Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a Medicine > GUM > Flashcards

GUM Flashcards

(289 cards)

Start Studying
1
Q

What are the functions of the urinary tract?

A
  1. To collect urine produced continuously by kidneys
  2. Store collected urine safely
  3. Expel urine when socially acceptable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where do stones tend to form in the ureters?

A
  1. Pelvic ureter junction
  2. Where it crosses iliac vessels
  3. Where it enters trigone of bladder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What nerves supply the bladder?

A
  1. Pelvic nerve
  2. Hypogastric plexus
  3. Pudendal nerve
  4. Afferent pelvic nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the origin of pelvic nerves?

A

S2 to S4 (keeps the pee of the floor)

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

What is the normal capacity of the bladder?

A

400-500ml

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

When is first sensation felt in the bladder?

A

100-200ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why does bladder pressure remain low when volume increases?

A

Receptive relaxation and detrusor muscle compliance

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

What is the reflex when voiding is inappropriate?

A

Guarding reflex

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

What is the role of the detrusor muscle?

A
  1. Relaxes during storage

2. Contracts during voiding

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

What is the role of the distal sphincter muscle?

A
  1. Contracts during storage

2. Relaxes during voiding

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

What are the storage LUTS?

A
  1. Frequency
  2. Nocturia
  3. Urgency
  4. Urgency incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the voiding LUTS?

A
  1. Hesitancy
  2. Straining
  3. Poor/intermittent stream
  4. Incomplete emptying
  5. Post-micturition dribbling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the red flag LUTS?

A
  1. Haematuria

2. Dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is benign prostatic hyperplasia (BPH)?

A

Increase in epithelial and stroll cell numbers in periurethral area of prostate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can cause BPH?

A
  1. Increase in cell number
  2. Decrease apoptosis
  3. Combination of both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is a requirement for BPH?

A

Androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is used to score LUTS symptoms?

A

International Prostate Symptom Score (IPSS)

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

What are the examinations done in LUTS pt.?

A
  1. General examination
  2. Abdomen examination
  3. External genitalia
  4. DRE
  5. Focussed neurological exam
  6. Urinalysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What investigations are done in LUTS/BPH?

A
  1. Flow rates and residual volume
  2. Frequency volume chart
  3. Renal biocehmistry
  4. PSA
  5. TRUSS
  6. Flexible cystoscopy
  7. Urodynamics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What can cause reduction of flow rate?

A
  1. Obstruction within lower urinary tract

2. Detrusor underactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is normal post void residual (PVR)?

A

<12ml

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

What are the complications of benign prostatic enlargement (BPE)?

A
  1. Symptom progression
  2. Infections
  3. Stones
  4. Haematuria
  5. Retention
  6. Interactive obstructive uropathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the clinical features of acute retention of urine (AUR)?

A
  1. Painful
  2. 600ml-1L residual urine
  3. Normal U&E
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the Rx for AUR?

A
  1. Catheterisation
  2. Alpha blockers - tamsulosin
  3. ISC
  4. Bladder outflow surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the clinical features of interactive obstructive uropathy?
1. Nocturnal enuresis 2. Residual volume 4L 3. High CRP 4. Diuresis
26
What is the Rx for interactive obstructive uropathy?
1. IV fluids 2. TURP 3. Indwelling catheter
27
What is the Rx for BPH?
1. Observation 2. Medical treatment 3. Surgical treatment
28
What is the medical treatment for BPH?
1. Alpha adrenergic antagonists e.g. tamsulosin 2. 5a-reductase inhibitors e.g. finasteride 3. Combination therapy 4. Anti-cholinergics
29
What are the indications for surgery in BPH?
RUSHES 1. Retention 2. UTIs 3. Stones 4. Haematuria 5. Elevated creatinine due to BOO 6. Symptom deterioration
30
Give 4 surgical treatments for BPH
1. Bladder neck incision 2. TURP 3. Bipolar 4. Greenlight laser
31
Give 4 complications of TURP
1. Sepsis 2. Haemorrhage 3. Clot retention 4. Erectile dysfunction
32
What is incontinence?
Involuntary loss of urine (failure of storage)
33
What is overactive bladder (OAB)?
Urgency with frequency, with or without nocturia, when appearing in absence of local pathology
34
What is the Rx for OAB?
1. Behavioural therapy 2. Anti-muscarinic agents 3. B3 agonists 4. Botox 5. Sacral neuromodulation 6. Surgery
35
Why does birth cause stress incontinence in females?
1. Denervation of pelvic floor and urethral sphincter | 2. Weakening of fascial support of bladder and urethra
36
How is stress incontinence managed in females?
1. Pelvic floor physiotherapy 2. Duloxetine 3. Surgery
37
What causes stress incontinence in males?
1. Neurogenic | 2. Prostatectomy
38
How is stress incontinence managed in males?
1. Artificial sphincter | 2. Male sling
39
What is most in spastic spinal cord injury?
1. Coordination | 2. Completion of voiding
40
What are the features of spastic spinal cord injury?
1. Reflex bladder contractions 2. Detrusor sphincter dyssynergia 3. Poorly sustained bladder contraction
41
What is lost in flaccid spinal cord injury?
1. Reflex bladder contraction 2. Guarding reflex 3. Receptive relaxation
42
What are the features of flaccid spinal cord injury?
1. Areflexic bladder 2. Stress incontinence 3. Risk of poor compliance
43
What is autonomic dysreflexia?
Overstimulation of sympathetic nervous system below level of lesion in response to a noxious stimulus
44
What are the symptoms of autonomic dysreflexia?
1. Headache 2. Severe HTN 3. Flushing
45
What are the risk factors for unsafe bladder?
1. Raised bladder pressure 2. Vesico-ureteric reflux 3. Chronic infection
46
What is an unsafe bladder?
One that puts kidneys at risk
47
What causes raised bladder pressure?
Prolonged detrusor contraction causing loss of compliance
48
What is the result of raised bladder pressure?
Problems with drainage of urine from kidneys and ultimately hydronephrosis and renal failure
49
What are the routes for reflex bladder?
1. Harness reflexes to empty bladder into incontinence device 2. Suppress reflexes converting bladder to flaccid type and then empty regularly
50
What are the management for paraplegic bladder?
1. Suprapubic catheter 2. Convene 3. Suppress reflexes or poorly compliant bladder converting bladder to safe type and then regularly empty using ISC
51
What can be used to suppress reflex bladder contractions?
1. Anticholinergics 2. Mirabegron 3. Intravesical botulinum toxin 4. Posterior rhizotomy 5. Cystoplasty
52
What is the mean age for prostate cancer?
72
53
What type of cancer are most prostate cancers?
Adenocarcinoma
54
What are the sites for prostate cancer?
1. Peripheral zone (70%) 2. Transitional zone (20%) 3. Central zone (10%)
55
How are prostate cancers graded?
Gleason scale
56
Which organs does prostate cancer spread to?
1. Bone 2. Lung 3. Liver 4. Kidneys
57
How does prostate cancer spread locally?
Through prostate capsule
58
What are the biomarkers for prostate cancer?
1. Tissue 2. PSA 3. PSMA 4. PCA3 5. Gene fusion products
59
When is PSA elevated?
1. Benign prostate enlargement 2. UTI 3. Prostatitis 4. Prostate cancer
60
What are 5 symptoms of prostate cancer?
1. Weight loss 2. Hesitancy 3. Frequency 4. Nocturia 5. Urgency
61
What is seen on examinations for prostate cancer?
1. DRE 2. Neurological exam 3. Overdistended bladder 4. Bony tenderness 5. Lymphadenopathy 6. DVT
62
What does DRE check for in prostate cancer?
A nodule, asymmetry, difference in texture and bogginess
63
What are the investigations for prostate cancer?
1. PSA 2. MRI prostate 3. Prostate biopsy 4. CT abdomen
64
What is normal PSA level?
<3ng/ml
65
What are the Rx for prostate cancer?
1. Active surveillance 2. Radical prostatectomy 3. Radiotherapy 4. Hormone therapy
66
What hormone therapies are used for prostate cancer?
1. Orchiectomy 2. LH-releasing hormone agonists e.g. goserelin 3. Anti-androgens e.g. flutamide
67
What are the side effects of hormone therapies?
1. Impotence 2. Depression 3. hot flushes 4. Lethargy
68
What are the Rx for metastatic prostate cancer?
1. Chemotherapy e.g. docetaxel 2. Biphosphonates 3. Radiotherapy 4. TURP 5. Nephrostomy
69
What is used to Dx prostate cancer?
1. LUTS 2. PSA 3. Transrectal USS 4. Prostate biopsy 5. Prostate cancer grading
70
What are the benefits of PSA testing?
1. Early diagnosis of localised disease | 2. Early Rx of advanced disease
71
What are the risks of PSA testing?
1. Overdiagnosis of insignificant disease | 2. Harm caused by investigation/Rx
72
What is the peak age for kidney cancer?
85-90
73
What is the mortality for kidney cancer?
35%
74
What are the risk factors for kidney cancer?
1. Smoking 2. Environment e.g. petroleum 3. Occupation e.g. leather tanners 4. Hormonal e.g. obesity 5. Genetic e.g. VHL
75
What is the classic triad of kidney cancer?
1. Mass 2. Haematuria 3. Pain
76
What are the blood signs of kidney cancer?
Raised PTH, EPO, PLC
77
What are the investigations for kidney cancer?
1. USS renal | 2. CT renal
78
What are the histological types in kidney cancer?
1. Clear cell 2. Papillary 3. Chromophobe
79
What are the Rx for kidney cancer?
1. Nephrectomy 2. Radiotherapy 3. Cryotherapy 4. Tyrosine kinase inhibitors
80
Where is bladder cancer more common?
1. Industrialised areas | 2. Schistosomiasis endemic areas
81
Give 4 risk factors for bladder cancer
1. Smoking 2. Tanner 3. Dye worker 4. Hairdresser
82
What is the presentation of bladder cancer?
1. Painless haematuria 2. Irritative LUTS 3. Flank pain 4. Weight loss 5. Pelvic mass
83
What type of cancer is most common in bladder?
Transitional cell carcinoma
84
What are the investigations for bladder cancer?
1. CT | 2. Cystoscopy
85
What is the Rx for bladder cancer?
1. TURBT 2. Chemotherapy 3. Immunotherapy 4. Cystectomy 5. Radiotherapy
86
What is the most common age for testicular cancer?
20-35
87
What are the risk factors for testicular cancer?
1. Cryptorchidism 2. Previous cancer 3. HIV 4. Klinefelter's syndrome 5. Maternal oestrogen exposure
88
What is the pathology of most testicular cancer?
Germ cell tumours - seminomatous and non-seminomatous
89
Where do testicular cancers metastasise to?
1. Epididymis 2. Spermatic cord 3. Scrotal wall
90
What is the presentation of testicular cancer?
1. Scrotal lump 2. Scrotal pain 3. Weight loss
91
What is the DDx for testicular cancer?
1. Hydrocele 2. Epididymal cyst 3. Indirect inguinal hernia 4. Varicocele
92
What are the investigations for testicular cancer?
1. USS testes 2. CT CAP 3. CT brain/spine 4. Tumour markers - AFP, LDH, hCG
93
What is the Rx for testicular cancer?
1. Orchidectomy 2. Sperm banking 3. RPLND 4. Radiotherapy 5. Chemotherapy
94
What are the complications of glomerulitis?
1. Haematuria 2. Proteinuria 3. High BP 4. Renal impairment
95
What is the presentation of acute nephritic syndrome (ANS)?
1. Acute kidney injury 2. Haematuria 3. Proteinuria 4. Oliguria 5. HTN 6. Fluid overload
96
Give 3 causes of ANS
1. ANCA associated vasculitis 2. SLE 3. Goodpasture's disease
97
What is the important diagnostic method for glomerular disease?
Urine dipstick
98
What does renal vasculitis involve?
Necrotising small vessel vasculitis involving capillaries, venues, arteriolar and small arteries
99
When does renal vasculitis usually occur?
5th to 7th decade
100
What are the symptoms of renal vasculitis?
1. Headache 2. Flu-like symptoms 3. Bloody discharge 4. Tender nodules 5. Wheeze
101
What are the investigations for renal vasculitis?
1. ANCA 2. Urine dipstick 3. Bloods 4. BP 5. CRP 6. Biopsy
102
What are the stages of treatment for renal vasculitis?
1. Induced remission | 2. Maintenance Rx
103
What is the induced remission treatment for renal vasculitis?
1. Steroids 2. Cyclophosphamide 3. Plasma exchange
104
What is the maintenance treatment for renal vasculitis?
1. Azathioprine | 2. Rituximab
105
What are the complications of renal vasculitis?
1. Declining renal function 2. Hypertension 3. Proteinuria 4. Osteoporosis 5. Malignancy
106
What is the pathophysiology of IgA nephropathy?
Mesangial proliferative glomerulonephritis (GN) with diffuse mesangial IgA deposits
107
When does most IgA nephropathy occur?
2nd or 3rd decade
108
What is the Dx for IgA nephropathy?
1. Biopsy | 2. Diffuse mesangial IgA deposits
109
What is the supportive Rx for IgA nephropathy?
1. RAAS inhibitors 2. Diet 3. Lower cholesterol
110
What is the immunosuppressive Rx for IgA nephropathy?
1. Steroids 2. Cyclophosphamide 3. Azathioprine
111
What is the presentation of nephrotic syndrome?
1. Heavy proteinuria 2. Hypoalbuminaemia 3. Oedema 4. Hypercholesterolaemia
112
What is nephrotic syndrome?
Metabolic consequences are hypoalbuminaemia, hypercoagulability, loss of binding proteins needing drug dose adjustments and risk of infections
113
Give 5 causes of nephrotic syndrome
1. Minimal change 2. Membranous 3. Focal segmental glomerulosclerosis 4. DM 5. Amyloid
114
What are the investigations for nephrotic syndrome?
1. Bloods 2. Urinalysis 3. Urine protein creatinine ratio 4. ANA, DNA 5. Antiphospholipase A2 receptor antibody 6. HepB Ag 7. Renal biopsy
115
Where is renal biopsy taken from and why?
Lower pole of kidney as its least vascular region
116
What is the Rx for nephritic syndrome?
1. Manage complications e.g. diuretics, ACEI 2. Treat underlying cause 3. Statins
117
What is the pathophysiology of membranous GN?
1. Thickening of glomerular capillary wall | 2. IgG complement deposit in sub epithelial surface causing leaky glomerulus
118
What causes secondary membranous GN?
1. Autoimmune conditions 2. Viruses 3. Drugs 4. Tumours
119
What are the clinical features of membranous GN?
1. Nephrotic syndrome | 2. Benign urinary sediment
120
What is the Dx for membranous GN?
1. Serum PLA2 Ab | 2. Renal biopsy
121
What is the Rx for membranous GN?
1. Steroids 2. Cyclophosphamide 3. CNI 4. Rituximab 5. Supportive Rx
122
What is the presentation of minimal change disease?
1. Nephrotic syndrome | 2. Benign urine sediment
123
What is the Dx for minimal change disease (MCD)?
Biopsy
124
What is the Rx for MCD?
1. Steroids 2. Cyclophosphamide 3. Cyclosporine
125
What are common causes of asymptomatic abnormalities?
1. IgA | 2. Thin membrane disease
126
What is chronic kidney disease (CKD)?
Progressive decline in kidney function with abnormal dipstick
127
What causes CKD?
1. IgA nephropathy 2. Membranous GN 3. DM 4. Mesangiocapillary GN 5. HIV associated nephropathy
128
What is the physiology of erections?
1. Cavernosal nerve stimulation with NO release 2. Smooth muscle relaxation 3. Compression of venous outflow 4. Increased cavernosal pressure and contraction of ischiocavernosus muscle 5. Rigid erection
129
What is the physiology of ejaculation?
1. Stimulation via pudendal nerve 2. Emission: peristaltic contraction of epididymus, vas deferent and seminal vesicles with simultaneous bladder neck contraction and external sphincter relaxation 3. Expulsion: rhythmic contraction of bulbospongiosus muscle
130
What is erectile dysfunction (ED)?
Persistent inability to attain and maintain an erection sufficient for satisfactory sexual performance
131
Give 5 causes of ED
1. DM 2. Smoking 3. HTN 4. Hypercholesterolaemia 5. Obesity
132
What is the presentation of non-organic ED?
1. Relationship difficulties 2. Performance anxiety 3. Normal morning erections and non-coital erections
133
What is the Hx of ED?
1. Early morning erections 2. Masturbation 3. Libido difficulties 4. Ejaculation dysfunciton 5. Anatomical difficulties
134
What are the examinations for ED?
1. External genitalia 2. DRE 3. CV exam 4. Gynaecomastia 5. Neurological exam
135
What are the investigations for ED?
1. FBC, BGL, LH/FHS, TFTs 2. Validated questionnaire (IIEF or SHIM) 3. Penile doppler USS 4. Nocturnal penile tumescence
136
What are the management options for ED?
1. Lifestyle changes 2. Optimise medication 3. Correct hormone imbalance 4. Counselling 5. Vacuums device
137
What medications can be used for ED?
1. PDE5 inhibitors | 2. Alprostadil
138
Give 2 examples of PDE5 inhibitors
1. Sildenafil | 2. Tadalafil
139
What are the SE of PDE5 inhibitors?
1. Headache 2. Flushing 3. Nasal congestion 4. Impaired colour vision 5. Priapism
140
What are the SE of alprostadil?
1. Urethral pain 2. Hypotension 3. Priapism 4. Pain 5. Penile fibrosis
141
What are the risks of penile prosthesis?
1. Urethral perforation 2. Cold glans 3. Concorde glans 4. Malfunction 5. Infection 6. Erosion
142
What is premature ejaculation?
Ejaculation which always occurs prior to or within 1 min of vaginal penetration and the inability to delay and negative consequences of distress, frustration or avoidance of sexual intimacy
143
What is the management for premature ejaculation?
1. Counselling 2. Quiet vagina technique 3. Squeeze technique 4. Topical local anaesthetic 5. SSRIs
144
What is Peyronie's disease?
Fibrotic plaque causing bend on erection
145
What can cause Peyronie's disease?
1. Dupuytren's contracture 2. Alcohol excess 3. DM
146
What is the presentation of Peyronie's disease?
1. Pain on erection 2. Deformity 3. Inability to have penetrative sex
147
What is the Rx for Peyronie's disease?
1. Nesbit's plication 2. Lue's procedure 3. Penile prosthesis
148
What is the pathophysiology of penile fracture?
Rupture of tunica albuginea
149
What is the presentation of penile fracture?
1. Sudden pain 2. Immediate detumescence 3. Inability to gain erection
150
What is the Dx for penile fracture?
1. Aubergine penis on exam 2. USS 3. MRI
151
What is the Rx for penile fracture?
Surgery for exporation and repair
152
What is priapism?
Prolonged, often painful, erection of penis in absence of sexual desire or stimulation lasting > 4 hr
153
What is the peak age for priapism?
20-50
154
What are the risk factors for priapism?
1. SCD 2. Prior trauma 3. ED medications 4. Recreational drug use
155
What are the investigations for priapism?
1. FBC, U&E 2. Sickle cell screen 3. Cavernosal blood gas analysis 4. Colour duplex USS
156
What is the Rx for priapism?
1. Analgesia 2. Ice pack 3. Aspiration +/- irrigation 4. Intracavernosal phenylephrine 5. Surgical shunts 6. Penile prosthesis
157
What are the functions of the kidneys?
1. Filter or secrete waste 2. Retain albumin, cells 3. Reabsorption 4. Control BP, fluids 5. Activate vit D 6. Synthesise EPO
158
What are the complications of CKD?
1. Anaemia | 2. Bone disease
159
Which drugs inhibit creatinine secretion?
1. Trimethoprim 2. Cimetidine 3. Ritonavir
160
What are the features of Fanconi syndrome?
1. Glycosuria 2. Acidosis with failure of urine acidification 3. Phosphate wasting (rickets/osteomalacia) 4. Aminoaciduria
161
Where is K most filtered and reabsorbed?
Proximal tubule and loop of Henle by Na/K cotransporter
162
What governs renal potassium control?
1. Distal delivery of Na | 2. Aldosterone
163
What drugs teat hypokalaemia?
1. Loop diuretics | 2. Thiazide diuretics
164
What drugs treat hyperkalaemia?
1. Spironolactone 2. Amiloride 3. ACEI 4. ARBs
165
What drugs are used for distal tubule?
Thiazides
166
What drugs are used for aquaporins?
Vasopressin antagonists
167
What drugs are used for collecting duct?
Aldosterone antagonist
168
What drugs are used for loop of Henle?
Loop diuretics
169
What is the role of prostaglandin on arterioles?
Preferentially dilates afferent arteriole
170
What is the role of angiotensin II on arterioles?
Preferentially constricts efferent arteriole
171
What is indicated in proteinuric CKD?
ACEI and ARB
172
What are the signs of nephrogenic diabetes insipidus?
1. Hypercalcaemia 2. Hypokalaemia 3. Lithium 4. Genetic link
173
What are the roles of calcitriol?
1. Increases Ca and phosphate absorption from gut | 2. Suppresses PTH
174
What does calcitriol deficiency cause?
Secondary hyperparathyroidism
175
What are the signs of secondary hyperparathyroidism?
1. Rugger jersey spine 2. Brown tumours 3. Radial border of phalanges 4. Salt and pepper skull
176
What is used to measure kidney function?
1. Creatinine 2. eGFR 3. Proteinuria 4. Albuminuria
177
What excretes creatinine?
Kidneys
178
What produces creatinine?
Muscle metabolism
179
What is the aetiology of CKD?
1. DM 2. HTN 3. Chronic glomerulonephritis 4. Obstructive uropathy 5. Cystic disease 6. AKI
180
How is CKD classified?
GFR category (normal to kidney failure) vs albuminuria increase
181
What are the risk factors for CKD?
1. Age 2. Male 3. HTN 4. Smoking 5. LV hypertrophy 6. DM 7. Dyslipidaemia
182
Why is BP control important in CKD?
It reduces decreases in GFR
183
What BP medications are used in CKD?
ABCDs 1. ACEI/ARBs 2. BB 3. CCB 4. Diuretics
184
What is the Rx for CKD?
1. Manage BP 2. Manage DM 3. Statins
185
Why is anaemia a complication of CKD?
Liver makes hepcidin which is normally filtered by kidneys, so get build up which reduces EPO production
186
What are the renal replacement therapies (RRT) specific managements for CKD?
1. Haemodialysis 2. Peritoneal dialysis 3. Transplant
187
How is a haemodialysis machine connected to blood supply?
AV fistula or tunnelled line
188
How does haemodialysis work?
1. Blood pumped out of fistula into blood line 2. Heparin added to prevent clots 3. Blood flows to dialysed, where impurities, salt and excess fluid are drawn into dialysis fluid 4. Clean blood returned
189
How does peritoneal dialysis work??
Infuses a sugary solution into abdomen which draws off toxins
190
What are the early complications of kidney transplant?
1. Delayed function 2. Surgical complications 3. Infection 4. Rejection
191
What happens if a transplanted kidney doesn't function straight away?
Pt. is put on dialysis
192
How is fluid status assessed?
1. Ankle oedema 2. Pulmonary oedema or crackles 3. High jugular venous pressure 4. High BP
193
What is the Rx for dehydration?
IV fluids
194
What is the Rx for overhydration?
Diuretics
195
What is the epidemiology of chlamydia?
Higher in females, drops off after 25
196
What is the epidemiology of gonorrhoea?
Higher in males, diagnoses common in range of ages
197
What bug causes chlamydia?
Chlamydia trachomatis
198
What bug causes gonorrhoea?
Neisseria gonorrhoeae
199
Where does chlamydia infection effect?
1. Urethra 2. Endocervical canal 3. Rectum 4. Pharynx 5. Conjunctiva
200
What are the symptoms of chlamydia and gonorrhoea for males?
1. Pain passing urine 2. Urethral discharge 3. Asymptomatic 50%
201
What is the incubation for chlamydia for males?
7-21 days
202
What are the complications of chlamydia for males?
1. Epididymoorchitis | 2. Reactive arthritis
203
What is the incubation in gonorrhoea for males?
2-5 days
204
What are the symptoms of chlamydia and gonorrhoea for females?
1. Discharge 2. Menstrual irregularity 3. Dysuria
205
Give 5 complications of chlamydia and gonorrhoea in females
1. Tubal factor infertility 2. Ectopic pregnancy 3. Conjunctivitis 4. Atypical pneumonia 5. Fitz Hugh Curtis syndrome
206
How is chlamydia diagnosed?
Nucleic acid amplification test (NAAT)
207
What is the prevalence of chlamydia in asymptomatic <25 year olds?
10%
208
What is the Rx for chlamydia?
1. Partner management 2. Test for other STIs 3. Doxycycline 4. Erythromycin
209
What is used instead of erythromycin in pregnancy?
Azithromycin
210
How is gonorrhoea diagnosed?
1. Near patient test 2. Microscopy 3. NAAT
211
What is the Rx for gonorrhoea?
1. Partner notification 2. Test for other STIs 3. Check Abx sensitivity 4. Ceftriaxone
212
Why is partner notification important?
1. Prevent re-infection of index pt. | 2. Prevent complications in asymptomatic contacts
213
What bug causes syphilis?
Treponema pallidum
214
When do women tend to get syphilis?
Reproductive age
215
What is the incubation for primary syphilis?
21-35 days
216
What is the development of syphilis ulcers?
1. Dusky macule 2. Papule 3. Indurated clean based non-tender ulcer
217
What is the most common presentation in secondary syphilis?
Maculosquamous rash
218
How is syphilis diagnosed?
1. Early moist lesions - ID motile spirochetes | 2. Serology from genital ulcer or rash
219
What are the serological tests for syphilis?
1. Screening EIA 2. TPPA 3. Non-treponemal test
220
What is the Rx for syphilis?
1. Penicillin injection | 2. Partner notification
221
What is the presence of bacteria in urine called?
Bacteriuria
222
What is pyuria?
Presence of leukocytes in urine
223
Who does uncomplicated UTIs effect?
Non pregnant women
224
What is the most common cause of UTI?
E. coli
225
What are the symptoms of a lower UTI?
Dysuria, frequency
226
What are the symptoms of an upper UTI?
Pyrexia, haematuria
227
How are UTIs diagnosed?
1. Urine dipstick 2. Microscopy 3. Culture 4. Sensitivity
228
What is seen on microscopy for UTIs?
1. WBC 2. RBC 3. Casts 4. Bacteria 5. Epithelial cells
229
What is the Rx for uncomplicated UTI?
1. Abx 3 days 2. Increase fluid intake 3. Void pre-post intercourse 4. Hygiene
230
What is the first line Abx for UTIs?
Nitrofurantoin
231
What other Abx can be used for UTIs?
1. Fosfomycin | 2. Pivmecillinam
232
What are the complications of long term catheters?
1. UTI/pyelonephritis 2. Stones 3. Obstruction 4. Chronic inflammation
233
How are UTIs diagnosed in pregnancy?
Culture
234
What is pyelonephritis?
Infection of renal parenchyma and soft tissues of renal pelvis/upper ureter
235
Who is affected by pyelonephritis?
Women <35
236
What is associated with pyelonephritis?
Sepsis and systemic upset, rigors
237
What are the symptoms of pyelonephritis?
1. Loin pain 2. Fever 3. Pyuria
238
What are the investigations for pyelonephritis?
1. Abdominal exam 2. Bloods incl. cultures 3. USS 4. MSU
239
What is the Rx for pyelonephritis?
1. Fluid replacement 2. IV Abx - coamoxiclav 3. Drain obstructed kidney 4. Catheter 5. Analgesia
240
What are the complications of pyelonephritis?
1. Renal abscess | 2. Emphysematous pyelonephritis
241
What is the commonest age for urolithiasis (stones)?
30-50
242
What is the most common cause of stones?
Dehydration
243
How can stones be prevented?
1. Overhydration 2. Low salt diet 3. Normal dairy intake 4. Healthy protein intake 5. Reduce BMU 6. Active lifestyle
244
How can cystine stones be prevented?
1. Excessive overhydration 2. Urine alkalisation 3. Cysteine binders e.g. captopril
245
What are the symptoms of stones?
1. Loin pain 2. Renal colic 3. UTI symptoms 4. Recurrent UTIs 5. Haematuria
246
What is renal colic?
Pain results from upper urinary tract obstruction
247
What are the signs of renal colic?
1. Unilateral loin pain 2. Rapid onset 3. Unable to get comfortable 4. Radiation to groin and ipsilateral testis/labia 5. Nausea/vomiting 6. Spasmodic/colicky
248
What is the investigation of ureteric colic?
1. Urinalysis, MSU 2. FBC, U&E, Ca, uric acid 3. NCCT-KUB 4. KUB XR 5. USS
249
What is the DDx for ureteric colic?
1. Ruptured AAA 2. Diverticulosis 3. Appendicitis 4. Ectopic pregnancy 5. Testicular torsion
250
What imaging technique is used for ureteric colic in pregnancy?
MRI
251
What is the Rx for ureteric colic?
1. Analgesia (NSAIDs/opiates) 2. Antiemetics 3. IV fluids 4. Observe for sepsis 5. IV Abx if indicated
252
What are the methods of kidney drainage?
1. Nephrostomy | 2. Ureteric stent
253
What is the Rx of urosepsis?
1. Medical 2. Lithotripsy 3. Surgical
254
What are the consequences of renal stones?
1. Renal or ureteric colic 2. Abscess 3. Fistula 4. Xanthogranulomatous pyelonephritis
255
What are the Rx for kidney stones?
1. EWSL 2. Ureteroscopy (laser) 3. PCNL 4. Nephrectomy
256
What is the pathophysiology of AKI?
Renal function decreased to point where body accumulates waste products and is unable to maintain homeostasis
257
What are the symptoms of AKI?
1. Oedema 2. Little urine 3. Fatigue 4. SOB 5. Confusion
258
What is the Dx for AKI?
1. Raise serum creatinine | 2. Fall urine output
259
What is the Rx for AKI?
1. Temporary haemodialysis 2. Diuretics 3. IV fluids 4. Ca infusion 5. Polystyrene sulfonate
260
What is acute renal failure?
Kidneys suddenly become unable to filter waste products from blood
261
What are the symptoms of acute renal failure?
1. Decreased urine output 2. Oedema 3. SOB 4. Fatigue 5. Confusion
262
What is cystitis?
Inflammation of bladder
263
What is the usual cause of cystitis?
Bladder infection
264
What are the symptoms of cystitis?
1. Urgency 2. Burning when urinating 3. Haematuria 4. Pelvic discomfort 5. Fever
265
What is the Ix for cystitis?
1. Urinalysis 2. Cystoscopy 3. USS pelvis
266
What is the Rx for cystitis?
1. Abx 2. Bladder distention 3. Surgery 4. Nerve stimulation
267
What is prostatitis?
Inflammation of prostate gland
268
What are the symptoms of prostatitis?
1. Severe pain in pelvic region 2. Pain when urinating 3. Not able to urinate 4. Malaise 5. Pain on ejaculation
269
What is the Ix for prostatitis?
1. Urinalysis 2. Bloods e.g. FBC, WCC 3. Post-prostatic massage 4. CT pelvis
270
What is the Rx for prostatitis?
1. Abx 2. Alpha blockers 3. NSAIDs
271
What are the symptoms of urethritis?
1. Dysuria 2. Haematuria 3. Discharge from penis 4. Hesitation
272
What are the causes of urethritis?
1. Gonorrhoea 2. Chlamydia 3. Bacteria in stool
273
What is the Dx for urethritis?
1. Physical exam 2. STI tests 3. Microscopy
274
What is the Rx for urethritis?
1. Azithromycin 2. Doxycycline 3. Ceftriaxone
275
What is the pathophysiology of polycystic kidney disease (PKD)?
1. Clusters of cysts develop in kidneys | 2. Kidneys enlarge and lose function
276
What are the symptoms of PKD?
1. Abdo pain 2. Haematuria 3. Frequency 4. UTI 5. Pain in sides
277
What are the Ix for PKD?
1. Renal USS 2. CT abdo/pelvis 3. MRI abdo/pelvis 4. Urinalysis
278
What is the Rx for PKD?
1. ACEIs 2. Analgesia 3. Abx 4. Dialysis
279
What are the symptoms for epididymal cyst?
1. Dull pain scrotum 2. Heaviness in scrotum 3. Redness scrotum 4. Increased pressure penis
280
What is the Ix for epididymal cyst?
1. Physical examination | 2. USS
281
What is the Rx for epididymal cyst?
Drainage via needle
282
What is the pathophysiology of hydrocele?
Swelling in scrotum that occurs when fluid collects in sheath surrounding testicle
283
What are the symptoms of hydrocele?
1. Painless swelling of testicles | 2. Pain in scrotum
284
How is hydrocele diagnosed?
1. Physical exam 2. Urinalysis 3. Bloods 4. USS
285
What is the Rx for hydrocele?
1. Surgical removal | 2. Surgical drainage
286
What is varicocele?
Enlargement of veins within scrotum
287
What are the symptoms of a varicocele?
1. Lump in testicle 2. Swelling in scrotum 3. Enlarged or twisted veins in scrotum 4. Dull, recurring pain in scrotum
288
What is the Ix for varicocele?
1. Physical exam | 2. Scrotal USS
289
What is the Rx for varicocele?
1. Varicocele repair | 2. Percutaneous embolisation

Phase 2a Medicine (15 decks)

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