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Flashcards in Management Deck (14)
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1
Q

What is the treatment for acute urinary retention?

A

Catheterise patient - note volume of fluid (>1 1/2L > chronic retention)
Dip to look for UTI, PSA

2
Q

What is the medical management for stones?

A
  • Increase fluid intake
  • Dietary modification e.g. decreased Na, sugar
  • Treat infection
  • Alkalinise urine (urate stones)
  • Specific medical therapies
3
Q

What are the specific medical therapies for stones?

A
  • Bendroflumethazide (hypercalciuria)
  • Allopurinol (hyperuricosuria)
  • Penicillamine (cystinuria)
4
Q

What is the surgical management for large stones?

A
  • Extracoporeal shock wave lithotripsy (ESWL)
  • Ureteroscopic
  • Percutaneous
  • Laparoscopic
  • Open operation
5
Q

What is the management for ADPKD?

A
  • Monitoring renal function
  • Family screening
  • High morbidity secondary to CVD
  • BP control from childhood is essential
  • No surgery
6
Q

What is the classic history for glomerular haematuria?

A
  • Known HTN, proteinuria
  • Recent URTI
  • Systemic symptoms e.g. rash, joint pains, weight loss
7
Q

What is the treatment for UTIs?

A

Simple lower UTIs usually respond to a 3-day course of an antibiotic such as trimethoprim, cephalexin or nitrofurantoin.

8
Q

What is the treatment for pyelonephritis?

A

24-48 hrs of IV gentamicin or temocillin followed by a 10 day course of oral antibiotics.

9
Q

What is the treatment for bladder cancer?

A
  • T1: Transurethral resection of bladder tumour (TURBT)
    Consider BCG therapy into bladder for multiple small tumours or high-grade tumours.
  • T2-3: radical cystectomy gold standard. Radiotherapy (worse survival rate) or salvage cystectomy.
  • T4: palliative chemo/radiotherapy. Chronic catheterisation and urinary diversions may help to relieve pain.
10
Q

What is the treatment for BPH?

A
  1. alpha blockers e.g. tamsulosin, alfuzosin, doxazosin, terazosin (reduce smooth muscle tone)
  2. 5 alpha-reductase inhibitors: add or used alone e.g. finasteride (conversion of testosterone to dihydrotestosterone)
11
Q

What is the treatment for someone low risk on gleason score?

A

Active surveillance

Treatment options come with risk of ED and long-term debilitating bowel disturbance.

12
Q

What surgery can be done for prostate cancer?

A
  • TURP
  • TUIP
  • Retropubic prostatectomy
  • Robotic prostatectomy
13
Q

What chemotherapy agents can be used for bladder cancer?

A

Mitomycin, epirubicin, gemcitabine

14
Q

What is the criteria for a urological 2 week referral?

A
  • Any patient aged over 45 with unexplained visible haematuria without UTI or haematuria recurs after treatment of UTI
  • Any patient over 60 with unexplained microscopic haematuria
  • Any man with raised PSA or abnormal feeling prostate
  • Any man with testicular mass or possible penile cancer