GU

Question 1

urge incontinence etiology

Answer 1

overactive bladder
contraction by detrusor

Question 2

urge incontinence test

Answer 2

US to r/o UTI
urodynamic studies: confirm

Question 3

urge incontinence tx

Answer 3

oxybutynin
mirabegron

Question 4

stress incontinence test

Answer 4

clinical
UA r/o UTI
Q tip test

Question 5

stress incontinence tx

Answer 5

1st: kegals, pessary
topical estrogen
surgery: bladder lift, urethral sling

Question 6

overflow incontinence etiology

Answer 6

nerves not telling detrusor to empty

Question 7

overflow incontinence test

Answer 7

post void residual w/ bladder US
urodynamic studies

Question 8

overflow incontinence tx

Answer 8

clean intermittent catheterization
surgical correction
alpha adrenergic blockers

Question 9

prolapse tx

Answer 9

conservative: kegels,
nonsurg: pessaries, estrogen tx
surgical

Question 10

cryptorchidism tx

Answer 10

refer to surgery after 1yo, no later than 3yo
higher risk of testicular cancer if not corrected

Question 11

peyronie dz etiology

Answer 11

plaque formation in tunic albuginea

Question 12

peyronie dz tx

Answer 12

clostridial collagenase injection
surgery

Question 13

vesicoureteral reflux sx

Answer 13

young pt, repeat UTIs

Question 14

vesicoureteral reflux test

Answer 14

voiding cystourethrogram (VCUG)
US (hydronephrosis)

Question 15

vesicoureteral reflux tx

Answer 15

prevent/tx UTI
manage HTN and renal insufficiency
surgery

Question 16

tx balanitis

Answer 16

candida: clotrimazole or miconazole cream
allergic: hydrocortisone cream

Question 17

cystitis labs

Answer 17

+ leukocyte esterase
+ nitrates
urine culture and sensitivity definitive

Question 18

Pyridium AE

Answer 18

used in UTI as analgesic
AE orange urine, can cause methylglobinuria if used <48h

Question 19

MCC epidymitis <35yo

Answer 19

urethritis, STI (chamydia, gonorrhea)

Question 20

MCC epididymitis >35yo

Answer 20

prostatitis, BPH, UTI (e.coli, klebsiella, pseudomonas, proteus)

Question 21

epididymitis sx

Answer 21

unilateral scrotal pain and swelling
+ Prehn sign
+ cremaster reflex

Question 22

epididymitis tx

Answer 22

NSAIDS, cool compress
gono/chlam: azithromycin/doxycycline and ceftriaxone
bacteria: bactrim, FQ, cephalexin (child)

Question 23

MCC orchitis

Answer 23

viral: mumps

Question 24

orchitis sx

Answer 24

• cremasteric sign
  + prehns sign

Question 25

orchitis tx

Answer 25

resolves in 1wk self limited

Question 26

MCC acute prostatitis

Answer 26

E. coli <35yo: chlamydia/gonorrhea

Question 27

acute prostatitis tx

Answer 27

initial: ampicillin and aminoglycoside <35: ceftriaxone and doxy outpt: bactrim or FQ prostate massage CI, risk of septicemia

Question 28

chronic prostatitis vs acute prostatitis

Answer 28

Acute: tender and boggy Chronic: nontender and boggy

Question 29

chronic prostatitis tx

Answer 29

bactrim TURP if refractory

Question 30

MCC pyelonephritis

Answer 30

E. coli

Question 31

pyelonephritis sx

Answer 31

CVA tenderness, N/V/F, chills, tachycardia

Question 32

pyelonephritis tests

Answer 32

WBC casts urine culture definitive leukocytosis

Question 33

pyelonephritis tx

Answer 33

outpt: bactrim, FQ

Question 34

urethritis MCC

Answer 34

chlamydia trachomatis

Question 35

chlamydia culture

Answer 35

does not grow on culture

Question 36

Urethritis most sensitive/specific test

Answer 36

Nucleid acid amplification test (NAAT)

Question 37

urethritis tx

Answer 37

coinfx: ceftriaxone + azithromycin or doxy non-gonococcal: azithromycin or doxy test parters and tx

Question 38

MC bladder cancer

Answer 38

transitional

Question 39

bladder cancer dx

Answer 39

gold: cystoscopy w/ bx CT w/ urography

Question 40

penile cancer MC

Answer 40

SCC

Question 41

penile cancer risk factors

Answer 41

HPV smoking

Question 42

MC prostate cancer

Answer 42

adenocarcinoma

Question 43

prostate cancer risk factors

Answer 43

>40yo, AA Fhx, smoking high fat diet*

Question 44

PSA monitoring

Answer 44

annual exam after 50yo 45yo if high risk

Question 45

PSA levels prostate cancer

Answer 45

>4: not prostate cancer specific >10: repeat in 8-10w

Question 46

prostate cancer tx

Answer 46

gold for mets: orchiectomy, antiandrogens +/- chemo if PSA still increased: GnRH (leuprolide)

Question 47

MC type testicular cancer

Answer 47

germ cell tumors: seminoma

Question 48

Common cause of testicular cancer

Answer 48

cryptorchidism

Question 49

non-seminoma GCT tests

Answer 49

+ AFP high Hcg radio resistance

Question 50

MC location testicular cancer

Answer 50

right side

Question 51

which testicular cancer doesn't have high AFP

Answer 51

pure seminoma: no tumor markers, sensitive to radiation, slow growing, stepwise spread

Question 52

wilms tumor sx

Answer 52

child large abdomen or palpable abdominal mass fever, abd pain, hematuria

Question 53

wilms tumor BIT

Answer 53

US

Question 54

wilms tumor tx

Answer 54

nephrectomy w/ chemo

Question 55

nephrolithiasis risk factors

Answer 55

dehydration, diet, hx of stones hyperparathyroidism

Question 56

MC stone nephrolithiasis

Answer 56

calcium oxalate

Question 57

struvite stones nephrolithiasis

Answer 57

F staghorn, coffin shaped alkaline

Question 58

uric acid stones nephrolithiasis

Answer 58

gout, high protein diet acidic radiolucent

Question 59

nephrolithiasis sx

Answer 59

acute colicky pain upper/lateral back or flank loin to groin (radiate to groin), CVA tenderness hematuria, F/N/V

Question 60

nephrolithiasis proximal ureter presentation

Answer 60

flank pain, CVA tenderness

Question 61

nephrolithiasis mid ureter presentation

Answer 61

mid abdominal pain

Question 62

nephrolithiasis distal ureter (VUJ) presentation

Answer 62

groin pain

Question 63

nephrolithiasis BIT

Answer 63

spiral/helical CT w/o contrast

Question 64

radiopaque stones nephrolithiasis

Answer 64

Calcium and struvite

Question 65

first line erectile dysfunction

Answer 65

PDE5: sildenafil, vardenafil, tadalafil

Question 66

PDE5 CI

Answer 66

sildenafil, tadalafil CI in nitrate use and CV dz

Question 67

1st line low flow priapism

Answer 67

phenylephrine CI in CV dz can do turbutaline if <4h

Question 68

risk factor hypospadias

Answer 68

advanced maternal age, placenta insufficiency preterm newborns, low birth weight

Question 69

hypospadias tx

Answer 69

surgery before 2yo

Question 70

lichen Planus associations

Answer 70

hep C ACE, thiazide, diuretics

Question 71

lichem planus sx

Answer 71

5Ps: pruritic, purple, polygonal, papules, plaques lacy white lines (Wickham striae)

Question 72

lichen Planus tx

Answer 72

topical high potency GC (betamethasone) self limiting

Question 73

paraphimosis tx

Answer 73

emergency manual reduction surgery

Question 74

phimosis tx

Answer 74

topical steroids, gentle stretching emergent: dilation w/ clamp and pain meds definitive, circumcision

Question 75

BPH tx

Answer 75

asx: no tx regardless of size 5 alpha reductase inhibitor (shrink prostate): finasteride, dutasteride alpha 1 adrenergic blockers: prazosin, terazosin TURP

Question 76

5 alpha reductase inhibitor AE

Answer 76

finasteride gynecomastia

Question 77

alpha adrenergic blocker AE

Answer 77

prazosin and terazosin hypotension (orthostatic)

Question 78

hydrocele MC location

Answer 78

right side

Question 79

hydrocele layer

Answer 79

tunica vaginalis

Question 80

varicocele MC location

Answer 80

left side

Question 81

varicocele right side

Answer 81

suspect inferior vena cava syndrome if right side only if sudden, renal cell carcinoma if child <10yo, retroperitoneal malignancy

Question 82

varicocele right side test

Answer 82

CT

Question 83

varicocele left side test

Answer 83

scrotal US/doppler

Question 84

MCC testicular torsion

Answer 84

bell clapper deformity

Question 85

testicular torsion sx

Answer 85

neg cremasteric reflex neg prehns sign

Question 86

testicular torsion tx

Answer 86

manual detorsion (<4-6h) 6+h: necrosis --> orchiectomy surg consult 1st then US

Question 87

urethral stricture test

Answer 87

post void residual (uroflowmetry) urethrography cystourethroscopy

Question 88

urethral stricture tx

Answer 88

dilation urethroplasty