Urology Flashcards
Nephropathy associated with malignancy
Membranous nephropathy
Can get amyloidosis but membranous nephropathy is much more common
AB to avoid in renal transplant
Trimethoprim
Can cause nephrotoxicity, especially when used in association with cyclosporin and tacrolimus
Urinary obstruction as a consequence of spinal cord compression
= neurogenic bladder
Diagnosis of vesico-vaginal fistula
Methylene blue + tampon
Investigation of suspected renal stones
NON CONTRAST
CT KUB
Drugs used in urge incontinence (2)
Oxybutynin
Mirabegron
Urine dipstick strongest indicator of UTI
Positive for Nitrites
Stronger positive predictor than leukocytes
Definition of Recurrent UTI
2 or more in 6 months
3 or more in 12 months
Investigation of Recurrent UTI
- USS urinary
2. Flexible cystoscopy
Management of Lower Urinary Tract Symptoms
- Alpha blocker e.g. tamsulosin
- 5-alpha reductase inhibitor e.g. finasteride
- TURP
Management of Erectile Dysfunction
= tadalafil
PDE5 inhibitor
Composition of Staghorn Calculus
Association
ammonium magnesium phosphate
Proteus
ESWL stone size
Can be used for stones <20mm in diameter
Cresmasteric reflex and torsion
Absent in torsion
May be present if torsion is of the appendage
Low pressure VS high pressure urinary retention
High pressure = if hydronephrosis is present
When can you test PSA after prostatitis?
1 month after
Management of hydronephrosis resulting from calculus
Nephrostomy
Management of RCC
Why?
Surgery
Often chemo or radio resistant
Normal residual urine values
< 65
> 65
<50ml in <65
<100ml in >65
Management of renal calculus in pregnancy
Lithotripsy contraindicated
Would do ureteroscopy
Management of invasive bladder cancer
Radical cystectomy
Management of R sided testicular torsion
Surgical fixation of both right and left testicle
Struvite =
ammonium magnesium phosphate
GnRH agonist used in prostate cancer
Zoladex
Zoladex is a…
GnRH agonist
Investigations in erectile dysfunction
- HbA1c and lipids
- AM testosterone
- Prolactin/FSH
Hypertension
Renal/Adrenal tumour
Child =
= nephroblastoma
Also known as Wilm’s tumour
Voiding of Urine - Nerve Supply
Parasympathetic = promotes voiding Sympathetic = inhibits voiding
Management of Urge Incontinence - Medications (3)
Oxybutynin and Tolteradine = anti-muscarinics
Mirabegron = B3 agonist
Management of Stress Incontinence - Medication
Duloxetine
Mechanism of Duloxetine in Stress Incontinence
Increases serotonin and noradrenaline concentrations
Increased pudendal nerve tone
Increased stimulation of urethral muscle
= increased contraction of sphincter
1st Investigation in Prostate Cancer
MRI
