Urology Pass Med Flashcards
What post voidal volume is normal for a patient <65yo?
<50mls
What post voidal volume is normal for a patient >65yo?
<100mls
Chronic urinary retention is defined as
> 500mls within bladder after voiding
Post catheterisation urine volume of …. suggests acute on chronic urinary retention
> 800mls
Treat an infected obstructed system with what surgical procedure
Percutaneous nephrostomy
Stones <2cm can be treated with what
Lithotripsy (extra corporeal shock wave lithotripsy)
Large proximal stones are best managed with a
Percutaneous nephrolithotomy
Analgesia of choice for renal colic
NSAID
If severe IM
First line diagnostic investigation of stones
CT KUB
Stones
<5mm
What would indicate treatment of a stone <5mm?
Lithotripsy and nephrolithotomy used in ureteric obstruction, renal development abn such as horseshoe kidney and previous renal transplant
What is the main group fo patients which lithotripsy is contraindicated
Pregnant
Stone burden less than 2cm in aggregate
Lithotripsy
Stone burden less than 2cm in pregnant females
Ureteroscopy
Complex renal calculus and stag horn treat
Percutaneous nephrolithotomy
What bacteria causes staghorn calculus
Proteus mirabilis
Treat renal cell carcinoma
Radical nephrectomy
Mass that transluminates in scrotum
Hydrocele
Why is the urinary catheterisation contraindicated in pelvic injury
As likely urethral injury
Acute scrotal pain and swelling after urological intervention
Epidiimorchitis
Painful teste drawn up into the groin
Testicular torsion
What is a varicocele associated with?
Infertility
When is urinary retention classes as high pressure
If renal function is impaired or if there is hydronephrosis
Occupational exposure to what is a recognised risk factor for TCC?
Aniline dye
What has replaced TRUS biopsy as the first line for prostate cancer
Multiparametric MRI
Manage hydrocele in adults
Refer urgently for testicular US
In torsion, when is the cremasteric reflex partially observed?
If affects the appendage only
How is sterilisation confirmed after vasectomy
Semen analysis to assess azoospermia
What normal activities can increase PSA levels
Prostate biopsy (do after 6 weeks) UTI (do after 4 weeks if proven) DRE (do after 1 week) Vigorous exercise (do after 48 hours) Ejaculation (do after 48 hours)
What is the nutcracker angle?
The abdo aorta and the SMV has the renal vein in between it
How can varicocele be a sign of malignancy?
Compression of renal vein at the nutcracker angle
What is TURP syndrome
During the procedure large volumes of irrigation of glycine is used which can lead to severe hyponatraemia
Following neon ladder reconstruction the patient is at increased risk of which cancer
Adenocarcinoma
What do you coprescribe with gosrelin and why
Anti androgen such as cyproterone acetate due to risk of rumour flare, this is due to initial stimulation of LH leading to increased testosterone
Why does rhadbo lead to AKI
As it causes acute tubular necrosis
Recurrent balanitis is an indication for
Circumscision
A pelvic fracture and highly displaced prostate should indicate a diagnosis of
Membranous urethral rupture
Which stones are radio lucent on X-ray
Urate and xanthine stones
Which stones are semi opaque on X-ray
Cystine stones
What is the most common stone
Calcium oxalate
Granular muddy brown casts
Acute tubular necrosis
What is a useful investigation for priapism? Arterial or cavernosal blood gas?
Cavernosal blood gas
What are the common complications of a TuRPs procedure
Turps syndrome
Urethral stricture/ UTI
Retrograde ejaculation
Perforation of the prostate
What is the triad of turps syndrome
Hyponatraemia
Fluid overload
Glycine toxicity
How do you manage turps syndrome
Fluid restrict and treat complications of hyponatraemia
First line treatment of BPH
Alpha 1 antagonist
Schistosomiasis is a risk factor for which type of bladder cancer?
SCC
Epididimorchitis with low STI risk is most likely to be caused by
E. coli
Why does chemo cause renal stones?
Increases Uris acid levels
What is struvite
Ammonium magnesium phosphate triple phosphate
4yo with right loin pain lethargy and haematuria could be a
Nephroblastoma
Most common cancer in 20-30yo males
Testicular cancer
What are the medical benefits of a circumscision
Reduces risk of STIs, penile cancer and UTI
What are the medical indications for circumscision
Phimosis
Recurrent balanitis
Balanitis xerotica obliterans
Paraphimosis
What is the main contraindication to circumscision?
Hypospadius