Brainscape's Knowledge GenomeTM

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


See full index

4th Year > Urology > Flashcards

Urology Flashcards

1
Q

main conditions covered in urology

A

UTI Incontinence Bladder cancer Stones Testes pathology Prostate pathology

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

most common cause of UTI

A

ascending infection - bacteria from large bowel colonises up through urethra

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

presentation of UTI

A

dysuria (pain) polyuria (increased frequency) nocturia (getting up to pee in night) pyelonephritis: fever loin pain rigors

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

what is pyelonephritis

A

upper uni (of ureters and kidneys)

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

what is cystitis?

A

inflammation of the bladder - not always infection

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

investigations for UTI

A

dipstick culture rarely microscopy

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

what does urine dipstick show in UTI

A

high nitrates -though not with enterococcus, staphylococci and pseudomonas leukocytes

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

Kass’s criteria for UTI culture

A

>10^5 organisms = significant <10^3 = no infection 10^4 = repeat sample

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

most common causative organisms for UTI

A

E.coli Proteus Pseudomonas aeruginosa Enterococcus Staphylococcus saprophytic

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

what type of bacteria is e.coli

A

gram -ve coliform causes fever due to endotoxin

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

how does a Proteus UTI present

A

FOUL smelling urine -like burnt chocolate? struvite stones increased urinary pH urolithiasis (renal stones)

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

how does a pseudomonas UTI present

A

gram -ve bacillus associated with catheters resistant to most antibiotics except ciprofloxacin

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

how does an enterococcus UTI present

A

most commonly hospital required comes from GI tract

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

how does a staphylococcus saprophyticus UTI present

A

in women of child bearing age gram -ve staph

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

treatment of female lower UTI

A

nitrofurantoin or trimethoprim 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

male UTI - uncatherterised treatment

A

nitrofurantoin or trimethoprim 7 days

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

complicated UTI/pyelonephritis/urosepsis treatment

A

IV amoxicillin + gentamicin for 3 days

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

what are the main types of incontinence

A

stress incontinence urge incontinence overflow incontinence

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

presentation and cause of stress incontinence

A

dribbles of urine on coughing, sneezing or excretion caused by weak pelvic floor causing bladder neck/urethra hyper mobility or neuromuscular defects causing spinster deficiency urine leaks when urethral resistance is exceeded by abdominal pressure

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

presentation and cause of urge incontinence

A

sudden urge to go - can be triggered by taps, being at front door ect often cant make it to the toilet caused by overactivity of the detrusor muscle

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

presentation and cause of overflow incontinence

A

caused by bladder outflow obstruction more common in men - caused by BPH constant dribbling

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

treatment for stress incontinence

A

lifestyle: -reduce caffeine intake -weight loss, stop smoking -pelvic floor exercises drugs: -Duloxetine (SNRI) Surgery -transvaginal tape -colposuspension (bit of bowel wrapped round urethra to keep it up)

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

treatment for urge incontinence

A

reduce caffeine bladder training antimuscarinics - oxybutynin

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

incontinence investigations

A

urinalysis - look for UTI/renal impairment bladder chart -record voided volumes, frequencies and incontinence pad test -determines severity urodynamics -records bladder volume and pressure

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

how to treat overflow incontinence

A

treat the BPH

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

BPH treatment

A

alpha blockers (tamsulosin) spironolactone TURPS (transurethral resection of the prostate)

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

what are renal stones made of

A

80% are calcium oxalate calcium phosphate uric acid struvite

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

what is a staghorn calculus

A

renal calculus in the shape of a stag horn body sits in the renal pelvis and horns extend into renal calyxes usually composed of struvite

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

renal calculi presentation

A

can be asymptomatic or severe loin to groin pain -colicky pain fluctuating in severity as the stone moves and settles -haematuria, nausea, vomiting, oliguria

30
Q

how to diagnose renal calculi

A

urine dipstick bloods for infection and kidney function CT KUB = gold standard

31
Q

medical management of renal calculi

A

NSAIDs eg. PR diclofenac antiemetic if N&V fluids antibiotics if infection stones <6mm have a >50% chance of passing without intervention but spontaneous passage can take weeks tamsulosin - alpha blocker helps with passage of stones

32
Q

surgical management of renal calculi

A

extracorporeal shock wave lithotripsy -shock waves given under x-ray guidance to break up stone so its easier to pass utereoscopy and laser lithotripsy -camera via urethra, stone broken up by targeted lasers

33
Q

one episode of renal stones makes another more likely, how do you prevent this

A

increase oral fluids reduce salt intake reduce oxalate rich foods for calcium stones (spinach, nuts, rhubarb, tea) reduce intake of rate (rich foods for uric acid stones) limit dietary protein

34
Q

most common bladder cancers

A

transitional cell carcinoma (95%) Squamous cell carcinoma (5%)

35
Q

bladder cancer presentation

A

frank, painless haematuria

36
Q

sites of bladder cancer metastases

A

local lymph nodes lungs

37
Q

what type of cell lines the bladder and why

A

transitional epithelium -tight junctions between cells -3-7 layers -constantly renews -prevents toxins passing into body

38
Q

risk factors for transitional cell carcinoma

A

smoking phenacetin (now banned analgesic) aniline (dye from manufacturing) cyclophosphamide (immunosuppressant)

39
Q

what are the two types of transitional cell carcinoma

A

papillary - most of them, grow like bushes non-papillary - more dangerous, all malignant, grow flat and invasively

40
Q

when does squamous cell carcinoma of the bladder occur

A

when theres been a metaplastic change in the epithelium to turn it from transitional to squamous causes: -schistosomiasis -long term catheter -long standing kidney stones -recurrent UTIs all cause inflammation and metaplasia

41
Q

treatment of bladder cancers

A

resection of the bladder -transurethral resection of bladder tumour Intravesical chemotherapy -localised chemo to the bladder via catheter if severe - cystectomy

42
Q

benign testical lumps/swelligns

A

hydrocele varicocele spermatocele hernia

43
Q

what is a hydrocele and causes

A

accumulation of fluid in the tunica vaginalis causes: idiopathic congenital - patent processes vaginalis connecting it to peritoneum infection injury always TRANSILLUMINATES

44
Q

what is a varicocele

A

dilated veins of venous plexus in testes - like varicose veins

45
Q

worrying presentation of varicocele

A

new onset on the left side in middle aged men think renal cancer!! left testicular vein drains into the renal vein. If renal cancer occludes renal vein it can cause back pressure down the testicular vein

46
Q

what is a spermatocele

A

cystic change within the vas of the epidydimus unknown cause can see sperm inside on biopsy

47
Q

how to differentiate between lumps

A

is it in the testes or separate? can you get above it? - cant get above hernia solid or cystic? is it painful?

48
Q

causes of acute testicular pain

A

torsion infection

49
Q

what is torsion and whats it’s presentation

A

twisting of the spermatic cord stops blood flowing through the testicular artery EMERGENCY extreme excruciating pain no precipitant can occur in sleep absent cremasteric reflex

50
Q

who gets torsion - causes

A

adolescent boys bell clapper deformity - tunica vaginalis is sitting in the wrong position and not holding the testes still- therefore they can rotate and even sit laterally

51
Q

how long does it take for the testes to die with torsion and how do you treat it

A

6 hours emergency surgery to untwist the spermatic cord use non-dissolvable sutures to fix the testes into a safe position MUST do both side - high risk of other side being affected

52
Q

type of testicular cancer and age groups

A

Seminomatous >35s Non-seminomatous <35s

53
Q

how does testicular cancer present

A

lump IN testicle

54
Q

what des a seminoma look like and how’s it treated

A

cut it open and it looks like a potato most common v responsive to radiotherapy 95% are cured

55
Q

what are the non-seminomatous cancers

A

much less common far more aggressive and can metastasise - although outcome is reasonable Teratoma Yolk sac Embryonal Trophoblas

56
Q

tumour markers for testicular cancers

A

alpha-fetoprotein - may be raised in teratomas (not seminomas) beta-hcg - may be raised in teratomas or seminomas (pregnancy test hormone) lactate dehydrogenase

57
Q

where do testicular cancers metastasise to

A

lungs liver brain

58
Q

what ar the 3 zones of the prostate

A

transitional central peripheral

59
Q

what zone of the prostate is affected by BPH

A
60
Q

what zone of the prostate has 70% of prostate cancers

A
61
Q

what is the verumontanium

A

where the ejaculatory ducts drain into the urethra

62
Q

presentation of prostate cancer

A

usually incidental after PSA or PR

this is because the cancers are usually in the peripheral zone so need to be v advanced to cause urinary symptoms

haematuria

haematospermia

bone pain, anorecia, weight loss

63
Q

what conditions raised PSA

A

BPH

prostatitis/UTI

retention

catheterisaion

cystoscopy

PR

cycling on a hard bicycle seat for long time

64
Q

what investigations do you do if abnormal PSA and PR

A

MRI - usually before biopsy

Trans-rectal ultrasound guided biopsy

10 biopsies taken

haematospermia and haematuria occur for 2-3 weeks after testing

65
Q

signs of prostate malignancy on PR

A

Assymetry

nodule

hard, craggy mass

66
Q

what type of cancer is 95% of prostate cancers

A

multifocal adenocarcinoma

67
Q

mets sites for prostate cancer

A

pelvic lymph nodes

bones - causes osteo SCLEROSIS bone mets - bone mets are usually lytic

68
Q

management of prostate caner

A

watchful waiting

active surveillance

radical surgery

radio therapy

if locally advanced - radiotherapy + hormonal therapy

if metastatic:

  • androgen depravation therapy (hormonal therapy, bilateral orchidectomy, maximal androgen blockage)
  • steroids
  • chemo

when prostate cells are deprived of androgens they undergo apoptosis

69
Q

what causes BPH

A
70
Q

treatment for BPH

A

alpha blockers - tamulosin

5-alpha reductase inhibitor - finasteride

TURP - transurethral resection of the prostate

4th Year (25 decks)

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