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Finals > Uro > Flashcards

Uro Flashcards

1
Q

What is a hydrocele?

A

It is a collection of serous fluid between the tunica albuginea and the tunica vaginalis.

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2
Q

What is found on examination of a hydrocele?

A

A hydrocele is fluctuate, trans illuminates, and is dull to percussion. The testis cannot be palpated separately. Can’t get above the swelling if it is primary / communicating (ie in patent process vaginalis)

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3
Q

What does the fluid look like when aspirated from a hydrocele?

A

Straw coloured with flecks of cholesterol.

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4
Q

Which testicular cancer is radiosensitive

A

Seminomas are sensitive.

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5
Q

What hormones does a teratoma testicular cancer produce?

A

bHCG, LDH, AFP

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6
Q

Most common testicular cancer in older men?

A

DLBCL

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7
Q

What are the two week wait criteria for testicular cancer?

A

Non-painful enlargement or change in shape / texture of testis

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8
Q

What is the difference on USS between seminomas and teratomas?

A

Seminomas have a homogenous appearance, teratomas have a heterogenous appearance.

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9
Q

What causes epididymis-orchitis?

A

STIs, UTIs, mumps, TB

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10
Q

What is the mechanism behind testicular torsion?

A

The spermatic cord becomes twisted and cuts off the blood supply to the testicle

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11
Q

What are Undescended testes a risk factor for?

A

Testicular cancer, testicular torsion.

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12
Q

What is the bell-clapper deformity?

A

Lack of anchoring of tunica vaginalis (containing spermatic cord) to posterior aspect of testicle. It predisposes to testicular torsion

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13
Q

What is Phehns sign?

A

Relief of testicular pain on elevation. Positive in epididymo-orchitis. Negative in torsion.

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14
Q

What is an orchidopexy?

A

Fixation of testicle to prevent torsion

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15
Q

What is a testicular varicocele?

A

Abnormal enlargement of the pampiniform venous plexus which drains the testicules.

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16
Q

When would you be worried about a varicocele?

A

New onset after age of 40 - can be caused by compression of left renal vein by pelvic / abdominal malignancy (e.g. RCC)

17
Q

How is Prostate Cancer graded?

A

The gleason score - it is a histological numerical score based off the two most common patterns of architecture seen in the tumour.

18
Q

what are prostate symptoms?

A

hesitancy, dribbling, nocturne, urgency, frequency, poor stream

19
Q

Which blood test monitors extra capsular spread in prostate cancer?

A

acid phosphatase

20
Q

what is the management for prostate cancer?

A

conservative - support groups, monitor, education
medical - hormonal therapy (Goserelin - a GnRH analogue, Cyproterone - an anti-antidrogen); RT (external beam, brachytherapy)
Surgical - radical prostatectomy (only for local disease; can be done retropubic, peritoneal or laparoscopic )

21
Q

what is post-TURP syndrome?

A

it is hyponatraemia (<125) caused by absorption of the irrigation fluid through the damaged prostate. it presents with confusion, nausea, headache, bradycardia, hypertension. it is treated with hypertonic saline and haemodialysis.

22
Q

what advice should you give patients for the two weeks following a TURP?

A

no sex, no driving, expect haematuria

23
Q

what is the management of BPH?

A

Conservative - avoid caffeine and alcohol, void twice in a row, bladder retraining
Medical - alpha blockers (Doxazosin, Tamsulosin, Terazosin - relax muscle surrounding the prostate), finasteride (5-alpha reductase inhibitors - suppress serum DHT to shrink prostate)
surgery - TURP, TULIP, retropubic prostatectomy

24
Q

where is bladder cancer the most common cancer?

A

Egypt, due to schistosomiasis causing squamous cell carcinoma.

25
Q

what are the 2ww criteria for bladder cancer?

A

> 45y/o and unexplained visible haematuria with no UTI or persisting after UTI treatment
60y/o and unexplained non-visible haematuria with raised WCC or dysuria

26
Q

how can carcinoma in situ be detected in the bladder?

A

during a cystoscopy and biopsy, use helix immunofluorescence

27
Q

what are the options after a radical cystectomy?

A

ileal conduit urostomy vs neobladder

28
Q

what is cut in a vasectomy?

A

the vas deferens

29
Q

what is done to confirm success after a vasectomy?

A

2x semen analysis 16 and 18w post-op

Finals (12 decks)

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