Urology Flashcards
What are the key Lower Urinary Tract symptoms to be aware of?
FUND (Irritative) HIPS (Obstructive)
Frequency, Urgency, Nocturia, Dysuria
Hesitancy, Incomplete emptying, Poor stream, Straining
How is Benign Prostatic Dysplasia defined?
Slow, progressive hyperplasia of the Transitional Zone of the prostate gland.
How does Benign Prostatic Hyperplasia typically present?
FUND HIPS
Severe pain - retention
Smoothly enlarged prostate on DRE
How would you manage a case of Benign Prostatic Hyperplasia?
Catheterise (Acute urinary retention emergency)
Alpha Blockers - tamsulosin
5alpha- reductase inhibitors - finasteride
Surgical - Transurethral resection of the prostate/Open prostatectomy
How does Prostate Cancer typically present?
FUND HIPS
Bone Pain, Cord Compression, FLAWS, Paraneoplastic Syndrome
Asymmetrical hard nodular prostate on DRE
How would you investigate a suspected case of Prostate Cancer?
1) MRI
Transrectal US Biopsy
LFTs/Bone Profile to check for metastases
What are the key risk factors for Bladder Cancer?
Dye Stuffs
Pelvic Irradiation
Smoking
Chronic UTIs
Schistosomiasis
Which type of cancer are most Bladder Cancers?
Transitional Cell Carcinomas
How does Bladder Cancer typically present?
Painless, Macroscopic Heamaturia
FUND (No HIPS)
FLAWS
How should you investigate a suspected case of Bladder Cancer?
Cytoscopy with biopsy
CT/MRI for staging
What are the main types of Urinary Incontinence
Stress
Urge
Functional
Overflow
How does a patient with a Urinary Tract Calculi typically present?
May be Asymptomatic
Severe Loin pain radiating to the groin
Nausea and Vomiting
DDx- Leaking AAA
What are the most common types of Urinary Stone?
Calcium Oxalate
Magnesium Ammonium Phosphate
Urate
Cysteine
How would you investigate a suspected case of Urinary Tract Calculi?
Non-contrast CT KUB
How should you manage a patient with a Urinary Tract Calculus?
Analgesia
<5mm - Allow to pass
>5mm - Urteroscopic Lithotripsy, PCNIL, ESWL (Surgery)
Signs of Obstructed & Infected Kidney? Urgent Nephrostomy
What are the typical symptoms of Testicular Torsion?
Sudden-Onset Severe Hemiscrotal Pain
Nausea and Vomiting
Swollen and Erythematous Scrotum
How should you manage a case of Testicular Torsion?
1) Exploratory Surgery within 6 Hours
Dopple Ultrasound to demonstrate reduced blood flow
What is a Hydrocele?
Collection of serous fluid within the Tunica Vaginalis.
How do Hydroceles typically present?
Asymptomatic Swelling
Can get above it
Transilluminative
Swelling cannot be separated from the testicle.
How should you investigate a patient presenting with symptoms of a Hydrocele?
US to exclude tumour
Urine Dipstick/MSU
Tumour Markers
What is a Varicocele?
Dilated veins of the Pampiniform Plexus forming a scrotal mass.
How does a Varicocele typically present?
Asymptomatic
‘Bag of Worms’ Scrotum
May reduce when lying down
How does Epididymitis and Orchitis typically present?
Painful, swollen and tender Testes.
Penile Discharge
Fever
What are the most common causes of Epididymitis and Orchitis?
<35 Yrs - Gonococcus & Chlamydia
>35 Yrs - Klebsiella, Coliforms
Mumps, Candida
How does Testicular Cancer typically present?
Painless, hard testicular mass
Swelling/Discomfort
Backache (Due to metastases to the Para-Aortic Nodes)
How would you investigate a suspected case of Testicular Cancer?
Tumour Markers - Alpha-Feroprotein, Beta-hCG, Lactate Dehydrogenase
USS
CT for staging
What are the most common causes of Hypertension in a young person?
Conn’s
Coarctation of the Aorta
Renal Artery Stenosis
