Urology Flashcards
How would you assess LUTS?
IPSS score
frequency volume chart
What are some urological emergencies?
testicular torsion uro-sepsis ureteric colic acute retention high pressure chronic retention haematuria trauma to urinary tract paraphimosis
What are some symptoms of kidney stones?
loin to groin pain haematuria UTIs HORRIBLE pain nausea and vomiting rapid onset of symptoms
How would you test for kidney stones?
non contrast CT
US if pregnant
Bloods - U&E, calcium, uric acid (exclude sepsis)
What is the treatment of kidney stones?
analgesia!! antiemetic IV antibiotics oxygen small (<5mm) - alpha blockers large (>1cm) need intervention - extracorporeal shock wave, ureterscopy, endoscopic
What is the prophylaxis of kidney stones?
large volume of fluids weight loss exercise soft water citrus reduce animal protein
What are some symptoms of UTI?
frequency pain haemturia foul smelling urgency incontinence loin pain fever nausea, vomiting confusion
How would you treat recurrent UTI?
lifestyle
antibiotic prophylaxis - continuous, symptomatic, post coital
USS kidneys, flexible cystoscopy
eostrogen status of post menopausal women
What are some presentations of testicular cancer?
painless/painful testis lump
dyspnoea (lung mets)
abdominal mass
What test do you need to do for haematuria and what are you looking to rule out?
CTIVU to rule out renal and bladder cancer
How do you treat renal cancer?
surgical excision
nephrectomy
How do you treat bladder cancer?
TURBT - transurertral resection of bladder tumour
non-invasive - resection +/- chemo
radical radiotherapy
Where does prostate cancer commonly spread to?
bone
What are some treatment options for prostate cancer?
radical prostatectomy radiotherapy - EBRT, brachytherapy androgen deprivation therapy active surveillance watch and wait
What are some risk factors for penile cancer?
HPV phimosis genital warts many partners HIV smoking penile injury
What are some differentials of groin lump?
inguinal and femoral hernias
lymphadenopathy
vascular abnormalities (e.g. femoral artery aneurysm, infected injection site)
Penis poblems
What are some differentials of testicular pain?
tortion or trauma to testis
epididymo-orchitis
referred pain from renal colic
What are some causes of urinary frequency or nocturia?
UTI prostatic hypertrophy DM renal failure cardiac failure drug related (e.g. diuretics, caffeine, alcohol) diabetes insipidus compulsive water drinking
What are some causes of urinary retention?
BPH prostate cancer neuro - MS, prolapsed disc post-op drug related blocked catheter
What are some causes of dysuria?
UTI
urethritis
prostatitis
structural abnormalities of urinary tract (children)
What are some causes of haematuria?
renal calculi UTI urinary tract malignancy glomeulonephritis bleeding disorders rhabdomyolysis
What are some differentials of testicular or scrotal swelling?
inguinal hernias hydrocele epididymo-orchitis incompletely descened testis varicoele epidiymal cyst testicular tumours torsion of testis
What are some causes of urinary incontinence?
prostatic hypertrophy stress incontinence urge incontinence UTI neurological - MS, dementia, confusion in elderly
What are some causes of vaginal discharge?
candidiasis chlamydia trichomonas gonococcus syphilis
Where does prostate cancer commonly metastasis to?
bone
What are treatment options for prostate cancer?
radio for metastasis
androgen deprivation therapy
chemo
What are some common SE of androgen deprivation therapy?
hot flushes, fatigue, erectile dysfunction
What is LHRH agoinst?
androgen deprivation therapy - reduces testosterone by acting on anterior pituitary
