Urology

Question 1

4 possible ddx for haematuria

Answer 1

pyelonephritis
renal ca
bladder ca
ureteric stone

Question 2

things to consider in a hx for haematuria

Answer 2

type- visible/non-visible
lower urinary tract symptoms
pain
fever
risk factors
trauma
comorbidities
meds
allergies
Fhx
Shx

Question 3

investigations for bladder cancer

Answer 3

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

Question 4

3 causes of raised PSA

Answer 4

BPH
Prostate ca
prostatitis

Question 5

4 signs and symptoms of prostatitis

Answer 5

pain around the perineum and anus
dysuria
burning and stinging 
urgency
increased freq

Question 6

5 Ix for prostate ca

Answer 6

digital rectal exam
PSA
MRI
TRUS+ biopsy
Bone scan

Question 7

Mx of low risk prostate cancer

Answer 7

active surveillance

Question 8

Mx of localised/locally advanced prostate cancer

Answer 8

radical prostatectomy, hormones and radical radiotherapy

Question 9

Mx of advanced prostate cancer

Answer 9

hormones, chemo, abiaterone

Question 10

components of a hx for testicular torsion

Answer 10

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

Question 11

ddx for testicular torsion

Answer 11

hydrocele
epididymitis
orchiditis 
varicocele
torsion of appendix testis

Question 12

Mx of testicular torsion

Answer 12

immediate surgical exploration
untwist and fixation
remove if infarcted

Question 13

difference in pt presentation with colicky pain vs peritonitic pain

Answer 13

colicky pain- pt moves lots to get comfy

peritonitic pain- pt v still

Question 14

analgesia for renal stones

Answer 14

PR diclofenac

Question 15

3 Ix for renal calculi

Answer 15

urine dip
bloods- FBC, creatinine, U&E, CRP, Ca2+, urate
CT KUB

Question 16

4 options for tx of renal calculi

Answer 16

surveillance
ureteroscopy and fragmentation
extracorporeal shock wave lithotripsy
percutaneous nephrolithotomy

Question 17

Tx for renal stones + pyelonephritis

Answer 17

nephrostomy and antibiotics- co-amox and gentamicin

Question 18

Is renal stones + pyelonephritis an emergency

Answer 18

YES

Question 19

two categories of lower urinary tract symptoms

Answer 19

storage

voiding

Question 20

storage problem symptoms

Answer 20

frequence
nocturia
urge incontinence

Question 21

voiding problem symptoms

Answer 21

hesitancy
variable/poor flow
terminal dribbling

Question 22

5 Ix for lower urinary tract symptoms

Answer 22

full hx
exam- abdo, genital, PRE (male)
urine dip
bloods- cr, U&E, PSA
flow rate/ post void residual

Question 23

3 medical tx for lower urinary tract symptoms and example of each

Answer 23

alpha blockers- tamsulosin
5 alpha reductase inhibitors- finasteride
anticholinergics- oxybutynin

Question 24

side effects of alpha blockers x4

Answer 24

dizziness
postural hypotension
retrograde ejaculation (semen into bladder)
palpitations

Question 25

5 alpha reductase inhibitor side effects x1

Answer 25

erectile dysfunction

Question 26

anticholinergic side effects x3

Answer 26

dry mouth, dry eyes, constipation