Genitourinary 3

Question 1

What is prostatitis?

Answer 1

Inflammation and swelling of the prostate gland, most commonly caused by E Coli

Question 2

How does prostatitis present?

Answer 2

Very tender prostate on DRE
Fever, chills, malaise
Voiding symptoms

Question 3

How is prostatitis investigated?

Answer 3

Urinalysis and culture

Blood cultures if febrile

Question 4

How is prostatitis managed?

Answer 4

Ciprofloxacin or levofloxacin for 14 days

Question 5

What is the most common bacterial STI?

Answer 5

Chlamydia

Question 6

What causes chlamydia?

Answer 6

Chlamydia trachomatis

Question 7

How does chlamydia present in men?

Answer 7

Testicular pain
Voiding symptoms, dysuria
50% asymptomatic

Question 8

How does chlamydia present in women?

Answer 8

Vaginal discharge and dysuria
White, yellow or green discharge
70% asymptomatic

Question 9

How is chlamydia diagnosed?

Answer 9

Nucleic acid amplification testing

Question 10

How is chlamydia treated?

Answer 10

Avoid sex until treatment finished and contact tracing

Single 1g dose of azithromycin and 7 days of doxycycline

Question 11

What is the 2nd most common STI in the UK?

Answer 11

Gonorrhoea

Question 12

What causes gonorrhoea?

Answer 12

Neisseria gonorrhoea

Question 13

How is gonorrhoea likely to present?

Answer 13

More likely to by asymptomatic

Question 14

How is gonorrhoea investigated?

Answer 14

NAAT
Microscopy - gram -ve diplococci
Culture - all infected areas with swab

Question 15

How is gonorrhoea treated?

Answer 15

Single ceftriaxone IM dose

Question 16

What is urolithiasis?

Answer 16

Presence of crystalline stones in the urinary tract

Question 17

Where do you find kidney stones?

Answer 17

Pelviocoureteric junction
Pelvic brim
Vesicoureteral junction

Question 18

What are kidney stones made of?

Answer 18

Form from crystal in supersaturated urine - most often composed of calcium oxalate (80% of cases)

Question 19

What can urolithiasis lead to?

Answer 19

Blockage of urinary tract which can cause hydropnephrosis

Question 20

What are the risk factors for urolithiasis?

Answer 20

Dehydration
High salt intake
Obesity - lowers pH
Congenital horseshoe kidney
Oxalate rich diet
Gout - uric acid stones

Question 21

How does urolithiasis present?

Answer 21

Most are asymptomatic
Causes severe colicky unilateral pain from loin to groin
N+V
Haematuria - 85%
Assume ruptured AAA until proven otherwise

Question 22

How is urolithiasis investigated?

Answer 22

KUBXR - first line
Non contrast CTKUB - gold standard
Urine dipstick
Blood tests

Question 23

How is urolithiasis managed?

Answer 23

Strong analgesia - diclofenac
Antibiotics
Tamsulosin/nifedipine - relaxes smooth muscle and helps expulsion
Percutaneous nephrolithotomy - used to expulse stones over 10mm

Question 24

How is urolithiasis prevented?

Answer 24

Thiazide diuretics

Hydration, reduce salt + oxalate intake

Question 25

What does urinalysis in pyelonephritis show?

Answer 25

White cells and microscopic haematuria

Question 26

What do bloods show for pyelonephritis?

Answer 26

Elevated ESR and CRP

Question 27

What does US show for pyelonephritis?

Answer 27

Rule out urinary tract obstruction or stones

Question 28

What does urinalysis and culture in prostatitis show?

Answer 28

Blood, WBCs and bacteria

Question 29

What is the degree of proteinuria in nephrotic syndrome?

Answer 29

>3g/24 hours

Question 30

What causes hypoalbuminaemia in nephrotic syndrome?

Answer 30

Loss of albumin in urine

Question 31

What causes oedema in nephrotic syndrome?

Answer 31

Loss of oncotic pressure

Question 32

What causes frothy urine in nephrotic syndrome?

Answer 32

Proteinuria

Question 33

What does urine dipstick show for urolithiasis?

Answer 33

Haematuria

Question 34

What do blood tests show for urolithiasis?

Answer 34

Raised calcium and phosphate

Question 35

What do blood tests show for nephrotic syndrome?

Answer 35

Renal function, elevated lipids

Question 36

Why is the urine creatinine:protein ratio taken in nephrotic syndrome?

Answer 36

To measure degree of proteinuria

Question 37

How does gonorrhoea present in men?

Answer 37

Dysuria, frequency, discharge

Question 38

How does gonorrhoea present in women?

Answer 38

Vaginal discharge, dysuria, pelvic pain

Question 39

Why are ACEi and ARBs used to treat nephritic syndrome?

Answer 39

BP control, reduces proteinuria and preserves renal function

Question 40

Why are steroids used to treat nephritic syndrome?

Answer 40

Reduces inflammation causing damage to kidney