP surgery form fluid absobred
rare but life threatening

Question 16

How many mls constitutes retention?

Answer 16

> 800

Question 17

What are male and female and both causes of retention?

Answer 17

Male: PBH, prostate cax, Stricture, abscess
Female: Prolapse, pregnancy, pelvic mass
Both: Blood clots, cauda equina, MS, HSV, transverse myelitis

Question 18

What kind of cancer is prostate?

Answer 18

Adenocarcinoma

Question 19

What zone of prostate gland does cancer arise?

Answer 19

Outer (peripheral)

Question 20

How is prostate cancer screened for?

Answer 20

PSA

Question 21

What causes false positive PSAs?

Answer 21

UTI
Ejaculation
Biopsies
Exercise

Question 22

Which progresses faster? BPH or Cax?

Answer 22

Cax

Question 23

What investigations are done in Prostate Cax?

Answer 23

FBC
U&E
LFT
PSA
FIRST LINE: Multiparametric MRI THEN
TRUS biopsy
CT/MRI bone scan

Question 24

What scoring in used in prostate cax?

Answer 24

Gleason (histology)

Question 25

What are management options for early stage prostate cancer>

Answer 25

``` Radical prostatectomy (erections affected big time) Radical radiotherapy (continence more affected) Brachytherapy- radioactive inserted to area ```

Question 26

How is late stage prostate cancer managed?

Answer 26

Androgen deprivation therapy- also reduced mets as testosterone dependent too (LHRH analogues) Electron beam radiography Watchful waiting

Question 27

What organism causes pyelonephritis?

Answer 27

E Coli

Question 28

What are symptoms of pyelonephritis?

Answer 28

``` Painful renal angle Fever Rigors Dehydration Peripheral vasocontriction ```

Question 29

What imaging is done in pyelonephritis?

Answer 29

USS

Question 30

What ABX used in pyelonephritis?

Answer 30

Gentamycin (heck U&E)

Question 31

What are predisposing factors for pyelonephirits?

Answer 31

``` T1DM T2DM Immunosupression Stress incontinence Anal sex Catheter Sctrucutal abnormality ```

Question 32

What condition predisposes to Renal cell carcinoma

Answer 32

Von Hippel Lidau

Question 33

What are substances renal and ureteric stones are made of?

Answer 33

Calcium oxolate Calcium phosphate Urate Struvite

Question 34

How does urolithiasis present?

Answer 34

``` Loin to groin pain Colicky Worse when need pee Can't get comfy Haematuria ```

Question 35

What Ix in urolithiasis?

Answer 35

U&E Ca and Urate Abdo Xray USKUB

Question 36

How are stones managed?

Answer 36

<7mm left or given alpha blocker and analgesia | Lithotripsy pr litholaplaxy or percutaneous nephrolithotomy

Question 37

What is recommended for patietns with recurrent stones

Answer 37

Less caffeine increased fluid intake allopurinol ir urate stones

Question 38

What causes urolithiasis?

Answer 38

``` Dehydration High calcium- PTH, vit D ingestion, sarcoidosis Infection Renal disease Loop diuretics Anatacids Gout ```

Question 39

How early does bladder cancer present?

Answer 39

Painless so LATE | Painless haematuria

Question 40

What is common type of bladder cax in UK?

Answer 40

Transitional cell carcinoma (TCC)

Question 41

What are risk factors for bladder cancer?

Answer 41

Smoking Age Male Aromatic amines

Question 42

What kind of bladder cancer is linked to schisto?

Answer 42

Squamous cell carcinoma

Question 43

What Ix is done in suspected bladder cancer?

Answer 43

Cystoscopy then CT/MRI

Question 44

how is bladder cancer managed?

Answer 44

Low grade- Transurethral resection (TURBT) and chemo | High grade- Radical cystectomy and lymphadenectomy or radical radiotherapy

Question 45

What is most sensitive test of fluid status?

Answer 45

LYing standing BP