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Yr 3 MedEd > Urology > Flashcards

Urology Flashcards

1
Q

Which lower urinary tract symptoms fit under the following categories:

  • Storage/ irritative
  • Voiding/ Obstructive
A 
FUND HIPS
Storage/ irritative
- Frequency
- Urgency
- Nocturia
- Dysuria

Voiding/ obstructive

  • Hesitancy
  • Incomplete empyting
  • Poor stream
  • Straining
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2
Q

When does Benign prostatic hyperplasia cause pain?
What is found on DRE in BPH?
Which imaging technique is used for BPH?

A
  • Pain caused in acute retention.
  • DRE: smooth enlarged prostate with a palpable midline groove.
  • USS urinary tact
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3
Q

What is the emergency treatment of BPH?
Give two medications used to treat BPH.
Give two surgical treatments for BPH:

A
  • Emergency: catheterise
    Medicines:
  • Alpha blocker: tamuslosin: relax smooth muscle of internal urinary sphincter.
  • 5alpha- reductase inhibitor- finasteride: inhibits conversion of testosterone to dihydrotestosterone (more potent than testosterone)- decrease in prostate size.
    Surgery
  • Transurethral resection of prostate (TURP). Open prostatectomy.
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4
Q

Give 3 symptoms of malignancy in prostate cancer

A
  • Bone pain
  • FLAWS
  • Cord compression
  • Paraneoplastic syndrome- e.g. hypercalcaemia.
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5
Q

What is found on DRE in prostate cancer?
What is the first line investigation for prostate cancer?
Give another investigation for prostate cancer.

A
  • DRE: asymmetrical hard nodular prostate.
  • MRI is first line investigation
  • Transrectal Ultrasound-guided biopsy.
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6
Q

What type are most bladder cancers? What type are they rarely?

A
  • Most bladder cancers are transitional cell carcinomas. Rarely squamous cell carcinoma
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7
Q

Give 5 risk factors for bladder cancer

A
  • Chemical Industry: rubber/ textiles
  • Pelvic irradiation
  • Smoking
  • Chronic UTIs
  • Schistosomiasis.
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8
Q

What type of symptoms are experienced in bladder cancer?

- What urinary sign is indicative of bladder cancer

A
  • Storage signs: FUND not HIPS

- Urinary sign: Painless Macroscopic Haematuria.

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9
Q

Give two appropriate investigations for bladder cancer.

A
  • Cytoscopy with biopsy

- CT/ MRI for staging.

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10
Q

What is stress incontinence? Give 1 risk factor.

What is urge incontinence? What is it due to?

A
  • Stress: physical movement/ activity (coughing/ laughing). Due to poor closure of bladder. Childbirth is a risk factor.
  • Urge: urine leaks after sudden intense urge to urinate. Due to detrusor overactivity.
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11
Q

What is functional incontinence?

What is overflow incontinence?

A
  • Functional: individual aware of need to urinate, unable to get to bathroom in time due to physical/ mental reasons.
  • Overflow: Involuntary release of urine from overfull bladder, in absence of need to urinate.
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12
Q

Give 3 symptoms of nephrolithiasis (urinary tract stone)
What is the male to female ratio?
What is the most common type of stone.

A
  • Severe loin to groin pain- patient writhing around in pain.
  • Nausea
  • Vomiting
    3x more common in men.
  • Most common is calcium oxalate.
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13
Q

Give two metabolic causes of urinary tract stones

Give two risk factors for nephrolithiasis.

A

Metabolic: hypercalcaemia, hyperuricaemia.

Risk factors: low fluid intake, structural abnormalities in urinary tract.

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14
Q

What is the gold standard investigation for urinary tract stones?
- What can be seen on urine dipstick?

A
  • Gold standard is CT-KUB.

- Urine: microscopic haematuria

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15
Q

What is the management of nephrolithiasis?

What defines an emergency in nephrolithiasis?

A

Management: Analgesia +

  • <5mm: allow to pass spontaneously.
  • > 5mm: surgery;
  • Utereoscopic lithotripsy
  • Extracorporeal shockwave lithotripsy
  • Percutaneous nephrolithotomy: large complex stones.

Emergency: Signs of obstructed and infected kidney. Requires nephrostomy to relieve obstruction.

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16
Q

Give 3 signs/ symptoms of testicular torsion

A
  • Sudden-onset sever hemiscrotal pain.
  • Nausea and vomiting
  • Swollen and erythematous scrotum

Differentials are strangulated hernia or epididymis-orchitis.

17
Q

What is the management of testicular torsion

A
  1. Exploratory surgery within 6 hours.
  2. Both testicles are fixed in place
  3. Nephrotic tissue may need removal
  4. Duplex ultrasound
18
Q

What is the definition of hydrocoele?
Which groups of men does it affect?
Give 3 causes other than idiopathic?

A
  • Definition: collection of serous fluid in tunica vaginalis.
  • Boys <1, older men
  • Trauma, tumour, infection
19
Q

Give 4 signs/ symptoms of hydrocoele

A
  • Asymptomatic swelling
  • Can get above swelling
  • Transilluminates- unlike varicocoele
  • Swelling cannot be separated from testicle.
20
Q

Give 3 investigations for hydrocoele

A
  • Ultrasound to exclude tumour
  • Testicular tumour markers
  • Urine dipstick/ MSU- check for infection
21
Q

What is the definition of varicocoele? Which side is it more common on?

A
  • Defintion: dilated veins of pampiniform plexus- forms scrotal mass. Associated with infertility.
  • More common on left (80-90%)
22
Q

Give 3 symptoms/ signs of varicocoele.

A
  • Usually asymptomatic
  • Scrotum feels like a bag of worms
  • Swelling may reduce when lying down.

not transluminable

23
Q

What age range is epidiydmitis and orchitis most common in?

What two pathogens are the cause for <35s.
Which group of pathogens are cause for >35s.

A
  • 20-30
  • <35: chlamydia and gonorrhoea
  • > 35: Coliforms e.g. enterobacter, Klebsiella.
    Others are mumps and candida.
24
Q

Give 3 symptoms/ signs of epididymitis and orchitis

Give 2 clinical signs for epididymitis and orchitis

A
  • Painful, swollen and tender testis/ epididymitis- less acute than testicular torsion.
  • Penile discharge (if STI)
  • Fever

Cremaster reflex
Phren sign

25
Q

Give 3 tests for epididymitis and orchitis.

A
  • Urine: dipstick
  • Urine: MCS
  • Bloods- FBC, CRP.

Enquire about sexual history.

26
Q

What age range is testicular cancer the most common male cancer?

  • Give 1 risk factor for testicular cancer.
  • Give two most common types of testicular cancer.
A
  • Commonest malignancy in 20-40s
  • Risk factor: maldescended tests.
  • Seminoma: 50%. Non-seminoma: 30%- appears ver different from testicular tissue (e.g. teratoma)
27
Q

Give 3 symptoms of testicular cancer.

A
  • Painless, hard testicular mass
  • Testicular swelling/ discomfort
  • Backache: metastasis to para-aortic nodes.
28
Q

Give 3 tumour markers for testicular cancer.

Give two other investigations.

A
  • alpha- fetoprotein
  • Beta- hCG
  • Lactate dehydrogenase

Testicular ultrasound
CT- allows staging.
Not biopsied because risk of spreading cancer

Yr 3 MedEd (31 decks)

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