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Y3 MedEd > Urology > Flashcards

Urology Flashcards

1
Q

What are storage urinary symptoms

A

FUND

Frequency
Urgency
Nocturia
Dysuria

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2
Q

What are voiding/obstructive urinary symptoms

A

HIPS

Hesitancy
Incomplete emptying
Poor stream
Straining
Others: terminal dribbling, overflow incontinence
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3
Q

Mx of BPH (medical 2 and surgical 2)

A

Medical
a-blockers to relax smooth muscle of internal urinary sphincter (e.g. tamsulosin)
5a-reductase inhibitors to prevent conversion of testosterone to dihydrotestosterone (more potent androgen) (e.g. finasteride)

Surgical
Transurethral resection of the prostate (TURP)
Open prostatectomy

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4
Q

1st line Ix for suspected prostate cancer

A

MRI – FIRST LINE

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5
Q

Ix for prostate cancer (4)

A

PSA – low specificity
MRI – FIRST LINE
Transrectal Ultrasound-guided Biopsy
LFTs/bone profile – check for metastatic effects

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6
Q

What are most bladder cancers

A

Transitional cell carcinomas

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7
Q

RF for bladder cancer (5)

A 
Dye stuffs 
Pelvic irradiation
Smoking 
Chronic UTIs 
Schistosomiasis
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8
Q

Symptoms of bladder cancer

A

Painless macroscopic haematuria
FUND (not HIPS)
FLAWS

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9
Q

Ix for bladder cancer (2)

A

Cystoscopy with biopsy

CT/MRI for staging

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10
Q

What is RF of stress related urinary incontinence

A

Childbirth

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11
Q

What is stress related urinary incontinence down to

A

Poor closure of the bladder

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12
Q

What is urge related urinary incontinence down to

A

Detrusor overactivity

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13
Q

What are rare causes of urinary incontinence (2)

A

Normal pressure hydrocephalus

Cord compression

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14
Q

What is functional incontinence

A

individual is aware of the need to urinate, but are unable to get to the bathroom in time due to physical/mental reasons

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15
Q

What is overflow incontinence

A

involuntary release of urine from an overfull bladder, in the absence of any need to urinate

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16
Q

What should you always consider as a DDx of nephrolithiasis

A

leaking AAA

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17
Q

4 types of urinary stone

A

CALCIUM OXALATE – most common
Magnesium ammonium phosphate
Urate
Cysteine

18
Q

What is the most common type of kidney stone

A

CALCIUM OXALATE – most common

19
Q

RF of nephrolithiasis (2)

A

Low fluid intake

Structural urinary tract abnormalities

20
Q

Gold standard Ix for urinary tract calculi

A

Non-contrast CT-KUB

21
Q

Ix for urinary tract calculi (4)

A

Urine dipstick (microscopic haematuria)
Non-contrast CT-KUB – GOLD STANDARD
Ultrasound
U&Es – check renal function

22
Q

Mx of nephrolithiasis

A

ANALGESIA
< 5 mm diameter – allow to pass spontaneously
> 5 mm diameter – SURGERY
Ureteroscopic lithotripsy
Extracorporeal Shockwave Lithotripsy (ESWL)
Percutaneous Nephrolithotomy (PCNL)

23
Q

What is percutaneous nephrolithotomy and under what circumstances is it performed

A

Percutaneous Nephrolithotomy (PCNL) – performed for large, complex stones (e.g staghorm calculus). After making a nephrostomy tract, a nephroscope is inserted which allows the disintegration and removal of stones.

24
Q

Presentation of testicular torsion (3)

A

Sudden-onset severe hemiscrotal pain
Nausea and vomiting
Swollen and erythematous scrotum

25
Q

What is the first step in Mx of suspected testicular torsion

A

Exploratory surgery

26
Q

Epidemiology of hydrocoele

A

Very young boys (< 1 yr)

Older men

27
Q

Causes of hydrocoele (4)

A

Idiopathic
Infection
Trauma
Tumour

28
Q

Can the swelling be seperated from testicle in a hydrocoele

A

No

29
Q

Ix for hydrocoele (3)

A

Ultrasound - exclude tumour
Testicular tumour markers
Urine dipstick/MSU – check for infection

30
Q

Varicocele is caused by which dilated veins

A

dilated veins of the pampiniform plexus forming a scrotal mass

31
Q

Why are varicoceles more common on the lef (3)t

A

Reasons for being more common on the left:
Angle at which the left testicular vein meets the left renal vein
Lack of effective valves between the left testicular vein and the left renal vein
Increased reflux from compression of the left renal vein

32
Q

Causes of epididimitis/orchitis under 35

A

<35 yrs: Chlamydia and Gonococcus

33
Q

Causes of epididimitis/orchitis over 35

A

> 35 yrs: Coliforms (e.g. Enterobacter, Klebsiella)

34
Q

How to differentiate epididimitis/orchitis from torsion

A

NOTE: less acute onset than torsion

35
Q

Where do testicular tumours metastasise

A

Para-aortic nodes

36
Q

Which tumour marker is never raised in seminomatous testicular cancer

A

AFP

37
Q

Which type of testicular tumours and what % is AFP raised in

A

• AFP is a marker for 50-70% of nonseminomatous tumours

38
Q

Which type of testicular tumours and what % is BHCG raised in

A

• ΒHCG is raised in 40% of nonseminomatous tumours

and 10% of seminomatous tumours

39
Q

What is lactate dehydrogenase a marker of

A

Testicular tumour burden

40
Q

Which tumour markers are involved in testicular cancer (3)

A

a-fetoprotein
b-hCG
Lactate Dehydrogenase

41
Q

What is a scrotal mass separate from the testes that transilluminates likely to be

A

Epididymal cyst

42
Q

What is a scrotal mass not separate from the testes that transilluminates likely to be

A

Hydrocoele

Y3 MedEd (34 decks)

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