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Flashcards in Genitourinary Deck (378)
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1

What is testicular torsion?

sudden onset of pain in one testis, making walking uncomfortable

2

At what age are you most likely to acquire testicular torsion?

11-30 years

3

What symptoms can accompany pain in testicular torsion?

Abdominal pain, nausea and vomiting

4

What is the appearance of a testis in testicular torsion?

inflamed, hot, tender, swollen in one testis (can be intermittent)

5

How will the testis lie in testicular torsion, in mild and severe?

Mild - high and transversely
Severe - horizontal

6

What investigations would you do for testicular torsion?

Doppler US - shows lack of blood flow to testis
Surgical exploration - the sooner the better to save the testis

7

What is the treatment for testicular torsion?

ask for consent for possible orchiectomy and bilateral fixation
expose and untwist testes and fix to scrotum

8

DD for testicular torsion?

epididymo-orchitis, idiopathic scrotal oedema, tumour, trauma, acute hydrocycle

9

What is benign prostatic hyperplasia?

hyperplasia of the epithelial and stromal cells of the prostate gland in the transitional zone

10

What part of the prostate undergoes hyperplasia in benign prostatic hyperplasia?

The transitional zone

11

Who most commonly gets benign prostatic hyperplasia?

males over 60

12

What complications does benign prostatic hyperplasia lead to?

Distorts the urethra and obstructs bladder outflow causing urinary retention, recurrent UTI, impaired renal function and haematuria

13

What are the symptoms of benign prostatic hyperplasia?

frequency and urgency of micturition, nocturia, hesitancy, intermittent flow, poor urine stream/dribbling, incomplete bladder emptying, enlarged smooth rostate, haematuria, bladder stones, UTI

14

What causes benign prostatic hyperplasia?

Androgen dihydrotesterone

15

What will a rectal examination show in benign prostatic hyperplasia?

enlarged and smooth prostate with a palpable midline sulcus

16

What investigations should you do for benign prostatic hyperplasia?

urine dipstick, microscopy and culture, FBC, U and E, creatinine, LFTs, increased PSA, US of urinary tract and transrectl and renal

17

What are the 4 zones in the prostate?

fibro-muscular, transitional, central and peripheral

18

Where is the most common place for prostate cancer to occur?

In the peripheral zone

19

What is the management of benign prostatic hyperplasia?

watchful waiting if mild
complete international prostate symptom score
complete voiding diary
selective a1 adrenoreceptor antagonists e.g.tamsulosin
5-a-reductase inhibitor e.g. finasteride
urethral catheterisation if retention
prostatectomy or permanent catheter
avoid caffeine and alcohol
relax when voiding and train bladder
prostate resection
incision of prostate

20

How do selective a1 adrenoreceptor antagonists e.g.tamsulosin help treat benign prostatic hyperplasia?

They relax smooth muscles in bladder neck and prostate to increase flow rate and reduce symptoms

21

How to 5-a-reductase inhibitor e.g. finasteride help treat benign prostatic hyperplasia?

They block the conversion of testosterone to dihydrotesterone to reduce dihydrotestosterone

22

What is an epididymal cyst?

A non malignant scrotal disease just above the testis that contains spermatocele fluid

23

When are you most likely to get an epididymal cyst?

in adulthood

24

What is the treatment of an epididymal cyst?

No treatment unless symptomatic, then remove

25

What is hydrocele?

Fluid within the tunica vaginalis

26

What are the causes of hydrocele?

primary - patent processus vaginalis
secondary - tumour, trauma, infection

27

What is the treatment of hydrocele?

Primary can resolve spontaneously, aspirate or surgery of placating the tunica vaginalis or inverting the sac

28

What is a varicocele?

Dilated veins of the pampiniform plexus, normally on the left, appear as dilated scrotal blood vessels, will a dull ache

29

What are potential complications of a varicocele?

Can be associated with subfertility and a dull ache

30

What is the treatment of a varicocele?

repair via surgery or embolization