Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Finals > Urology > Flashcards

Urology Flashcards

(62 cards)

Start Studying
1
Q

Common locations of urinary tract stone deposition

A
  1. Pelviureteric junction
  2. Pelvic brim
  3. Vesicoureteric junction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Composition of renal stones

A

Calcium oxalate (75%)
Magnesium ammonium phosphate (15%)
Also: urate (5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Presentation of urinary tract stones

A

Asymptomatic, or:

  1. Pain - spasms of renal colic ‘loin to groin’, with nausea/vomiting
  2. Infection - can coexist (inc risk if voiding impaired), eg UTI, pyelonephritis, pyonephrosis
  3. Haematuria
  4. Proteinuria
  5. Sterile pyuria
  6. Anuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Investigations for renal calculi

A

Bedside - urine dip (usually +ve for blood)
Bloods - FBC, UE, phosphate, glucose, bicarb, urate
Imaging - non-contrast CT (99% visible), KUB XR (80% visible)
Others - urine Ca, oxalate, urate, citrate, Na, creatinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Initial management of renal calculi

A

Analgesia -> diclofenac 75mg IV/IM, or 100mg PR
Fluids if unable to tolerate PO
ABx if infection (e.g taz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Management of renal calculi

A

<5mm in lower ureter = 95% pass spontaneously, inc fluids

> 5mm/pain not resolving:

  • medical = nifedipine or a-blockers (tamsulosin) promote expulsion
  • extracorporeal shockwave lithotripsy (US waves shatter stone), or ureteroscopy
  • percutaneous nephrolithotomy -> when large, multiple, or complex
  • open surgery is rare
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Indications for urgent intervention for renal calculus and why

A

Delay kills glomeruli

When there’s infection AND obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prevention of renal calculi

A

General = plenty of fluids, normal dietary Ca intake
Ca stone = thiazide diuretic
Oxalate stone = dec oxalate intake, pyridoxine
Urate = allopurinol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Predisposing factors that make renal calculi more likely

A

Recurrent UTIs
Metabolic = hypercalciuria/hypercalcaemia, hyperPTH, neoplasia, renal tubular acidosis
Urinary tract abnormalities (hydronephrosis, horseshoe kidney, ureterocele)
Foreign bodies (stents, catheters)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the common causes of urinary tract obstruction

A

Luminal (stones, blood clot, sloughed papilla, tumour)
Mural (congenital/acquired stricture, NM dysfunction)
Extra-mural (abdo or pelvic mass/tumour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clinical features of upper urinary tract obstruction

A

Acute = loin pain radiating to groin. May be superinfosed infection ± loin tenderness, or enlarged kidney

Chronic = flank pain, renal failure, superimposed infection, polyuria (impaired urinary concentration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clinical features of lower urinary tract obstruction

A

Acute = acute urinary retention with severe suprapubic pain ± acute confusion

Chronic = urinary freq, hesitancy, poor stream, terminal dribbling, overflow incontinence, distended + palpable bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Causes of acute lower urinary tract obstruction

A 
Prostatic obstruction
Urethral strictures
Anticholinergics
Blood clots
Alcohol
Constipation
Post-op
Infection
Neuro (Cauda Equina)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of chronic lower tract obstruction

A 
Prostatic enlargement (common)
Pelvic malignancy
Rectal surgery
DM
CNS (transverse myelitis/MS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of upper urinary tract obstruction

A

Nephrostomy or ureteric stent
A-blockers help reduce stent-related pain (dec ureteric spasm)
Pyeloplasty (to widen the PUJ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Problems associated with ureteric stenting

A 
Stent-related pain
Trigonal irritation
Haematuria
Fever
Infection
Tissue inflammation
Encrustation
Biofilm formation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Management of lower urinary tract obstruction

A

Urethral or suprapubic catheter to relieve acute retention.
In chronic, only catheterise if there’s pain, infection, or renal impairment (intermittent self-catheterisation may be required)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe the underlying pathology and clinical features of benign prostatic hyperplasia

A

Benign nodular or diffuse proliferation of musculofibrous and glandular layers of the prostate

Features = LUT symptoms (nocturia, freq, urgency, dribbling, poor stream/flow, hesitancy, haematuria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Investigations in benign prostatic hyperplasia

A 
Bedside = urine dip
Bloods = PSA, UE
Imaging = US, transrectal US ± biopsy
Others = MSU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of benign prostatic hyperplasia

A 
Lifestyle = avoid caffeine and alcohol
Drugs = 
- a-blockers (tamsulosin) dec SM tone
- 5a-reductase inhibitors (finasteride)
Surgery = transurethral resection of prostate, transurethral incision of the prostate, retropubic prostatectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of renal cell carcinoma

A

50% found incidentally
Haematuria, loin pain, abdo mass, anorexia, malaise, w/l
May cause a varicocele if invasion of L renal v compresses L testicular v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Management of renal cell carcinoma

A

Radical nephrectomy
Cryotherapy and radio ablation if unfit/unwilling
Usually radio+chemo resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Prognosis of RCC

A

Mayo prognostic risk score:
0-1 = 96.5% 10yr survival
>10 = 19.2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Presentation of TCC

A 
Painless haematuria
Frequency
Urgency
Dysuria
UT obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Prognosis of TCC
Varies with clinical stage/histological grade: 10-80% 5yr survival
26
What is a Wilms' tumour
Nephroblastoma | Childhood tumour of primitive renal tubules and mesenchymal cells
27
Symptoms of prostate cancer
``` May be asymptomatic Nocturia Hesitancy Poor stream Terminal dribbling Obstruction (w/l ± bone pain indicates mets) ```
28
Management of prostate cancer
``` Radical prostatectomy if <70 Radical radio (alt curative option) Hormone therapy alone delays progression (so if elderly, unfit) Active surveillance (esp if >70) ```
29
Prognosis of prostate cancer
10% die in 6m | 10% live >10yrs
30
Describe balanitis and how you'd treat it
Acute inflammation of the foreskin and glans Associated with strep and staph More common in DM Treat = abx, circumcision, hygiene advice
31
Describe phimosis and paraphimosis and how you'd treat them
Phimosis = foreskin occludes meatus (causes recurrent balanitis and ballooning) Paraphimosis = what tight foreskin is retracted and becomes irreplaceable (leads to oedema and even ischaemia of glans) Treat = pt squeezes glans, ice packs and lidocaine gel. May require dorsal slit/circumcision
32
Describe prostatitis and how you'd treat it
May be acute or chronic Causes = S faecalis, E. coli, chlamydia Features = UTI, retention, pain Treat = analgesia, levofloxacin
33
Presentation of TCC
Painless haematuria Recurrent UTIs Voiding irritability
34
How would you distinguish between different scrotal masses on examination?
Can't get above = inguinoscrotal hernia Separate and cystic = epididymal cyst Separate and solid = epididymitis/varicocele Testicular and cystic = hydrocele Testicular and solid = tumour, haematocele, granuloma, orchitis
35
Describe hydroceles
Fluid within tinica vaginalis 1' = associated with patent processus vaginalis 2' = testis tumour/trauma/infection
36
Management of hydroceles
Aspiration | Surgery
37
Causes and features of epididymo-orchitis
Chlamydia E coli N gonorrhoae TB Features = sudden-onset tender swelling, dysuria, sweats/fever
38
Investigations in epididymo-orchitis
Bedside - 1st catch urine, STI screen Bloods - ?STI bloods Imaging - N/A Other - urethral discharge
39
Management of epididymo-orchitis
If <35yo: doxycycline If gonorrhoea suspected: add ceftriaxone IM STAT If >35yo (mostly non-STI): associated UTI, give ciprofloxacin ABx should be used for 2-4wks Warn of possible infertility and symptoms worsening before improving
40
Describe varicoceles
Dilated veins of pampiniform plexus. Usually L side Often visible as distended scrotal blood vessels (‘bag of worms’) Pts complain of a dull ache Associated with subfertility (repair has little impact)
41
Describe haematoceles
Blood in tunica vaginalis Follows trauma May need drainage/excision
42
Outline the different types of testicular malignancy
Seminoma (55%) => 30-65yo Non-seminomatous germ cell tumour (33%) - prev teratoma => 20-30yo Mixed germ cell tumour (12%) Lymphoma
43
Signs of testicular malignancy
Typically painless testis lump found after trauma. There may also be: - haematospermia - secondary hydrocele - pain - SOB (lung met) - abdo mass (enlarged nodes) - effects of secreted hormones - mets
44
Risk factors for testicular cancer
Undescended testis Infant hernia Infertility
45
Symptoms and signs of testicular torsion
Sudden onset of pain in one of the testis, makes walking uncomfortable Pain in abdo, N+V are common Signs = inflammation of one testis (v tender, hot, and swollen)
46
Differentials for testicular torsion
Epididymo-orchitis - but pts tend to be older, have symptoms of UTI, more gradual onset Also consider - tumour, trauma, acute hydrocele
47
Investigations in testicular torsion
Only if diagnosis is equivocal -> if likely torsion, get to surgery Doppler US may show lack of blood flow to testis
48
Management of testicular torsion
Surgery -> consent for possible orchidectomy + bilateral fixation Expose and untwist the testis. If colour looks good, return to scrotum Fix both testes to the scrotum
49
Describe the incidence of undescended testes
About 3% boys are born with at least 1 undescended testis (30% of premature) <1% after 1st yr of life
50
Causes of undescended testes
Complete absence of testis from scrotum - may be anorchism Retractile testis - excessive cremasteric reflex (reassure) Maldescended - may be found anywhere from abdo to groin Ectopic testis - usually found in sup inguinal pouch, but may be abdo, perineal, penile, or femoral triangle
51
Complications and management of maldescended/ectopic testes
Complications = infertility, x40 inc risk test Ca, inc risk test trauma, inc risk torsion Manage = restores potential for spermatogenesis, inc risk of malignancy remains, but becomes easier to diagnose - surgery = orchidopexy - hormonal = most commonly hCG if in inguinal canal
52
How long does it take for results to be seen with finasteride treatment of BPH?
Up to 6m
53
Management of ureteric stone with hydronephrosis
Nephrostomy
54
Pelvis fracture + highly displaced prostate
Membraneous urethral rupture
55
Cause of fall after management of urinary retention
Physiological diuresis may be followed by pathological diuresis May lead to hypovolaemia, dehydration, and electrolyte imbalance -> do daily U+Es
56
Non-malignant causes of a raised PSA
BPH Prostatitis and UTI (wait 1m before doing PSA) Ejaculation (avoid for 48hr before PSA) Vigorous exercise (avoid for 48hr before PSA) Urinary retention Instrumentation of urinary tract
57
Risk factors for bladder TCC
Smoking Aniline dyes Rubber manufacture Cyclophosphamide
58
Risk factors for bladder squamous cell cancer
Schistosomiasis BCG treatment Smoking
59
What is TURP syndrome? What are the RFs?
Rare + life-threatening complication of transurethral resection of prostate surgery due to venous disruption and absorption of irrigation fluid. RFs: - surgery >1h - height of bag >70cm - resented >60g - large blood loss - perforation - large amount of fluid used - poorly controlled CHF
60
Infection associated with stag-horn calculi
Proteus (mirabilis)
61
Mechanism of action of goserelin in prostate Ca
GnRH agonist - provides -ve FB to ant pit
62
Removal of renal stones in pregnancy women
Ureteroscopy

Finals (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions