Brainscape's Knowledge GenomeTM

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


See full index

Clinical > Urology > Flashcards

Urology Flashcards

1
Q

Discuss the management of patient with signs of infection and a stone causing obstruction

A

Ureteric obstruction due to a stone with infection is a surgical emergency
- sepsis 6
- decompression via nephrostomy tube placement in IR/ ureteric stent placement
Then definitive treatment e.g. stone removal if needed at later date

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

Management of renal colic with stone of 3.5mm on US

A

A&A Analgesia and advice on stone prevention

Stones <5mm usually pass spontaneously within 4 wks

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

When would you consider open surgery for renal stones?

A

If other treatment failed, if there is complex stone burden or an endoscopic surgery is not an option.

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

What advice would you give on stone prevention?

A

High fluid intake

Diet low in animal proteins and low in salt

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

What are the options without doing open surgery?

A

Shockwave lithotripsy
Ureteroscopy ± stent placement - good option in pregnant women with stone burden <2cm
Percutaneous nephrolithotomy - complex renal calculi and stag horn calculi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How could you classify renal stones?

A 
By composition 
- Calcium oxalate 80%
- uric acid 5-10%
Calcium  phosphate + oxalate 10%
Struvite 2%
Cystine 1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Someone with Crohn’s disease has a higher risk of forming what type of stone?

A

Calcium oxalate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of stone is classically associated with infection?

A

Struvite

- proteus? infection

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

What are the risk factors for renal calculi?

A

Intrinsic - age 20-50 , male 1.3x, History ( 10% annual recurrence rate), genetic ( 25% have fam hx, caucausion and asian more common, genetic disorders e.g. familial renal tubular acidosis

Extrinsic - low fluid intake, hot climates, diet.

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

What is the imaging of choice for renal colic?

A

CT KUB

Pelvic X ray

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

What is the association between a diet high in Ca and the formation of renal stones?

A

None

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

Causes of urethral stricture

A

Trauma - instrumentation or pelvic #
Infection
Chemo, radiation
Balantitis xerotica obliterans

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

What are the symptoms of a urethral stricture?

A 
Hesitancy 
Strangury 
Poor stream 
Terminal dribbling 
Incomplete voiding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of urinary retention

A

Obstructive
Neurological
Myogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Obstructive causes of urinary retention

A
  • mechanical ( BPH, urethral stricture, stones, constipation)
  • dynamic ( post op pain, drugs, = increased smooth muscle tone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Neurological causes of urinary retention

A

Due to either sensory or motor disruption

  • pelvic surgery
  • MS
  • DM
  • Spinal injury / compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Myogenic causes of urinary retention

A

Over distension of bladder due to

high alcohol intake or post anaesthesia

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

Clinical presentation of acute urinary retention

A

Suprapubic tenderness
Palpable bladder dull to percussion
Large prostate on PR
less then 1L drained on catheterisation

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

What would be seen on imaginary of patient with urinary retention?

A

US bladder volume, hydronephrosis, dilate ureters

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

What are the management options for a patient with urinary retention?

A
  1. Conservative ( analgesia, walking, running water or hot bath)
  2. Catheterise ( + monitor urine output with fluid replacement to manage post-obstructive diuresis. Then try to void without catheter after 24-72hrs.
  3. TURP indicated if TWOC fails or there is impaired renal fan.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When is a suprapubic catheter contraindicated?

A

Known or suspected bladder cancer
undiagnosed haematuria
Prep lower abdomen surgery.

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

Most common type of bladder cancer?

A

Transitional 90%

SCC 10%

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

What is a risk factor for SCC?

A

Schistosomiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Large soft mass in the scrotum that can be separated from the testicle. Most prominent with the patient standing

A

Inguinal Hernia

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

Non tender, soft, fluctuant lump at the superior pole of the testicle that is separate from the testicle itself. Transilluminated with light

A

Epididymal cyst

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

Non tender soft fluctuant lump around the testicle that transilluminates with light

A

Hydrocele

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

Mildly tender, soft, irregular lump separate from the testicle

A

Varicocele

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

Scrotal exam finds hard, irregular lump, non tender

A

Testicular cancer

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

Very tender, hot swollen testicular swelling most prominent at the superior pole and back of the testicle

A

Epididymo-orchitis

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

How does LHRH agonist work?

A

LHRH stimulates release of LH from pituitary. LH then stimulates release of testosterone.
The LHRH agonists bind to the pituitary and initially stimulate LH release but the constantly high levels of LH eventually result in a down regulation and absence of testosterone.

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

Most common type of testicular cancer

A

Germ cell tumors 90% ( seminoma most common 50%)

32
Q

Examples of non germ cell testicular cancers

A

Epidermoid, adneomatoid, carcinoid

33
Q

Leydig cell and Sertoli cell tumors are examples of

A

Mixed germ cell tumors

34
Q

Most common type of non-seminomatous tumor

A

Teratoma

35
Q

Most common type of renal stone

A

Calcium oxalate

36
Q

Anabolic steroid use is linked to what type of cancer

A

Prostate cancer

37
Q

Exposure to aromatic amines is linked to what

A

Bladder cancer

38
Q

Long term dialysis increases risk of what type of cancer

A

Renal cancer

39
Q

Best image to use in renal colic

A

CT KUB

40
Q

Bell clapper deformity predisposes to what?

A

Testicular torsion

41
Q

Why does bell clapper deformity predispose to testicular torsion?

A

Absence of the normal posterior attachment of the testicle to the tunica vaginalis

42
Q

21 y/o man with painless, hard, irregular left testicular lump where AFP v elevated, beta hCG elevated, lactate dehydrogenase v elevated? Dgx?

A

Teratoma

43
Q

Management of epididymis-orchitis

A

Ciprofloxacin or doxycycline if STI

44
Q

Initial management of BPH

A

Tamsulosin [alpha blocker - relax smooth muscle]

Finasteride [5-a reductase inhibitors = Block testosterone +reduce prostate size]

45
Q

Time window for testicular torsion

A

6hrs

46
Q

Management of stone less than 2cm in aggregate

A

Lithotripsy

47
Q

Mgmt stone burden less than 2cm in pregnant female

A

Ureteroscopy

48
Q

Complex renal calculi ans staghorn calculi management

A

Percutaneous nephrolithotomy

49
Q

Ureteric calculi less then 5mm mgmt

A

expectantly?

50
Q

Complications of shockwave lithotripsy

A

Solid organ injury

Stone fragmentation causing ureteric obstruction

51
Q

Risk factors for TCC

A

Smoking
exposure to aniline dyes in printing and textiles
Rubber manufacture
Cyclophosphamide

52
Q

T/F smoking is a risk factor for SCC of bladder?

A

true

53
Q

indications for circumcision

A

Phimosis
Recurrent balantitis
Balantitis xerotica obliterans
Paraphimosis

54
Q

Lump not separated from testes that transilluminates

A

Hydrocoele

55
Q

Most cases of acute epididymis-orchitis are due to?

A

Chlamydia

56
Q

Why doe varicoceles typically occur on the left?

What are possible associations with varicoceles?

A

Left because testicular vein drains into the renal vein

May be the presenting feature of a renal cell carcinoma

Bilateral varicoceles may affect fertility

57
Q

What type of drug is tamsulosin and how does it work?

A

Alpha 1 antagonist

Decreases smooth muscle tone of bladder and prostate

58
Q

S/Es of tamsulosin

A

Dixxiness, dry mouth, depression

Risk of orthostatic hypotension

59
Q

How long for 5 alpha reductase inhibitors to work? Give Eg

MOA

A

Finasteride
6 moths to reduce prostate volume and slow dx progression
block conversion of testosterone to dihydrotestosterone which induces BPH

60
Q

Erectile dysfunction, reduced libido, ejaculation problems and gynaecomastia are possible side effects of what drug used for BPH?

A

5 alpha reductase inhibitor finasteride

61
Q

Hyponatremia+ Fluid overload + glycine toxicity are part of what?

A

TURP syndrome

62
Q

Elevated AFP is associated with what type of cancer?

A

Testicular non seminoma ENDODERMAL

63
Q

Difference between a renal cell carcinoma and a renal cyst on CT scan?

A

RCC is a separated mass containing solid and liquid components
Cysts are not separated.

64
Q

Cause of epididymitis by age group

A

less than 35 - STI chlamydia or gonorrhea

over 60 E coli

65
Q

Tx of erectile dysfunction

A

Phosphodiesterase inhibitors e.g. sildenafil

Do not give nitrates at same time

66
Q

tx of kidney stones

A

If < 0.5cm → Pain control
If > 0.5cm → medical expulsion therapy [e.g. CCB]
If 1.5cm → Stenting or Lithotripsy
If >3cm → Surgery
If septic / acute upper UT obstruction → Nephrostomy tube and figure out after

67
Q

Causes of haematuria

A 
start from top -> down 
Medications 
Drug induced → ketamine + cyclophosphamide 
Chemical
Radiation cystitis 
Renal
Glomerulonephritis
PKD
Renal cell carcinoma
Renal calculi
Ureter 
Urothelial cancer
Outside malignancy
Cervical ca
Calculi 
Strictures 
Bladder
UTI
Most common
Cystitis
Bladder stones 
Bladder ca and pelvic ca
Prostate 
Prostate ca
BPH
Urethra
Structures
Urethritis
68
Q

Undescended testes after 3 months

A

Refer to surgery

69
Q

Radiouscent gallstones

A

Urate

70
Q

Past paper q on bladder cancer

A

Intrathecal Chemo may be used

71
Q

what is the link between gynaecomastia and testicular cancer

A

Gynaecomastia in testicular cancer occurs due to an increased oestrogen:androgen ratio

72
Q

Typical age for testicular cancer

A

20-30yrs

73
Q

small fluid-filled lump. smooth regular character, and that it feels separate from the body of the testicle.

A

An epididymal cyst

74
Q

what type of drug is goserelin

A

GnRH agonist

75
Q

What is the first-line in patients with benign prostatic hyperplasia

A

Alpha 1 antagonist

76
Q

classic age for testicular teratomas and seminomas

A

Teratomas for the troops (20-30), Seminomas for the Sergeants (30s/40s onwards)

77
Q

HCG and AFP may be raised in what type of cancers

A

teratoma and yolk sac

not seminomas

Clinical (45 decks)

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