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Finals Studying - Condensed > Urology > Flashcards

Urology Flashcards

1
Q

most common composition of renal stone

A

calcium oxalate

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2
Q

composition of struvite stones

A

magnesium
ammonium
phosphate

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3
Q

types of renal stone

A 
calcium oxalate 
struvite 
uric acid 
calcium phosphate 
cystine
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4
Q

predisposition to renal crystal formation

A

altering pH

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5
Q

what pH condition causes struvite stones

A

alkali

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6
Q

stag-horn calculi

A

large calculi that extend into at least 2 calyces

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7
Q

Ix of renal stone

A

CT KUB (CT stone search)

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8
Q

most common type of stone to form stag horn calculi

A

struvite

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9
Q

Mx renal stone <5mm

A

conservative Mx
increase fluid intake
analgesia (diclofenac)
alpha-blockers

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10
Q

Mx renal stone <2cm

A

extracorporeal shock wave lithotripsy (ECSWL)

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11
Q

Mx renal stone <2cm + pregnant

A

ureteroscopy

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12
Q

Mx renal staghorn calculi

A

Percutaneous nephrolithiotomy

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13
Q

Mx renal stone if evidence of ureteric obstruction or infection

A

nephrostomy + stent

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14
Q

types of bladder cancer

A

transitional cell (papillary vs non-papillary)

squamous cell

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15
Q

main risk factor for squamous cell bladder ca

A

schistosomiasis

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16
Q

Ix bladder cancer

A

cystoscopy + biopsy

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17
Q

Mx superficial bladder cancer

A

transurethral resection of bladder (TURB)

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18
Q

Mx high grade bladder cancer

A

TURB + intra-vesical chemo

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19
Q

haematuria in someone just back from lake malawi

A

schistosomiasis

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20
Q

role of PSA

A

liquification of semen

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21
Q

is there a screening programme for prostate Ca

A

no - but pt can request PSA but must be counselled about risk of false positive and negatives

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22
Q

upper limit of normal PSA

A

(age-20)/10

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23
Q

cause of BPH

A

natural ageing process - imbalance of androgen/oestrogen

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24
Q

g/s Ix of BPH

A

Rectal USS with biopsy

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25
Q

Mx of BPH

A
  1. alpha blocker (tamsulosin)
    • 5 alpha reductase inhibitor (finasteride)
  3. transurethral resection of prostate (TURP)
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26
Q

s/e of alpha blockers

A 
drowsiness
depression 
dry mouth 
low BP 
ejaculatory failure 
increased weight

(relief on stopping drug)

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27
Q

s/e of 5 alpha reductase inhibitors

A

excreted in semen
impotence
reduced libido
gynaecomastia

(no relief on stopping drug - 3-6m later)

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28
Q

most common type of prostate ca

A

adenocarcinoma

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29
Q

most common area for prostate cancer

A

peripheral zone

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30
Q

most common place for prostate ca mets

A

bone - sclerotic lesions

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31
Q

Ix prostate Ca

A

rectal USS + biopsy

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32
Q

gleason score

A

used from prostate biopsies
5-6 biopsies taken from each side of prostate
2 grades assigned to each pt - primary grade is largest area of tumour, secondary grade is next largest area

33
Q

Mx prostate ca

A 
any of:
active surveillance 
radical prostatectomy +/- lymph node dissection 
radical XRT 
hormone therapy
34
Q

how does hormonal Tx used in prostate Ca work

A

prostate ca depends on testosterone for growth, so depriving ca cells of testosterone delays tumour progression
circulating testosterone exerts -ve feedback on pituitary LH secretion

35
Q

hormonal Tx used in prostate Ca

A

Androgen deprivation therapy
- LHRH agonists (Leuprorelin, Goserelin)

Anti-Androgens

  • Steroidal (cyproterone acetate)
  • Non-steroidal (bicalutamide, flutamide)
36
Q

risk of starting LHRH agonists in prostate Ca

A

they initially stimulate LH and FSH, so more testosterone.
need to give anti-androgen cover for 3d.
risk of spinal cord compression

37
Q

Mx of man with prostate ca and back pain

A

radical prostatectomy + dexamethasone for spinal cord compression

38
Q

balanitis

A

inflammation of the glans penis

39
Q

most common cause of balanitis

A

candida

40
Q

Mx balanitis

A

improve hygiene
gentle saline washes
if severe discomfort - 1% hydrocortisone

41
Q

presentation of epididymal cyst

A

posterior to testicle

can get above it

42
Q

man with swollen testis but it can be felt -Dx?

A

epididymal cyst

43
Q

Mx epididmyal cyst

A

supportive

44
Q

presentation of hydrocele

A

non-tender swelling
transilluminates
can get above it

45
Q

hydrocele can be the presenting feature of - ?

A

testicular ca

46
Q

Ix hydrocele

A

Doppler USS with colour

47
Q

presentation of varicocele

A

left side

“bag of worms”

48
Q

varicocele can be the presenting feature of - ?

A

renal cell carcinoma

49
Q

Ix varicocele

A

Doppler USS

50
Q

paraphimosis

A

foreskin can’t be pulled back over glans - most commonly due to foreskin being pulled back for catheterisation and not placed back
prevents venous return leading to oedema

51
Q

Mx paraphimosis

A

iced glove

manual decompression

52
Q

phimosis

A

the foreskin can’t be retracted past the glans

53
Q

mx phimosis

A

daily gentle traction

topical steroid to soften foreskin

54
Q

Ix of ?renal injury

A

CT with contrast

55
Q

Ix ?bladder injury

A

CT cystography

56
Q

Ix ?urethral injury

A

retrograde urethrogram

57
Q

classification of testicular tumours

A

germ cell (95%)

  • seminoma
  • non-seminoma (yolk sac, teratoma, choriocarcinoma)
58
Q

tumour marker for non-seminoma testicular tumour

A

AFP

59
Q

tumour marker for seminoma testicular tumour

A

PLAP, hCG

60
Q

Ix testicular ca

A

USS

61
Q

Mx testicular ca

A

orchidectomy (inguinal approach)

62
Q

1st Ix of frank haematuria, pt >50

A

CT urogram

63
Q

1st Ix of frank haematuria, pt <50

A

USS

64
Q

2nd Ix of frank haematuria

A

cystoscopy

65
Q

Microscopic haematuria (+) and no symptoms - Ix?

A

no Ix

66
Q

Microscopic haematuria (++) and no symptoms - Ix?

A

no Ix

67
Q

Microscopic haematuria (++) and symptoms - Ix?

A 
<50 = USS 
>50 = CT urogram
68
Q

man with macroscopic haematuria + on on warfarin - what do u do?

A

Urgent referral to urology for Ix

69
Q

woman aged 23 with microscopic haematuria in urine.
check in 2w time and no haematuria.
check again and haematuria. Ix?

A

cystoscopy

70
Q

man with dark urine, muscle pain and difficulty getting out chair - Dx? Ix?

A

rhabdomyolysis

CK

71
Q

alpha-1-adrenoceptors - role?

A

contraction of smooth muscle

72
Q

alpha-2-adrenoceptors - role?

A

release of noradrenaline

73
Q

man taking methotrexate but wants to conceive - how long should he wait after stopping Tx?

A

at least 6m

74
Q

<65 y/o normal post-void volume

A

50ml

75
Q

> 65y/o post-void volume

A

100ml

76
Q

Ix recurrent UTI

A
  1. urine analysis
  2. FVC
  3. Flow + Scan
  4. US KUB & post-void scan
  5. cystoscopy (rule out bladder ca)
77
Q

Ix hydronephrosis

A

USS

78
Q

drugs causing erectile dysfunction

A

SSRIs

Beta blockers

Finals Studying - Condensed (22 decks)

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