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Urology Flashcards

1
Q

What investigation is done for refluc?

A

MCU

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2
Q

Is Creatinine an early or late sign of renal impairment?

A

Late

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3
Q

What does RAAS activation cause?

A 
Vasoconstrictoin
Fluid retention (aldosterone)
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4
Q

Does para or sympa make you pee?

A

Para makes you pee

S2-4- muscarinics

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5
Q

What is used to manage urge incontinence?

A

Antimuscarinics

Oxybutynin

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6
Q

What part of prostate is affected in BPH?

A

transitional zone

Smooth and enlarged

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7
Q

What are red flags for LUTs for prostate cancer/

A 
Haematuria
Persistant UTI
Decreased renal function
Saddle anaethesia
Abnormal neurology
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8
Q

How is BPH investigated?

A 
U&E
PSA
Urine dip
Bladder scan for retention volume
USS for hydronephrosis
Plain film Xray
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9
Q

How is BPH managed conservatively?

A

Limit caffeine

Stop diuretics

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10
Q

What is medical management of BPH?

A

ALPHA blockers- Tamulosin to relax smooth muscle

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

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11
Q

What are side effects of alpha blockers?

A

headache
postural hypotension
swollen legs and hands
delayed ejaculation

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12
Q

What are side effects of finasteride?

A

whole body affected as all organs testosterone works on

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13
Q

How is BPH surgically managed?

A

TURP

Core out middle of prostate

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14
Q

What are side effects of TURP?

A 
Incontinence
Bleeding
Infection
Erectile dysfunction
Impotence
Penis size change
Retrograde ejaculation
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15
Q

What is TUR syndrome?

A

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

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16
Q

How many mls constitutes retention?

A

> 800

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17
Q

What are male and female and both causes of retention?

A

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

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18
Q

What kind of cancer is prostate?

A

Adenocarcinoma

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19
Q

What zone of prostate gland does cancer arise?

A

Outer (peripheral)

20
Q

How is prostate cancer screened for?

21
Q

What causes false positive PSAs?

A

UTI
Ejaculation
Biopsies
Exercise

22
Q

Which progresses faster? BPH or Cax?

23
Q

What investigations are done in Prostate Cax?

A 
FBC
U&E
LFT
PSA
FIRST LINE: Multiparametric MRI THEN
TRUS biopsy
CT/MRI bone scan
24
Q

What scoring in used in prostate cax?

A

Gleason (histology)

25
Q

What are management options for early stage prostate cancer>

A 
Radical prostatectomy (erections affected big time)
Radical radiotherapy (continence more affected)
Brachytherapy- radioactive inserted to area
26
Q

How is late stage prostate cancer managed?

A

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

27
Q

What organism causes pyelonephritis?

28
Q

What are symptoms of pyelonephritis?

A 
Painful renal angle
Fever
Rigors
Dehydration
Peripheral vasocontriction
29
Q

What imaging is done in pyelonephritis?

30
Q

What ABX used in pyelonephritis?

A

Gentamycin (heck U&E)

31
Q

What are predisposing factors for pyelonephirits?

A 
T1DM
T2DM
Immunosupression
Stress incontinence
Anal sex
Catheter Sctrucutal abnormality
32
Q

What condition predisposes to Renal cell carcinoma

A

Von Hippel Lidau

33
Q

What are substances renal and ureteric stones are made of?

A

Calcium oxolate
Calcium phosphate
Urate
Struvite

34
Q

How does urolithiasis present?

A 
Loin to groin pain
Colicky
Worse when need pee
Can't get comfy
Haematuria
35
Q

What Ix in urolithiasis?

A

U&E
Ca and Urate
Abdo Xray
USKUB

36
Q

How are stones managed?

A

<7mm left or given alpha blocker and analgesia

Lithotripsy pr litholaplaxy or percutaneous nephrolithotomy

37
Q

What is recommended for patietns with recurrent stones

A

Less caffeine
increased fluid intake
allopurinol ir urate stones

38
Q

What causes urolithiasis?

A 
Dehydration
High calcium- PTH, vit D ingestion, sarcoidosis
Infection
Renal disease
Loop diuretics
Anatacids
Gout
39
Q

How early does bladder cancer present?

A

Painless so LATE

Painless haematuria

40
Q

What is common type of bladder cax in UK?

A

Transitional cell carcinoma (TCC)

41
Q

What are risk factors for bladder cancer?

A

Smoking
Age
Male
Aromatic amines

42
Q

What kind of bladder cancer is linked to schisto?

A

Squamous cell carcinoma

43
Q

What Ix is done in suspected bladder cancer?

A

Cystoscopy then CT/MRI

44
Q

how is bladder cancer managed?

A

Low grade- Transurethral resection (TURBT) and chemo

High grade- Radical cystectomy and lymphadenectomy or radical radiotherapy

45
Q

What is most sensitive test of fluid status?

A

LYing standing BP

Nephrology & Urology (3 decks)

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