Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3b > Urology > Flashcards

Urology Flashcards

1
Q

Causes of acute urinary retention

A 
BPH
Prostate cancer
Urethral strictures
Prolapse - cystocele, rectocele, uterine
Fibroids
Ovarian cyst
Bladder cancer
Infection - prostatitis, cystitis
Anticholinergics
Alcohol
Constipation
Cauda equina syndrome
Multiple sclerosis
Spinal cord compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Investigations for acute urinary retention

A 
USS bladder
Urinalysis
MSU
FBC
PSA
MRI spine - cauda equina/cord compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Management for acute urinary retention

A

Catheterise
alpha blocker - tamsulosin
TWOC - trial without catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What zone of the prostate enlarges in benign prostatic hyperplasia?

A

Inner (transitional) zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms for benign prostatic hyperplasia

A 
Frequency
Urgency
Nocturia
Hesitancy
Poor stream/flow
Terminal dribbling
Bladder stones
Haematuria
Overflow incontinence
UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Investigations for benign prostatic hyperplasia

A

PSA - rule out prostate cancer
Rectal examination - smooth, symmetrical and soft, maintained central sulcus
Urine dipstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What conditions is PSA raised in?

A 
BPH
Prostate cancer
Urinary retention
UTI
Vigorous exercise
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Management for benign prostatic hyperplasia

A

Lifestyle - avoid caffeine and alcohol, train bladder

Alpha blockers - Tamsulosin
5alpha-reductase inhibitors - Finasteride

Surgery - TURP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do alpha blockers (tamsulosin) work?

A

Relaxes smooth muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side effects of tamsulosin

A

Postural hypotension
Dizziness
Dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does 5alpha-reductase inhibitors (finasteride) work?

A

Block conversion of testosterone to dihydroxysterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Side effects of finasteride

A

Impotence

Low libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Side effects of TURP surgery

A

Incontinence
Retrograde ejaculation
Erectile dysfunction
Strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Risk factors for prostate cancer

A 
Old age
Family history - BRCA, HPC-1
Tall
Use of steroids
Increased testosterone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms of prostate cancer

A 
Nocturia
Hesistency
Poor stream
Terminal dribble
Obstruction
Haematuria
Erectile dysfunction
Weight loss
Fatigue
Bone pain
Anorexia
Palpable lymph nodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where does prostate cancer metastase to?

A

Bone
Lung
Liver
Lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigations for prostate cancer

A

PSA - elevated
DRE - firm/hard, asymmetrical, irregular
Transrectal USS and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What grading system is used to grade prostate cancer

A

Gleason grading system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the grades in the grading system used for prostate cancer

A

Grade 1 = Well differentiated cancer
Grade 2&3 = Moderately differentiated
Grade 4 = Poorly differentiated
Grade 5 = Anaplastic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management for prostate cancer

A

Disease confined to prostate - radical prostatectomy, radical radiotherapy, brachytherapy, hormone treatment

Metastatic disease - Hormonal drugs e.g. Goserelin, bilateral orchidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where does renal cell carcinoma arise from?

A

Proximal renal tubular epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Symptoms of renal cell carcinoma

A

Classic TRIAD:
Haematuria
Loin pain
Abdominal mass

Anorexia
Weight loss
Fatigue
Night sweats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Risk factors for renal cell carcinoma

A 
Smoking
Obesity
Hypertension
Long term dialysis
Von Hippel-Lindau disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Investigations for renal cell carcinoma

A

Increased BP
FBC - polycythaemia from EPO secretion
Chest x-ray “cannon ball” metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Treatment for renal cell carcinoma

A

Partial nephrectomy - 1st line

Radiotherapy + chemotherapy -> Sunitumab, bevacizumab, sorafenib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the main type of bladder cancer?

A

Transition cell carcinoma (90%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are other types of bladder cancer?

A

Squamous cell carcinoma (10%)
Adenocarcinoma
Sarcoma
Small cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What organism causes squamous cell carcinomas?

A

Schistosomiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of bladder cancer

A

Smoking
Rubber industry/dyes
Schistosomiasis -> squamous cell carcinomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Symptoms of bladder cancer

A 
Painless haematuria
Recurrent UTI's
Voiding irritability
Weight loss
Bone pain

“Dye factory worker with painless haematuria”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Investigations for bladder cancer

A

Cystoscopy with biopsy - diagnostic
Urine - microscopy/cytology
CT urogram
Urine dipstick - haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treatment for bladder cancer

A

Transurethral resection of a bladder tumour (TURBT)
Chemotherapy - mitomycin + doxorubicin + cisplatin
Radical cystectomy - gold standard
Palliative chemo-radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Complications of cystectomy

A

Sexual and urinary malformation
Urinary retention
Hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which locations are renal stones commonly located?

A

Pelvic brim
Pelviuteric junction
Vesicouteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common type of renal stone?

A

Calcium oxalate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are other types of renal stone?

A

Calcium phosphate
Magnesium ammonium phosphate (struvite)
Urate
Cysteine

37
Q

Where is urate renal stones seen?

A

In hyperuricaemia seen in leukaemia

38
Q

Causes of renal stones

A 
Recurrent UTIs
Hypercalcaemia
Hyperparathyroidism
Sarcoidosis
Hyperthyroidism
Addison's
Cushing's
Renal tubular acidosis
Medications - Diuretics, antacids, corticosteroids, aspirin
Foreign body - stents, catheters
39
Q

Symptoms of renal stones

A 
Renal colic
Loin to groin pain
Colicky
Nausea and vomiting
Cannot lie still
Haematuria
Fever
Rigors
40
Q

Investigations for renal stones

A

Urine dipstick - haematuria
FBC, U&E’s
Non-contrast KUB - gold standard

41
Q

Treatment for renal stones

A

Diclofenac - risk of CV disease
Antiemetic if nausea and vomiting
Fluids
Stones <5mm = pass spontaneously
Stones >5mm = Medical explusive therapy - tamsulosin, nifedipine
Extracorporeal shockwave lithotripsy - contraindicated in pregnancy
Ureteroscopy in pregnancy

42
Q

Define pyelonephritis

A

Infection in the renal pelvis (between the kidney and ureter and parenchyma)

43
Q

Risk factors for pyelonephritis

A

Female
Structural urological deformities
Diabetes

44
Q

Common organisms causing pyelonephritis?

A

E.coli
Klebsiella
Enterococcus
Pseudomonas

45
Q

Symptoms of pyelonephritis

A 
High fever
Loin to groin pain
Haematuria
Rigors
Dysuria and urinary frequency
Pain on bimanual palpation of the renal angle (over kidney)
46
Q

Investigations for pyelonephritis

A

Urine dipstick - haematuria, proteinuria, leukocyte esterase, nitrite
CT scan
Ultrasound scan
DMSA scans - shows renal scarring

47
Q

Management for pyelonephritis

A

Broad spectrum antibiotics e.g. co-amoxiclav
IV rehydration
Analgesia
Antipyretics

48
Q

Name the two types of testicular tumours

A

Seminoma

Teratoma

49
Q

Which type of testicular tumour is most common in the young (20-30 year olds)?

A

Teratoma

50
Q

What age group are seminomas common in?

A

30-65 years old

51
Q

Risk factors for testicular tumours

A

Infant hernia
Infertility
Undescended testes

52
Q

Signs in testicular tumours

A

Painless testis lump
Haemospermia
Secondary hydrocele
Dyspnoea - lung mets

53
Q

What are the tumour markers found in testicular tumours

A

Alpha fetoprotein
Beta-hCG
Lactate dehydrogenase

54
Q

What tumour markers are raised in teratomas?

A

Alpha fetoprotein

Beta-hCG

55
Q

What tumour markers are raised in seminomas?

A

Beta-hCG

56
Q

How does testicular tumours spread to the lymph nodes

A

Via para-aortic node

57
Q

Where do testicular tumours metastasise?

A

Lymphatics
Lung
Liver
Brain

58
Q

Treatment for testicular tumours

A

Radical orchiectomy

Chemo/radiotherapy

59
Q

Define hydrocele

A

Fluid within the tunica vaginalis

Treatment: Aspiration, surgery

60
Q

Define varicocele

A

Dilated veins of pampiniform plexus (testicular veins)

Feels like ‘a bag of worms’

Left side more commonly affected

Dullache, dragging or soreness

61
Q

What can cause a varicocele

A

Renal cell carcinoma (RCC) - compression of the renal vein

62
Q

Define epididymal cyst

A

Small painless cysts, bilateral

USS for confirmation - milky fluid = spermatocele

63
Q

Define epididymo-orchitis

A 
Epididymitis = inflammation of epididymis
Orchitis = inflammation of teste
64
Q

Causes of epididymo-orchitis

A 
Chlamydia (in under 35 year olds)
E.coli
Mumps
N. gonorrhoea (in under 35 year olds)
TB
65
Q

Features of epididymo-orchitis

A 
sudden-onset swelling
Dysuria
Sweats/fever
Unilateral
Urethral discharge
Dragging/heavy sensation
66
Q

Investigations for epididymo-orchitis

A

First catch urine sample - chlamydia/gonorrhoea
USS
Urine culture

67
Q

Treatment for epididymo-orchitis

A

Doxycycline - Chlamydia
Ceftriaxone - Gonorrhoea
Antibiotics
Analgesia

68
Q

Define testicular torsion

A

Acute/sudden onset of unilateral testicular pain
Often triggered by activity (e.g. playing sports)
6 hour window after onset before damage is irreversible

69
Q

Symptoms of testicular torsion

A 
Sudden onset of pain in one testis
Abdominal pain
Nausea and vomiting
Tender, hot and swollen
Abnormal lie - horizontal, rotated and elevated
Absent cremasteric reflex
70
Q

Differential diagnoses for testicular torsion

A

Epididymo-orchitis - has symptoms of UTI and more gradual onset

71
Q

Management for testicular torsion

A

Untwist the testicle

Possible orchiectomy

72
Q

Define urinary incontinence

A

Involuntary leakage of urine

73
Q

Define urge/overactive bladder

A

Overactivity of the detrusor muscle of the bladder

Suddenly feeling the urge to pass urine

74
Q

Symptoms of urge/overactive bladder

A

Urgency
Frequency
Nocturia
Key in door - latchkey incontinence

75
Q

Causes of urge/overactive bladder

A 
Stroke
Parkinson's
Dementia
Urinary infection
Diabetes
Diuretics
Atrophic vaginitis
Urethritis
76
Q

Define stress incontinence

A

Weakness of the sphincter muscles

Occurs when coughing, laughing, lifting and exercise

77
Q

Causes of stress incontinence

A

Pregnancy
Following birth
Post-menopausal women - low oestrogen - weakening pelvic support

78
Q

Define mixed incontinence

A

Combination of urge and stress incontinence

79
Q

Define overflow incontinence

A

Due to obstruction to the outflow of urine

80
Q

Causes of overflow incontinence

A 
Prostate enlargement
Anticholinergics
Fibroids
Pelvic tumours
Multiple sclerosis
Diabetic neuropathy
Spinal cord injuries
81
Q

Risk factors for incontinence

A 
Increased age
Postmenopausal status
Increased BMI
Previous pregnancies
Pelvic organ prolapse
Pelvic floor surgery
Multiple sclerosis
Cognitive impairment and dementia
82
Q

Investigations for incontinence

A

Urinalysis - UTI check
Frequency volume chart
Post-void residual bladder volume
Urodynamic testing

83
Q

Medical management for stress incontinence

A

Duloxetine - SNRI

84
Q

Surgical management for stress incontinence

A

Tension free vaginal tape
Sling
Colposuspension

85
Q

Non-pharmalogical management for stress incontinence

A

Pelvic floor exercises

86
Q

Medical management for urge incontinence

A

Anticholinergics - Oxybutynin, tolteridone, solifenacin
Mirabegron - Beta3 adrenergic agonist
Botox

87
Q

Non-pharmacological management for urge incontinence

A

Bladder training

88
Q

Side effects of oxybutynin

A

Blurred vision
Constipation
Retention
Dry mouth

Phase 3b (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions