Urology/renal

Question 1

hydrocele vs epidermal cyst?

Answer 1

epidermal cyst - separate from the body of the testicle + found posterior to the testicle
do NOT transilluminate

hydrocele - in tunica vaginalis - soft, non-tender swelling of the hemi-scrotum. Usually anterior to and below the testicle. Can get above it unlike a hernia
transilluminates

Question 2

What cancer is a varicocele associated with?

Answer 2

RCC

Question 3

How long can it take finasteride to work?

Answer 3

5 alpha-reductase inhibitors
Reduce testosterone conversion –> reduce prostate size
take up to 6m to work

Question 4

What bloods results would you see with rhabdomyolysis?

Answer 4

Hyper K, PO4, uric acid, CK
Hypo Ca

Question 5

What medical mx can be given for renal stones (not pain relief)?

Answer 5

Alpha-adrenergic blockers eg tamsulosin can help facilitate stone passage. They work by relaxing the smooth muscle in the walls of the ureter, thereby allowing the stone to pass more easily, used if 5-10mm size

Question 6

most common causitive agent in <20 yrs for epeidiy-morchitis vs >35?

Answer 6

chlamydia <20
e.coli >35

Question 7

How do you diagnose post-strep glomerulonephritis?

Answer 7

Anti-streptolysin O titres

Question 8

How is stress incontinence mx?

Answer 8

Lifestyle - wt loss, no caffeine, no excess fluids
pelvic floor exercises
surgery
duloxetine/ SNRI

Question 9

What diet do u follow in renal failure

Answer 9

Patients with renal failure are advised to adopt a diet which has low stuff so kidney filters less
Low protein
Low phosphate
Low sodium
Low potassium

Question 10

Different stages of CKD?

Answer 10

stage 1 - egfr >90 + markers of kidney damage (proteinuria or raised cr/ urea)

stage 2 - ecgfr 60-90 + markers of kidney damage

stage 3a- eGFR 45-59 with or without kidney damage

stage 3b- eGFR 30-44

Question 11

Overflow incontinence vs urge vs overactive bladder vs stress?

Answer 11

LUTS type sx and bladder palpability = over flow incontinence - can be caused by prostate or nerve s=damage

Urge incontinence would be preceded by a sudden need to urinate.

An overactive bladder syndrome is a form of urge incontinence caused by an overactive bladder, it too would be associated with incontinence, polyuria and nocturia. Detrusor overactivity is the cause.

Stress incontinence would be likely associated with raised intraabdominal pressure, such as a sneeze or a cough.

Question 12

What is schistosoma infection linked to?

Answer 12

developing squamous cell carcinoma of the bladder.

Question 13

How do the results for urine osmalility and sodium look for pre-renal vs renal AKI?

Answer 13

pre-renal ie poor perfusion of kidney –> Kidneys act to concentrate urine and retain sodium - urine osmolality high, urine sodium low

Renal ie acute tubular necrosis / nephritis —> Kidneys can no longer concentrate urine or retain sodium - urine osmolality low, urine sodium high

Question 14

In a patient with recurrent renal stones due to hypercalcuira how may risk be reduced?

Answer 14

thiazide diuretics

Question 15

Mx of epidimyo-orchitis?

Answer 15

If unknown organism: ceftriaxone 500mg intramuscularly single dose, plus oral doxycycline 100mg twice daily for 10-14 days if younger man where STI more likely cause

cipro used if older man

Question 16

What is the surgical mx of testicular torison in presence of a bell clapper deformiity?

Answer 16

should involve fixation of both testes to prevent torsion of the other testes

Question 17

Mx of hydrocele?

Answer 17

Adult patients with a hydrocele require an ultrasound to exclude underlying causes such as a tumour