Passmed Uro

Question 1

Complications of Transurethral Resection

Answer 1

TURP

Tur syndrome
Urethral stricture/UTI
Retrograde ejaculation
Perforation of the prostate

Question 2

Features of TUR syndrome

Answer 2

1 Hyponatraemia: dilutional

2. Fluid overload
3. Glycine toxicity

Question 3

How does rhabdomyolysis cause AKI

Answer 3

Acute tubular necrosis

Question 4

3 causes of raised PSA

Answer 4

BPH / Ca
Prostatitis / UTI
ejaculation
urinary retention

Question 5

Gold standard Ix for stones

Answer 5

non-contract CT scan.

Question 6

Best Ix in bladder Ca

Answer 6

Flexible cystoscopy

Question 7

Acute upper urinary tract obstruction due to stone mx?

Answer 7

nephrostomy

ESWL is for smaller

Question 8

2 causes of unilateral / bilat hydronephrosis

Answer 8

Uni - PACT 
Pelvic-ureteric obstruction (congenital or acquired)
Aberrant renal vessels
Calculi
Tumours of renal pelvis

Bilat - SUPER 
Stenosis of the urethra
Urethral valve
Prostatic enlargement
Extensive bladder tumour
Retro-peritoneal fibrosis

Question 9

Mx of chronic urinary tract obstruction

Answer 9

Ureteric stent or a pyeloplasty

Question 10

Renal cell carcinoma usual pres?

Paraneoplastic features?

Answer 10

haematuria

hypertension and polycythaemia

Question 11

Nephroblastoma vs neuroblastoma on imaging

Answer 11

neuroblastoma is usually calcified

Question 12

CI to circumscision

Answer 12

hypospadius

Question 13

Which stones are caused by excessive tissue breakdown ? (they are radiolucent)

Answer 13

Uric acid

Question 14

A 72-year-old man is diagnosed with prostate cancer and goserelin (Zoladex) is prescribed. Which one of the following is it most important to co-prescribe for the first three weeks of treatment?

Answer 14

cyproterone acetate
[Anti-androgen treatment such as cyproterone acetate should be co-prescribed when starting gonadorelin analogues due to the risk of tumour flare. This phenomenon is secondary to initial stimulation of luteinising hormone release by the pituitary gland resulting in increased testosterone levels.]

Question 15

Which testie tumour often has normal afp / hcg levels

Answer 15

seminoma

Question 16

Most common renal malignancy

Answer 16

renal adenocarcinoma

Question 17

Key comp and Ix to check following acute urinary retention

Answer 17

AKI

Serum creatinine

Question 18

How long does finasteride take to work/

SEs?

Answer 18

up to 6 months

erectile dysfunction, reduced libido, ejaculation problems, gynaecomastia

Question 19

2 inherited associations with RCC

Answer 19

von Hippel-Lindau syndrome

tuberous sclerosis

Question 20

1st line mx for chronic urinary retention

Answer 20

intermittent self catheterisation

Question 21

1 piece of advice and 2 drug options for noctuira

Answer 21

advise about moderating fluid intake at night

furosemide 40mg in late afternoon

desmopressin

Question 22

When do you get a bulbar urethral rupture

Answer 22

traddle type injury e.g. bicycles

Question 23

when do you get a membranous urethral rupture

Answer 23

pelvic fracture

Question 24

Ix traumatic urethral injury.?

Mx?

Answer 24

Investigation
ascending urethrogram

Management
suprapubic catheter (surgical placement)

Question 25

Eg of an anti androgen used with goserelin to prevent initial rise in testosterone?

Answer 25

flutamide

Question 26

1 piece of advice and 2 drug options for noctuira

Answer 26

advise about moderating fluid intake at night

furosemide 40mg in late afternoon

desmopressin

Question 27

A 67-year-old man presents with painless frank haematuria. He recently began complaining of a mild testicular ache and describes his scrotum as a ‘bag of worms’. He is a heavy smoker smoking 60 cigarettes a day for 47 years. On examination he is cachectic. His left testicle appears to have a tortuous texture. His blood reveals anaemia and polycythemia. What is the most likely diagnosis?

Answer 27

RCC of left kidney

Question 28

A 15-year-old boy develops sudden onset of pain in the left hemiscrotum. He has no other urinary symptoms. On examination the superior pole of the testis is tender and the cremasteric reflex is particularly marked.

Answer 28

Torsion of testicular appendage

The cremasteric reflex is usually preserved when the torsion affects the appendage only.

Question 29

A 14-year-old boy develops sudden onset severe pain in the left testicle radiating to the left groin. He is distressed and vomits. On examination the testis is very tender and the cremasteric reflex is absent.

Answer 29

torsion of the spermatic cord

The cremasteric reflex is usually absent in torsion.

Question 30

Eg of an anti androgen used with goserelin to prevent initial rise in tesotsterone?

Answer 30

flutamide

Question 31

A 19-year-old man attends his GP after noticing a lump in his scrotum while showering. He reports some discomfort in the area but no pain. He is in a long-term relationship with his girlfriend and his last sexual health screen two weeks previously was clear.

On examination, there is a soft mass on the anterior aspect of the left testis that is indistinguishable from the testis itself. It is not tender to touch and transilluminates.

Which of the following is the most likely diagnosis?

Answer 31

Hydrocoele

Hydrocoeles can be differentiated from other testicular lumps as they are not separate to testis and transilluminate

Question 32

Which stones are radio lucent

Answer 32

urate + xanthine stones