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Renal > Urology extra > Flashcards

Urology extra Flashcards

1
Q

Gold standard bladder cancer investigation

A

Cystoscopy

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2
Q

Gold standard renal stone investigation

A

USS followed by Non-contrast CT KUB

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3
Q

What risks being damaged with carotid endarterectomy?

A

Ipsilateral hypoglossal nerve - supplies ipsilateral motor to the tongue therefore when pointing out tongue it will deviate towards the affected side

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4
Q

Monitoring of therapeutic efficacy of LMWH

A

No monitoring needed

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5
Q

Monitoring of therapeutic efficacy of unfractionated heparin

A

APTT

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6
Q

Most common hyperechoeic liver lesion on USS

A

Normal AFP - always likely to be hemangioma (tumours are also hyperechoeic but HCC will cause raised AFP)

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7
Q

Treatment of liver amoebic abscess

A

Metronidazole

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8
Q

Scan of liver amoebic abscess

A

Ill defined boundaries

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9
Q

Features of benign adrenal adenoma

A

Lipid core

Less than 3cm

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10
Q

What is Waterhouse- Friderichsen syndrome?

A

Adrenal gland failure due to bleeding into the adrenal glands, caused by severe bacterial infection - normally meningococcus

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11
Q

Which kidney stones are radiolucent

A

Xanthine and urate

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12
Q

What can happen with medical prostate cancer treatment

A

On starting goserelin can get initial flare up of prostate cancer symptoms causing by initial increase in LH production
This can be prevented with pre-treatment with flutamide - synthetic antiandrogen

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13
Q

What is Leriche syndrome

A

Triad of buttock + thigh claudication, erectile dysfunction, thigh muscle wasting
Caused by atheromatous disease of iliac vessels
Patients with CV risk factors
Treat with angioplasty and stents

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14
Q

What do raised fibrin degradation products imply

A

Disseminated intravascular coagulation

Especially if low platelets

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15
Q

Virus related to development of nasopharyngeal carcinoma

A

EBV

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16
Q

Management of kidney stone if infection

A

Percutaneous nephrostomy or ureteroscopy

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17
Q

Management of a kidney stone if smaller than 2cm

A

ESWL

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18
Q

Management of a small kidney stone if pregnant

A

Ureteroscopy

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19
Q

Management of a kidney stone if larger than 2cm

A

Percutaneous nephrolithotomy

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20
Q

How long before operation should antiplatelets be stopped

A

7 days

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21
Q

How do juvenile polyps present?

A

Haematomas
Rectal bleeding
Cherry red lesion on anal verge

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22
Q

Painful defecation and bright red anal bleeding in 4yr old boy

A

Anal fissure

Hx of constipation

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23
Q

Reed- Sternberg cells?

A

Hodgkins lymphoma

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24
Q

Abdo xray in hirschsprungs

A

Dilated bowel loops - air fluid levels

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25
Q

X ray in necrotising enterocolitis

A

Air in bowel wall

Continuum of mesenteric ischaemia

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26
Q

Features of meconium ileus

A

newborn with abdominal distention and billous vomiting

xray shows dilated bowels and mottled ground glass appearance

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27
Q

Addisonian crisis features

A

Hyponatraemia
Hyperkalaemia
Hyperglycamia i

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28
Q

What are post-splenectomy patients at risk of

A

Encapsulated bacterial infection eg. pneumococcus and meningococcus
therefore pneumovax every 5 years and 2weeks before surgery
Should also be given influenza vaccination

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29
Q

Type of cancer underlying pagets disease

A

Ductal Carcinoma In Situ - 70%

Invasive carcinoma - 30%

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30
Q

What is needed to confirm diagnsois of achalasia

A

Manometry

31
Q

What is needed in oesophageal cancer diagnosis

A

CT scan - staging

Endoluminal ultrasound - looking for signs of irreducibility such as invasion into the pericardium or pleura

32
Q

Difference between type 1 and type 2 respiratory failre

A

Type 1 - low po2 + low/normal co2

Type 2 - low po2 - high co2

33
Q

Treatment of pseudomembranous colitis following antibiotics etc causing c-diff infection

A

Fluids +oral metronidazole for 10 days

If not treated then vancomycin

34
Q

Signs of neurogenic shock

A

Bradycardia and profound hypotension

35
Q

Metabolic features of pyloric stenosis

A

Hypochloraemic hypokalaemic metabolic alkalosis

36
Q

Which is autoimmune PBC or PSC

A

Both
PBC more in women - associated with RA and Sjogrens
PSC more in men - associated with UC

37
Q

What is Buerger disease

A

Vasculitis of medium-sized vessels - progressive obliteration of distal arteries in upper and lower limbs

38
Q

Who is Buerger disease most common in?

A

Asians and Ashkenazi Jews
Young men (under 45) who smoke heavily
HLA-B12

39
Q

Symptoms of Buerger disease

A

Pain

Can also get chronic inflammation, thrombosis, ulceration and gangrene

40
Q

Arteriography in Buerger disease

A

Normal proximal vessels

Distal occlusions with multiple ‘corkscrew’ collaterals

41
Q

Management of Buerger disease

A

Stopping smoking

Analgesia

42
Q

What is gunstock deformity

A

Deformity resulting from mal-union of supracondylar fractures leading to a cubitus varus deformity

43
Q

What is Chagas disease?

A

Parasitic disease of the tropics caused by protozoan Trypanosoma - has different stages of inection

44
Q

Where is Chagas disease endemic?

A

Central america and south america

45
Q

Acute stage symptoms of Chagas disease

A

Skin nodule - chagoma - at site of inoculation associated with non-specific symptoms eg. fever, malaise, anorexia and lymphadenopathy
these resolve spontaneously

46
Q

Second stage of Chagas disease

A

Occur after many years in 30% of patients
Presenting complaint is dysphagia - destruction of myenteric plexus with subsequent disruption of peristalsis - leads to oesophageal dilatation
Also dementia and cardiomyopathy

47
Q

What is seen on imaging with second stage of Chagas disease

A

Megaoesophagus on Barium swallow

48
Q

Treatment of Chagas disease

A

Anti-parasitic medication

Management of secondary manifestations

49
Q

What is Rosving sign

A

Palpation in left iliac fossa with appendicitis causing pain in right iliac fossa

50
Q

Why might you get headache with symptoms of acromegaly

A

SOL from pituitary tumour growing (GH secreting)

As well as standard symptoms from GH secretion

51
Q

Symptoms of acromegaly

A

Excessive sweating, headaches, thick oily skin, hypertrophy of tissues
Prognathism

52
Q

What do you get increased risk of with acromegaly

A

Atheromatous disease and colon cancer

53
Q

What is cholangiocarcinoma associated with

A

UC, PSC and lesser extent Crohns

will present with Courvoisiers law

54
Q

What happens with Brown Sequard syndrome

A

Unilateral transection of spinal cord
Ipsilateral motor loss (+ proprioception and vibration)
Contralateral sensory loss for pain + temp

55
Q

DDX for jaundice, hepatomegaly, ascites and malaise, with neuropsychiatric features in a 12 yr old boy

A

Wilsons - CAUSES JAUNDICE!

56
Q

Gastrochisis vs exomphalos

A

Gastroschisis herniation of abdominal contents with no coverage
Exomphalos lies in a sac with two membranes

57
Q

What viruses is anal carcinoma associated with?

A

HPV 16, 18, 31 and 33

58
Q

When is surgery indicated for infant umbilical hernia

A

If persist after 1st 2 years of life

59
Q

Type of polyps in IBD

A

Pseudopolyps (pseudo because areas of swollen bowel mucosa)

60
Q

What are false aneurysms

A

Collection of blood lying outside but communicating with vessel - does not include vessel wall
Also called pseudoaneurysm
Commonly occur after trauma or iatrogenic injury ie. angiography
Will be pulsatile i.e if in groin

61
Q

AFP tumour indicators for?

A

HCC and testicular tumours

62
Q

First step in managing an open fracture

A

IV antibiotics and debridement of tissue

63
Q

Features of discoid lupus

A 
Cutaneous manifestations only 
Cheeks and other skin exposed areas
Scalp leading to alopecia 
Palms and soles can be affected 
Avoid UV light exposure
64
Q

What is seen on xray in posterior dislocation

A

Light bulb sign - abnormally rounded appearance of the humeral head
Diagnosis confirmed on lateral view

65
Q

What is acral lentiginous melanoma

A

Rare but 1/2 of melanomas in dark skinned people. Typically in 60s
Found on hairless areas (palsm, soles, nails etc) May be mistaken for bruises

66
Q

Most common type of malignant melanoma

A

Superficial spreading type

67
Q

Most aggressive type of melanoma

A

Nodular melanoma - present as pigmented nodular lesion - grow rapidly

68
Q

Features of lentigo maligna melanoma

A

Develop within an area of sun-damaged skin, progress over a period of years into malignant lesion

69
Q

Do branchial cysts transilluminate?

A

No

70
Q

Immediate treatment of acute closed angle glaucoma

A

Pilocarpine eye drops to constrict pupil an cause miosis

71
Q

What is Tensilon test

A

Mysasthenia gravis test - edrophonium bromide - short-acting anti-cholinesterase

72
Q

What is Milroy disease

A

Congenital primary lymphoedema - failure of lymph vessels to develop in utero
Primary lymphoedema is called called lymphoedema praecox if presents over 35yrs and lympheodema tarda if after 35 years

73
Q

Features of psoas abscess presentation

A

Non-specific
Flank, abdo. hip and thigh pain
Fever + limp
Any action requiring movement and flexion of hip causes pain
Treat with incision and drainage and IV antibiotics

Renal (9 decks)

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