Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Scott's Notes > Urology > Flashcards

Urology Flashcards

1
Q

What might cause a urinary tract obstruction?

A

Luminal, mural, extramural

Luminal
Stones,
Clots
Sloughed papillae

Mural
Stricture
Tumour
Neuromuscular dysfunction

Extramural
Prostate
Tumour
Retroperitoneal fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How might a urinary tract obstruction present?

A

Acute vs chronic, upper vs lower

Acute upper - loin to groin pain
Acute lower - distension followed by pain

Chronic upper - flank pain and renal failure

Chronic lower - prostate features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How would you investigate a urinary obstruction?

A 
Bloods
Urine
USS - hydronephrosis
Radionucleotide imaging - renal function
CT/MRI
Ureterograms - allows drainage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how would you manage a urinary obstruction?

A

Upper
Nephrostomy (stoma)
Ureteric stent

Lower
Urethral or suprapubic catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some complications of ureteric stenting?

A 
Common:
Infection
Haematuria
Trigonal irritation (part of internal bladder wall)
Encrustation

Rare
Obstruction
Rupture
Stent migration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What might cause a urethral stricture?

A

Trauma inc fractures
Infections e.g. gonorrhoea
Chemotherapy
Balanitis xerotica obliterans (lichen sclerosus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How would a urethral stricture present?

A 
Voiding difficulty
Hesitancy
Strangury
Poor stream
Dribbling
Pis en deux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you investigate a urethral stricture

A 
PR exam for prostate
Palpate urethra and examine meatus
Urodynamics
Urethr/cystoscopy
Retrograde urethrgram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the pathogenesis of obstructive uropathy?

A

Acute retention on a chronic background may go unnoticed for days due to lack of pain
Renal function usually returns after a few days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the complications of an obstructive uropathy?

A 
Hyperkalaemia
Metabolic acidosis
Post obstructive diuresis
Na, HCO3 losing nephropathy
Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the causes of acute urinary retention?

A

Obstructve, neurological, myogenic

Obstructive
BPH, strictures, clots, stones,

Neurological
Surgery, MS, DM, spinal injury

Myogenic
Post anaesthesia, EtOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the management of acute urinary retention?

A

Conservative
Analgesia, privacy, walking

Catheter (3 way if clots)
Hourly UO recording
Tamsulosin
TWOC

If TWOC fails then TURP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the types of chronic urinary retention, and how are they managed?

A

High and low pressure (detrussor pressure at end micturation)

High pressure-> early catheter
Low pressure -> avoid catheter if poss, early TURP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the pros and cons of suprapubic catheterisation?

A 
Pros:
Fewer UTIs
Reduces stricture formation
TWOC without catheter removal
More comfortable

Cons:
Comre complex and more complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the causes of haematuria?

A 
Infarction
Infecton
Trauma inc stones
Malignancy GN
PKD
Prostate problems
Bleeding diatheses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How might the timing of haematuria help point to a source?

A

Beginning of stream -> urethral
Throughout -> renal/bladder/systemic
End -> Bladder stone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What vascular complication is retroperitoneal fibrosis likely to cause?

A

Periaortitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the common anatomical sites for renal stones to lodge?

A

Pelviureteric junction
Pelvic brim
Under vas or uterine artery
Vesicoureteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the different types of urolithiasis?

A

Ca Oxalate (75%) esp in Crohns
Struvite (15%)-> staghorn calculus
Urate (5%) radiolucent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What factors are associated with renal stones?

A 
Dehydration
Hypercalcaemia
UTIs
Gout
Structural abnormalities
Diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the gold standard investigation for ?urolithiasis?

A

CT KUB - 99% of stones visible

Xray KUB for urate and cysteine stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

WHat is the conservative management of a renal stone, and what critera must be met for this to be used?

A

Must be <5mm in lower 1/3 of ureter

Analgesia
Fluids
Abx if infection
95% pass spontaneously so discharge with a sieve…

23
Q

What should be done for stones 5-10mm and expected to pass?

A

Medical expulsive therapy with nifedipine or tamsulosin +- prednisolone

24
Q

When should a stone be considered for active removal, and what are the options for doing so?

A 
Indications
>10mm
Persistent
Renal insufficiency
Infection
Options
Lithotripsy (shockwave therapy)
Ureterorenoscopy
Percutaneous nephrolithotomy
Laparotomy - rare
25
Q

What are the risk factors for renal cell carcinoma?

A 
Obesity
Smoking
HTN
Dialysis (15%)
Von Hippel Lindau
26
Q

What is the histological typing of RCC?

A

Adenocarcinoma - commonly clear cell

27
Q

How does RCC present?

A

50% incidental
Classic triad of haematuria, loin pain, loin mass
Systemic Fx
SOB

28
Q

What are the paraneoplastic features of RCC?

A 
EPO -> polycythaemia
PTHrP -> Hypercalcaemia
Renin -> HTN
ACTH -> Cushings
Amyloid
29
Q

What is the pathology of transitional cell carcinoma?

A

V malignant

50% in bladder

30
Q

Which cell layer is affected in BPH?

A

Inner transitional layer

31
Q

What is the medical management of BPH?

A

1st. alpha blockers e.g. tamsulosin
SFx inc drowsiness and hypotension
2nd 5alpha reductas inhibitors e.g. Finasteride

32
Q

What is the surgical management of BPH and what are its complications?

A

TURP

Immediate, early, late

Immediate
TUR syndrome - large fluid absorption leading to hyponatraemia
Haemorrhage

Early
Haemorrhage
Infection
Clot retention

Late
Retrograde ejaculation
ED
Incontinence
Strictures
Recurrence
33
Q

Which ethnic group are predisposed to prostate cancer?

A

Black people

34
Q

What are the PR findings in prostate cancer?

A

Hard irregular prostate with loss of the midline sulcus

35
Q

What is a Gleason score?

A

Score the two worst affected areas and sum them

36
Q

What is the management of prostate cancer?

A

Radical
Radical prostatectomy
Brachytherapy (palladium seeds)

Medical
LHRH analogues e.g. goserelin
ANtiandrogens

37
Q

What are the common infective agents of prostatitis?

A

E. Faecalis
E. Coli
Chlamydia

38
Q

How does prostatitis typically present?

A

UTI/dysuria
Pain (back/ejaculation)
Fevers and rigors
Retention

39
Q

How do stress and urge incontinences present in women, and how are they managed??

A

Stress - leakage on coughing (pelvic floor training)

Urge - sudden unprovoked (bladder training)

40
Q

What differentials might you give for testicular torsion?

A

Epididymo orchitis - older pts with UTI symptoms
Torted Hydatid of Morgagni - less painful
Tumour
Trauma
Hernia strangulation
Appendicitis

41
Q

Varicocele presentation and management?

A

CFx
Bag of worms which reduces on lying down
Common in cyclists
More common on left hand side

Rx
Scrotal support
Clipping testicular vein

42
Q

Hydrocele presentation and management?

A

CFx
May be secondary to tumour/trauma/infection
Transluminates on USS

Rx
Often self limiting
Aspiration
Surgery

43
Q

Presentation and management of epididimo orchitis?

A

Fever, dysuria, UTI fx in older man with hot red swollen balls

Rest, analgesia, scrotal support, abx, drainage if necesary

44
Q

What is the typical presentation of testicular cancewr?

A 
Often incidental lump
Haematospermia
2ary hydrocele
SOB from mets
Abdo mass (lymphadenopathy)
Gynaecomastia
45
Q

What is the commonest type of testicular tumour?

A 
Germ cell (95%)
Pure seminomas (40%)
Non seminomas inc teratomas (60%)

5% are sex cord stromal (Leydig and Sertoli cells)

46
Q

What staging system is used for testicular cancer?

A

Royal Marsden Classification

47
Q

What are the tumour marker(s) for testicular cancer?

A

AFP

hCG

48
Q

What is balanitis?

A

Acute inflammation of the foreskin and glans

49
Q

What are the common causes of balanitis?

A

Strep
Staph
Candida in DM

50
Q

What is the management of balanitis?

A

Hygiene
Abx
Circumcision

51
Q

What is phimosis?

A

When the foreskin occludes the meatus and cannot be retracted

52
Q

How does phimosis present and how is it treated?

A

Dyspareunia, infection, ballooning

Rx with circumcision

53
Q

What is paraphimosis and its main complication?

A

Irreplaceable retracted foreskin which may cause glans ischaemia

54
Q

What are the risk factors for penile cancer?

A

HPV 16, 18, 31
Smegma
Lichen sclerosis

Scott's Notes (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions