Urology Flashcards
What drugs promote urinary retention?
CCBS and anticholinergics
What drugs promote urinary frequency/nocturia?
Loop and thiazide diuretics
What drugs promote inability to micturate?
Alpha-adrenergic agonists and decongestants
Pharmacological causes of haematuria
- Rifampicin
- Nitrofurantoin
- Phenylbutazone
- Anticoagulants
5 side effects of alpha blockers
- Dizziness
- Orthostatic hypotension
- Muscle weakness
- Nasal congestion
- Ejaculation problems
What 2 drugs contraindicate the use of alpha blockers?
Nitrates and phosphodiesterase-5 inhibitors
What do 5-alpha reductase inhibitors inhibit?
Conversion of testosterone into dihydrotestosterone
5 side effects of phosphodiesterase 5-inhibitors
- Priapism
- Flushing
- Headaches
- Dyspepsia
- Impaired vision
Abx for prostatitis?
Fluroquinolone -Ofloxacin (cipro, o, levo)
Abx for pyelonephritis?
Cephalosporin beta-lactam - Cefalexin or fluroquinolone ciprofloxacin
Abx for chlamydia?
Azithromycin or doxycycline
Abx for gonorrhoea?
Azithromycin and IM ceftriaxone
Common bacteria to cause acute prostatitis?
E. coli
What type of cancer is prostate cancer?
Adenocarcinoma
Where does prostate cancer metastasise to?
Lymph nodes, bones, bladder, rectum
Management of prostate cancer
Surveillance, radiotherapy, brachytherapy, radical prostatectomy
Most common cause of epididymitis?
STIs
3 causes of orchitis
- STI
- Mumps
- Inguinal hernia
Where do hydroceles develop?
Tunica vaginlasis or spermatic cord
What is a communicating hydrocele?
A congenital serous fluid build up that drains peritoneal fluid.
What is a complication of a communicating hydrocele?
Inguinal hernia
A hydrocele in an adult is commonly caused by?
STIs
What age group suffers from varicocele?
Adolescent boys
What is a varicocele?
Abnormal dilation of internal spermatic veins and pampiniform plexus
A neonate presents with nausea and vomiting alongside lower abdominal pain. What is the diagnosis?
Testicular torsion
What are the RF for testicular torsion?
Trauma, exercise, neonates, adolescents
Name 3 common bacteria that cause pyelonephritis?
- E. coli
- Enterococcus faecalis
- Coliform
What is costovertebral angle tenderness a sign of?
Pyelonephritis
What is the management of kidney stones?
Surgical decompression < 10 mm, potassium citrate or allopurinol with sodium bicarbonate.
What is a FBC sign of RCC?
Erythrocytosis due to raised EPO
Painless haematuria can be a sign of
Bladder carcinoma
Management of bladder carcinoma
Transurethral resection, intravesical chemotherapy and BCG bladder injection.
3 referral criteria for frank haematuria
- Haematuria with no UTI
- Haematuria after UTI treatment
- > 60 years and dysuria
A complication of ureteric trauma that requires stents is
Fistula formation
Stress incontinence is commonly seen in
Older women with a history of traumatic vaginal delivery
Overflow incontinence is commonly seen in
Chronic urinary retention - Fibroids, BPH, diabetic neuropathy
RF for urge incontinence include
Age, obesity, smoking, FH
3 RFs for prostatitis
- UTI
- Catheters
- BPH
What should be performed prior to rectal examination?
PSA levels
What 2 medications should be avoided in BPH?
Antidepressants and decongestants - can worsen urinary symptoms
Diagnostic investigation of epididymitis
Scrotal ultrasound
Undescended testes are termed
Cryptorchidism
Cryptorchidism increases the risk of
Testicular cancer
An absent cremasteric reflex is a sign of
Testicular torsion
Balanitis is more common in men who have
Foreskin present (not-circumcised)
2nd most common bacteria to cause cystitis
Staph saprophyticus
Urethritis is commonly caused by
STIs
3 causes of upper urinary tract obstructions
- Malignancy
- Ureteric trauma - scars/strictures
- Kidney stones
Gold-standard for kidney stone diagnosis
CT-KUB
Which type of stone is not seen on x-ray?
Uric acid
Staghorn calculi are commonly caused by what and what do they consist of?
Repeated UTIs and struvite (ammonia based)
Stones may resolve themselves when they are what size?
< 6cm
Recurrent stones can be treated with what 2 medications
Allopurinol or potassium citrate and sodium bicarbonate
xanthine oxidase inhibitor and alkalisation
Define urge incontinence
Overactive bladder
Define stress incontinence
Weakness in pelvic floor/sphincter muscles
Mixed incontinence is
Urge + stress