Urology Crash Course Flashcards
Urinary stones classically obstruct at three major sites
Gold standard for urinary tract calculi?
Non contrast CT KUB
Spontaneous passage of stones
Conservative management of small stones
Analgesia and anti-emetics (PR diclofenac)
Discharge - stone clinic
3 methods for intervention
Ureteroscopy
Urological procedure often utilising energy devices to break up the stone
Shockwave lithotripsy
Non-invasive procedure that uses shockwaves to break up the stones
Percutaneous nephrolithotomy
Nephroscope is passed into the collecting system and used to break up stones
Tends to be reserved for larger stones such as stag horn calculi
Stag horn calculi
Cause = urease producing bacteria (proteus mirabilis)
Urgent decompression. - stones
Nephrostomy and a ureteric stent
If infection/AKI
Nephrostomy under local anaesthetic
Often preferred in severe sepsis
Stent and nephrostomy
Hydrocele
Typically present with a non-tender scrotal swelling that trasnilluminates
In infants - often related to a patient processes vaginalis
Other causes - trauma, infection, cancer but often idiopathic
Communicating vs non-communicating hydrocele
Patent processes vaginalis - infants - communicating
Non-communicating normally in adults
Testicular cancer accounts for …% of new cancers diagnosed in men in the UK
1%
A
D
E
A
All of the above
Typical first-line investigation for suspected prostate cancer
MRI prostate
How to grade prostate cancer?
Prostatic biopsy after a MRI prostate
Gleason score
Sum of the grade of most dominant and second most dominant cell morphology
More advanced disease - prostate cancer symptoms
Bone pain and wt loss
What is the most common bladder cancer?
Transitional cell carcinoma
Cyclophosphamide
Schistosome haematobium is associated with which type of bladder cancer?
Squamous cell carcinoma
Less common in western world
TURBT
Trans-urethral resection of bladder tumour gives a histological sample + assessment of invasion
Muscle invasive vs non-muscle invasive bladder cancer
