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Concepts / Lists > Urology / GU > Flashcards

Urology / GU Flashcards

1
Q

epididymitis vs orchitis

A

epididymitis usually bacterial

orchitis usually viral

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2
Q

MC cause epididymitis-orchitis by age

A

men <35 - chlamydia (2nd gonorrhea)
men >35 + children - enteric organisms e.coli, klebsiella
viral in children - mumps mc

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3
Q

testicular torsion

A

spermatic cord twists and cuts off testicular blood supply

-65% in teenagers 10-20yo

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4
Q

cryptorchidism

A

undescended testicle

  • mc in premature infants (70% descend spontaneously)
  • MC right side
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5
Q

complications of cryptorchidism

A

TESTICULAR CANCER (both in affected and unaffected side), subfertility, torsion and hernia

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6
Q

mc type of testicular cancer

A

germinal cell tumors (seminoma or nonseminomatous) - usually malignant

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7
Q

testicular cancer - germinal cell (MC) tumor types

A 
seminoma (mc men 30-40s):
simple (lack tumor markers)
sensitive (to radiation)
slower growing
step-wise spread

non-seminomatous (mc <10 yo): embryonal cell, teratoma, yolk sac
-increased serum a-fetoprotein, inc B-hCG and radiorestistance

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8
Q

communicating hydrocele

A

peritoneal/abdominal fluid enters via patent processus vaginalis (swelling worse w/ valsalva)

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9
Q

varicocele

A

varicose veins in testes
MC left side; primary usually idiopathic; secondary can occur in abdominal mass compression of renal veins (mc w/ right side) or superior mesenteric artery compression of left renal vein (nutcracker syndrome)
-sudden onset on left side in older men –> possible renal cell carcinoma
-right-sided in children <10 –> possible retroperitoneal malignancy

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10
Q

spermatocele (epididymal cyst)

A
  • scrotal mass that contains sperm
  • painless, superior, posterior and separate from teste
  • transilluminates and no tx necessary
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11
Q

paraphimosis

A

foreskin trapped behind corona of glans, constricting –> urologic emergency (tx by reduction of edema w/ cool compress and push OR granulated sugar, injection of hyaluronidase OR incision on dorsal)

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12
Q

phimosis

A

inability to retract foreskin over the glans (tx by circumcision)

  • normal until adolescence (13-22 yo)
  • pathologic can be caused by DM - chronic glycosuria can lead to infx
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13
Q

prostatitis

A

prostate gland inflammation 2ndary to ascending infection

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14
Q

acute prostatitis differential by age

A

> 35 yo - e.coli MC, pseudomonas, klebsiella, proteus
<35 yo - chlamydia + gonorrhea (other e.coli, treponema, trichomonas, Gardnerella)
-viral may be seen in children (mumps mc)

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15
Q

chronic prostatitis causes

A

e.coli 75-80%, enterococci

trich, HIV, stx or fx abnormality, recurrent UTIs

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16
Q

risk factors for prostate cancer

A

genetics, high fat intake, obesity, AA
adenocarcinoma (95%)
-hormonally dependent on inc dihydrotestosterone production

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17
Q

prostate cancer clinical sx

A

asymptomatic until invasion of bladder
urethral obstruction (freq, urg, retention, dec stream)
back pain/ bone pain (inc incidence mets to bone)

18
Q

when to do DRE + PSA

A

@ 50 yo

AA or family history @ 40

19
Q

bladder cancer MC type

A 
transitional cell (TCC)
-other, squamous, adeno, sarcoma, small cell
20
Q

bladder cancer RF

A

smoking MC
exposure to dyes, rubber, leather, age >40, cauc M 3x mc
*highest rate of recurrence of all cancers

21
Q

renal cell carcinoma

A
  • tumor of proximal convoluted tubule (v metabolically active so most prone to dysplasia)
  • RF: smoking, dialysis, HTN, obesity, men
22
Q

erection physiology

A

parasympathetic –> artery dilation and muscle relaxation

flaccid state via sympathetic –> norepi –> arterial vasoconstric and venous dilation (reduce inflow and increase outflow)

23
Q

pathophysiology of ED

A
  • abrupt usually psychological, gradual worsening more likely systemic causes
  • neurologic (DM), psychogenic, vascular (atherosclerosis), prolactinoma, trauma, sx
  • meds: BB, HCTZ, CCB, SSRIs, TCAs
24
Q

priapism

A

prologned erections w/out sex stimulation

  • ischemic MC - decreased venous outflow may lead to compartment syndrome
  • nonischemic - due to increased arterial inflow (related to trauma)
25
Q

differential for hematuria

A

<40 mc GU infx, nephrolithiasis
>40 mc urinary tract cancer, prostatic dz

upper GU: nephrolithiasis, kidney dz, renal cell CA, trauma, DM, sickle cell
lower GU: BPH, urothelial cell cancer
pseudo hematuria: rhabdo, beets, rhubarb, myoglobinuria, hemoglobinuria
meds: ibuprofen, phenazopyridine, rifampin

26
Q

urethritis

A

gonoccocal urethritis - acute onset of sx (3-4 days), opaque, yellow, white or clear discharge, pruritus

non-gonococcal - clamydia MC, 5-8 days –> purulent or mucopurulent discharge, pruritus.

  • hematuria, pain with intercourse
  • other types: ureaplasma urealyticum, trichamonas
27
Q

enuresis

A

primary monosymptomatic bedwetting - in children >5 in the absence of sx of infx

28
Q

bladder control (parasympathetic/sympathetic)

A

sympathetic tone closes bladder neck and increased pelvic floor tone

parasympathetic tone increases in micturation, allowing relaxation

29
Q

functional incontinence

A

problem that keeps the patient from quickly getting up to the bathroom

30
Q

mixed incontinence

A

combo of stress + urge in 40-60%

31
Q

stress incontinence

A

urnie leakage due to increased intraabdominal pressure

  • laxity of pelvic floor muscles (childbirth, sx, postmenopause or post-prostatectomy)
  • sneeze, cough, laugh
32
Q

urge incontinence

A

leakage accompanied by or preceded by urge

  • detrusor muscle overactivity “overactive bladder”
  • detrusor stim by muscarinic acetylcholine receptors
33
Q

overflow incontinence

A

urinary retention (incomplete emptying)

  • decreased detrusor muscle “underactive bladder” atony
  • bladder outlet obstruction in BPH
34
Q

gleason score

A

for prostate cancer –> 1-10 (1 well-differentiated, not as bad; 10 is not well-formed and worse prognosis) staged into 1-5 (after score)

35
Q

MC STDs

A

HPV, chlamydia, gonorrhea (in order)

36
Q

MC UTI in infants

A

group B strep

>1yo - e.coli

37
Q

Struvite stone

A

staghorn calculi, urease producing bacteria

38
Q

stone size for passage

A

<5 mm likely to pass on own

39
Q

bladder calculi

A

elderly men

-associated w/ urinary stasis –> mc cause is infection of residual bladder urine w/ urea-splitting organisms

40
Q

name 5 urea-splitting bacteria (contribute to stones)

A 
proteus
pseudomonas
klebsiella
staphylococcus
mycoplasma

Concepts / Lists (16 decks)

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