GU system

Question 1

Anatomy of penis

Answer 1

2 corpora cavernosa covered by tunica albigunea. 1 corpus spongiosum, surrounding the urethra.

Question 2

Blood supply to penis

Answer 2

Internal pudendal artery

Question 3

Lymphatic drainage of penis

Answer 3

Deep and superficial inguinal nodes

Question 4

What is the scrotum made up of?

Answer 4

Smooth muscle, elastic layer of Darto’s fascia, combined layers of Camper and Scarpa fascia

Question 5

Camper’s fascia

Answer 5

Fatty layer, more superficial

Question 6

Scarpa’s fascia

Answer 6

Membranous layer, deeper

Question 7

Causes of hematuria

Answer 7

Common: UTI, GN, bladder cancer, renal stone, BPH. Other: coagulopathy, sickle cell, anticoagulation, CT disease, renal disease, cystitis, prostatitis, epididymitis

Question 8

Testicular tumor types

Answer 8

95% are germ cell tumors: seminomas, nonseminomas, and mixed. 1-2% are stromal cell tumors: Leydig cell, Sertolid cell.

Question 9

Treatment for early pure seminoma?

Answer 9

Inguinal orchiectomy + radiation therapy

Question 10

Treatment for nonseminomas?

Answer 10

Inguinal orchiectomy + retroperitoneal lymph node dissection +/- chemo

Question 11

What is a normal urinary pH?

Answer 11

5.85

Question 12

If pH > 6, what type of stone should you suspect?

Answer 12

Presence of urease-producing organisms such as Proteus -> struvite stone

Question 13

Urine is acidic or basic with uric acid stones?

Answer 13

Acidic (pH

Question 14

What imaging for nephrolithiasis?

Answer 14

Non-contrast CT. Also: plain films (won’t see all types of stones), US for hydonephrosis, IVP.

Question 15

Histology of prostatic carcinoma

Answer 15

Adenocarcinoma. Starts at periphery (in contrast to BPH, which starts periurethral area).

Question 16

What are possible complications of XRT for prostate cancer?

Answer 16

Proctitis, urethritis, rectal strictures and fistulae, impotence (up to 50%)

Question 17

Renal cell carcinoma epi

Answer 17

Men > women. Age 55-60 most common. Increased risk with smoking.

Question 18

Paraneoplastic syndromes assoc with RCC?

Answer 18

Hypercalcemia (PTH), galactorrhea (prolactin), Cushing syndrome

Question 19

Diagnosis of RCC

Answer 19

ultrasound is key for differentiating cyst from solid tumor. CT is method of choice for dx and staging

Question 20

Bladder cancer epi

Answer 20

Men > women. Peak age 60-70. TCC has better prognosis than adenocarcinoma and SCC

Question 21

Risk factors for bladder cancer

Answer 21

Smoking. Exposure to dye. Chronic UTI. Recurrent nephrolithiasis.

Question 22

Treatment of superficial carcinoma of bladder

Answer 22

Endoscopic resection with repeat cystoscopy q3-6 months. Majority will have recurrence though. Then you can do intravesicular chemo

Question 23

Treatment of invasive bladder cancer

Answer 23

Simple or radical cystectomy

Question 24

Treatment of metastatic bladder cancer

Answer 24

Chemo: cisplatin, MTX, doxorubicin, cyclophosphamide, vinblastine. Prognosis is generally