Urology Flashcards
4 possible ddx for haematuria
pyelonephritis
renal ca
bladder ca
ureteric stone
things to consider in a hx for haematuria
type- visible/non-visible lower urinary tract symptoms pain fever risk factors trauma comorbidities meds allergies Fhx Shx
investigations for bladder cancer
urinalysis
cyscoscopy
CT urogram- contrast given and allowed to pass to urogenital tract
CT KUB- for gross pathology
CT AP
Bloods- U&E, FBC, Cr, clotting, LFT, calcium, PSA
US for non-visible haematuria
3 causes of raised PSA
BPH
Prostate ca
prostatitis
4 signs and symptoms of prostatitis
pain around the perineum and anus dysuria burning and stinging urgency increased freq
5 Ix for prostate ca
digital rectal exam PSA MRI TRUS+ biopsy Bone scan
Mx of low risk prostate cancer
active surveillance
Mx of localised/locally advanced prostate cancer
radical prostatectomy, hormones and radical radiotherapy
Mx of advanced prostate cancer
hormones, chemo, abiaterone
components of a hx for testicular torsion
is the testis in the normal position pain radiation to lower abdomen? nausea and vomiting feeling hot/ fever testicle position tender on palpation wide gait
ddx for testicular torsion
hydrocele epididymitis orchiditis varicocele torsion of appendix testis
Mx of testicular torsion
immediate surgical exploration
untwist and fixation
remove if infarcted
difference in pt presentation with colicky pain vs peritonitic pain
colicky pain- pt moves lots to get comfy
peritonitic pain- pt v still
analgesia for renal stones
PR diclofenac
3 Ix for renal calculi
urine dip
bloods- FBC, creatinine, U&E, CRP, Ca2+, urate
CT KUB
4 options for tx of renal calculi
surveillance
ureteroscopy and fragmentation
extracorporeal shock wave lithotripsy
percutaneous nephrolithotomy
Tx for renal stones + pyelonephritis
nephrostomy and antibiotics- co-amox and gentamicin
Is renal stones + pyelonephritis an emergency
YES
two categories of lower urinary tract symptoms
storage
voiding
storage problem symptoms
frequence
nocturia
urge incontinence
voiding problem symptoms
hesitancy
variable/poor flow
terminal dribbling
5 Ix for lower urinary tract symptoms
full hx exam- abdo, genital, PRE (male) urine dip bloods- cr, U&E, PSA flow rate/ post void residual
3 medical tx for lower urinary tract symptoms and example of each
alpha blockers- tamsulosin
5 alpha reductase inhibitors- finasteride
anticholinergics- oxybutynin
side effects of alpha blockers x4
dizziness
postural hypotension
retrograde ejaculation (semen into bladder)
palpitations
5 alpha reductase inhibitor side effects x1
erectile dysfunction
anticholinergic side effects x3
dry mouth, dry eyes, constipation
