Urology

Question 1

Prostate size relates to cancer risk. True or false.

Answer 1

False.

Question 2

Give 4 LUTS

Answer 2

Lower urinary tract symptoms

Frequency, urgency, intermittency, nocturia, straining, weak stream

Question 3

What is BOO?

Answer 3

Bladder outflow obstruction

Question 4

What is Tamsulosin? When may it be used?

Answer 4

An alpha blocker used to relax the prostate. Used in BPH.

Question 5

Name two medications used in BPH.

Answer 5

Tamsulosin - alpha blocker

Finasteride - 5a reductase inhibitor

Question 6

Which medications do we use in overactive bladders?

Answer 6

Anti-cholingergics: oxybutynin

Question 7

What affect do beta agonists have on the bladder?

Answer 7

Relax the bladder.
Alpha blockers
Beta agonists = both relax the bladder.

Question 8

Give x3 causes of urinary retention.

Answer 8

BPH
UTI
Cancer

Question 9

At which PSA number do we investigate individuals?

Answer 9

PSA >3

Question 10

When may PSA be raised?

Answer 10

Urinary infection
BPH
Prostate cancer

Question 11

When do we do a cytoscopy?

Answer 11

To assess patient’s bladder e.g. haematuria.

Question 12

Give x3 loin pain differentials.

Answer 12

AAA
Testicular torsion
Perforated PU
appendicitis
MI
diverticulitis

Question 13

Which tumour marker is only secreted by teratomas?

Answer 13

AFP - alpha fetoprotein.

Question 14

How would you operate on a testicular tumour?

Answer 14

Radial Inguinal orchidectomy

Question 15

Teratomas are common amongst which age group?

Answer 15

20-35 years; younger patients.

Question 16

Which is the basic renal cell screening test?

Answer 16

Ultrasound.

Question 17

After relieving retention, what is one test we MUST perform?

Answer 17

DRE

Question 18

Which test confirms acute urinary retention?

Answer 18

Bladder scan residual

Question 19

Which symptoms indicate BOO (bladder outflow obstruction)?

Answer 19

Frequency
Urgency
Nocturia
Poor flow
Intermittent flow 
Terminal dribbling

Question 20

What is the function of PSA?

Answer 20

To liquefy the ejaculate to make fertilisation more likely.

Question 21

Name three conditions where the PSA may be raised

Answer 21

BPH
UTI
acute and chronic prostatitis

Question 22

Which is the first initial investigation for testicular torsion

Answer 22

Urine dipstick.

Testicular torsion is an emergency!!

Question 23

How would you differentiate between a patient’s presentation of testicular torsion and epididymo-orchitis?

Answer 23

Testicular torsion has a much more rapid onset of pain.

Question 24

How do we treat a testicular torsion?

Answer 24

Analgesia and urgent surgery.

Question 25

What is the epididymis?

Answer 25

A tube that connects the vas deferens to the testes.

Question 26

What is transilluminance?

Answer 26

Shining a light behind a scrotal lump and seeing if that light travels through.

Question 27

What is the pampiniform plexus?

Answer 27

The network of veins which drain the testes and spermatic cord.

Question 28

What is a variocele?

Answer 28

An abnormal dilatation of the pampiniform plexus.

Question 29

Industrial dye exposure is a risk factor to which cancer specifically?

Answer 29

Bladder cancer.

Question 30

Loin to groin pain is indicative of which diagnosis?

Answer 30

Renal colic (stones)

Question 31

Loin to groin pain is indicative of which diagnosis?

Answer 31

``` Renal colic (stones) Appendicitis (but would have a fever). ```

Question 32

Which are the two common cancers in urology to cause haematuria?

Answer 32

Renal cell carcinoma | Transitional cell carcinoma

Question 33

Give 3 main risk factors for renal cell carcinoma.

Answer 33

Smoking Obesity Von Hippel-Lindau disease

Question 34

Name the procedure whereby we remove one or both of the testicles.

Answer 34

Orchidectomy

Question 35

What is the most appropriate initial investigation for a renal colic?

Answer 35

CT KUB | Urine dipstick.

Question 36

What is the most appropriate initial investigation for a renal colic?

Answer 36

``` CT KUB (except in pregnancy where ultrasound would be the most suitable). Urine dipstick. ```

Question 37

Are renal tract stones more common in males or females?

Answer 37

Males by upto x4!

Question 38

Man with Benign prostatic hyperplasia presents to A&E with acute urinary retention with pain and discomfort. What is the first necessary step?

Answer 38

Catheterise the patient.

Question 39

Which class of drugs are used in BPH?

Answer 39

Alpha blockers e.g. tamsulosin | 5a reductase inhibitors e.g. finasteride

Question 40

When evaluating a mass in the scrotum, which are the questions we should be asking?

Answer 40

- Can we palpate the mass? | -

Question 41

Define hernia

Answer 41

An abnormal protrusion of a viscus from one cavity into another.

Question 42

If we cannot palpate a lump in the scrotum what are two differentials?

Answer 42

Must be coming from above i.e. the abdomen 1. hydrocele of spermatic cord 1. inguinal hernia

Question 43

Give two characteristics of an inguinal hernia

Answer 43

They have a cough reflex; increased pressure | They can be reduced (pushed inwards).

Question 44

How would you attempt to differentiate between an inguinal and a femoral hernia clinically?

Answer 44

Inguinal hernia is superior and medial to the pubic tubercle.

Question 45

How would you attempt to differentiate between a direct and indirect inguinal hernia clinically?

Answer 45

Place 2 fingers over the deep ring. Ask patient to cough. If hernia protrudes = direct hernia.

Question 46

A femoral hernia is seen/ felt in which location?

Answer 46

Inferior and lateral to the testicle.

Question 47

'bag of worms' = ?

Answer 47

Variocele