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Phase 2a > Renal + GU > Flashcards

Renal + GU Flashcards

1
Q

Name 3 processes that contribute to urine storage

A

Receptive relaxation

  • Detrusor stretching
  • no tension
  • no increase pressure

Symapthetic stimulation
T11 - L2
Detrusor relaxation

Pudendal nerve stimulation
S2 - S4
E.U.S contraction

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2
Q

factors affecting eGFR

A

Extreme muscle mass is misleading

  • bodybuilder
  • amputee
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3
Q

Kidney functions

A
  • Elimination of wate material
  • Regulation of volume + body fluid composition
  • Endocrine
    EPO, Renin, Active Vit D
  • Reabsorption
    Glucose, a.a, bicarbonates
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4
Q

how is urine transported in the ureter

A

Peristalsis

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5
Q

How is reflux of urine prevented at the bladder

A

Valvular mechanism
- At the Vesicoureteric
junction

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6
Q

What is the only protein in the urine

A

Tom Horsfall - Secreted by thick loop

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7
Q

Nerve that controls urine storage

A

Hypogastric plexus
T11 - L2
Noradrenaline NT

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8
Q

Nerve that controls voiding urine

A

Pelvic nerve
S2 - S4
Ach NT

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9
Q

Voluntary control of urine

A

Pudendal nerve
S2 - S4
Ach NT –> E.U.S

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10
Q

What controls the guarding reflux

A

Onuf’s nucelus

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11
Q

What is located in the PAG

A

Pontine mictruition centre

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12
Q

Function of the pontine mictruition centre

A
  • Inhibitory signals to the detrusor muscle
  • Excitatory signals to Onuf’s nucleus
  • Signals from T11-L2 (Hypogastric nerve) via sympathetic nerves
  • Bladder relaxes
  • Contraction of internal urethral sphincter
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13
Q

Voiding phase pathophsiology

A
  • Pontine mictruition centre sends excitatory signals to detrusor
  • Inhibits Onufs nucleus
  • Signals from S2-S4 (Pudendal nerve) via PNS
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14
Q

How much urine can the bladder store and when is the firsr sensation of bladder storage felt

A

500ml

100-200ml - first sensation

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15
Q

Name the 3 common sites for kidney stones to lodge

A
  • Pelviureteric junction
  • Pelvic brim
  • Vesicoureteric junction
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16
Q

What are most kidney stones made from

A
  • Calcium oxalate
  • Calcium phosphate
  • Mg ammonium phospahte
    (Struvite)
  • Uric acid
  • Cystine
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17
Q

Name 2 factors contributing to urine supersaturation

A
  • decreased urine volume
  • Increase/decrease urine
    pH
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18
Q

Name 2 factors decreasing the action of stone forming inhibitors

A

Mg

Citrate

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19
Q

Name 4 foods that increase oxalate diet intake

A

Spinach
Chocolate
Tea
Rhubarb

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20
Q

Name 1 complication of a stone causing obstruction within the urinary tract

A

Hydronephrosis

  • Proximal dilatation of ureter and renal pelvis due to obstruction
  • can cause lasting kidney damage
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21
Q

What causes hypercalciuria leading to calcium stones

A

Hyperparathyroidism
Excessive Ca2+ intake
Primary renal disease - PCKD

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22
Q 
Stone composition:
Struvite stones 
- metals 
- assosc
- what favours this stone 
  formation
A

Ammonium
Mg
Ca2+

Chrnoic UTIs

  • Klebsiella
  • Pseudomonas

Alkaline urine pH
Increase ammonium conc

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23
Q

Stone composition:
Uric acid
- Assosc
- which patients are high risk

A

Hyperuricaemia
Clinical gout
Dehydration

Pts with ileostomies

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24
Q

Renal colic presentation

- Sx

A 
Pain
- Acute flank (Stabbing)
- Radiation:
  Loin/Groin/Genitals 
Nausea
Vomitting 
Sweating

Triad:
Fever
Acute flank pain
Vomitting

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25
Q

Bladder stones signs

A
  • Urinary frequency

- Haematuria

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26
Q

Urethral stones signs

A

Bladder outflow obstruction

  • Anuria
  • Painful bladder distension
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27
Q

Renal colic signs

A
  • Can’t lie still
  • Nausea
  • Haematuria
  • Dysuria
  • Strangury
    severe pain
    strong desire to urinate
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28
Q

Renal colic differential diagnosis

A

Ectopic pregnancy
Appendicitis
Diverticulitis
Testicular torsion

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29
Q

Renal colic investigations

A

Urine dipstick
- Haematuria

Midstream urine
- Culture + sensitivity

1st line:
- KUB X-ray

GOLD/ Diagnostic:
- non contrast KUB CT
- No contrast so no renal
damage

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30
Q

Indications for renal colic intervention

A
  • Persistent pain
  • Infection
  • Failure of stone to pass
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31
Q

Renal colic management

A

NSAIDs
- Diclofenac (75mg)

Fluids

Abx if infection

  • Gentamicin
  • Cefuroxine
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32
Q

What size must a stone be to require medical intervention

A

Stone < 5mm - spontaneous resolution

Stone > 5mm or pain not resolving
- medical expulsive therapy

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33
Q

What can be used to help aid spontaneous passage of stones

A

Tamsulosin

  • Alpha blocker
  • promotes expulsion
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34
Q

What is AKI

A

clinical syndrome of decreased renal function occuring over hours/days
- Usually reversible

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35
Q

Critera for AKI diagnosis

A

Rise in creatnine:
>26micrmol/L in 48hrs

Rise in creatnine >1.5x baseline within 7 days

Urine output < o.5ml/kg/h for 6hrs

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36
Q

name and describe the classification used in AKI

A

RIFLE

R - Risk 
I - Injury 
F - Failure
L - Loss
E - End stage kidney 
     disease
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37
Q

Limitations of using creatnine as a biomarker

A

Muscle mass

Dilution

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38
Q

AKI risk factors

A 
Pre-existing CKD
Age 
Male 
Co-morbidities 
- DM
- CVD 
- Cancer
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39
Q

How can AKI be classified

A

Pre renal
Intra renal
Post renal

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40
Q

Pre renal AKI causes

A

Hypovolemia

  • Trauma
  • Burns

Decrease CO - MI

Systemic vasodilation

  • Sepsis
  • Anaphalaxis

Afferent A vasoconstriction
- NSAIDs

Efferent A vasodilation
- ACEi/ARB

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41
Q

Inra renal causes of AKI

A

Glomerulonephritis

  • SLE
  • Infection

Acute interstitial nephritis

  • Drugs
  • Infection

Acute tubular necrosis
- Secondary to ischaemia due to hypovolemia

Vasculitis
- SLE

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42
Q

Post renal AKI causes

A

Obstructive uropathy

  • Kidney stones
  • Strictures (Ureter/Urethral)
  • Renal tract malignancy
  • BPH
  • Prostatic cancer
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43
Q

How can you differentiate between pre or intra renal AKI causes from urine tests

A

Intra renal has HIGH Na+ urine compared to pre-renal

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44
Q

Causes of Acute tubular necrosis

A
  • Gentamicin
  • NSAIDs
  • ACEi
  • Acute pancreatitis
  • MI / CCF
  • Diuretics
  • Haemorrhage
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45
Q

AKI presentation

A
  • Anuria

Uraemia sx:

  • Fatigue
  • Seizures
  • Weakness
  • nausea
  • confusion
  • vomitting

Dehydration –> Poor tissue tirgor

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46
Q

AKI emergencies and consequent complications

A

Hyperkalaemia
- Arrhythmias

Fluid overload

  • Heart failure
  • Pulmonary oedema

Metabolic acidosis

Uraemia

  • Encephalopathy
  • Pericarditis

No urine produced

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47
Q

AKI differential diagnosis

A
  • AAA
  • DKA
  • CKD
  • Heart failure
  • Metabolic acidosis
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48
Q

AKI investigations

A 
Urinalysis:
Dipstick --> Infection
                    Haematuria
                    Proteinuria
                Glomerulonephritis

Imaging:
- US –> obstruction
- CT-KUB –> Retroperitonea;
fibrosis

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49
Q

Pre renal AKI tx

A
  • Fluids

- Abx if sepsis

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50
Q

Post renal AKI tx

A

Catheter

Nephrostomy

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51
Q

AKI general tx

A

Stop nephrotoxic drugs

  • NSAIDs
  • ACEi

Fluid balance

  • monitor intake
  • monitor urine output
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52
Q

Indications for dialysis after AKI

A
  • Pulmonary oedema
  • Severe metabolic acidosis
    pH < 7.1
  • Removal of causative nephrotoxic drugs
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53
Q

What is CKD

A

Long standing reduction in kidney function

  • Permanent
  • Progressive
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54
Q

What GFR is assosciated with CKD

A

GFR < 60ml/min/1.73m2

With or without Albuminuria

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55
Q

CKD causes

A
  • Diabetes
  • HTN
  • Glomerulonephritis
  • Age related decline
  • Congenital –> PCKD
  • Amyloidosis
  • SLE

Tubulointerstitial disease
1 –> UTI / Stones
2 –> Drugs / toxins

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56
Q

what is the typical decline in GFR as we age

A

2ml/ min/ year

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57
Q

CKD presentation

A 
Early:
Malaise
Loss of appetite 
Uraemic: Yellow
                 Itchy
Anaemia 
Fluid overload: Oedema 
- Pulmonary
- Peripheral 
Kidneys apprear SMALL

Late:
Myoclonus
Oligouria

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58
Q

Where do renal cell carcinomas arise from

A

Proximal convuluted tubulal epithelium

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59
Q

RCC risk factors

A
  • Smoking
  • Obesity
  • Von - hippel lindau syndrome
  • Petroleum
  • Asbestos
  • Leather tanners
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60
Q

Renal cell carcinoma presentation

A
  • Haematuria
  • Loin/Flank pain
  • Mass
  • Fever
  • Weight loss
  • Malaise
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61
Q

Renal cell carcinoma complications

A 
L. sided varicoceles
- Renal tumour obstructs 
  gonadal vein 
- Impedes drainage of 
  testes 
- Dilatation of testicular 
  veins

IVC invasion

  • Metastases
  • Lung
  • Bones
  • Liver
62
Q

Renal cell carcinoma investigations

A

US
- Distinguish cyst from
complex cyst or tumour

CT

MRI
- Tumour staging

CXR
- Cannonball mets

Bloods

  • Polycythaemia
  • Raised ESR
63
Q

What is lined by transitional cells

A 
calyces
renal pelvis
ureter
bladder
urethra
64
Q

Risk factors fot TTC

A 
Smoking 
Beta - napthylamine 
Azo dyes 
Aoromatic amines
Aldehydes
- Hairdressers
- Painters
- Rubber industry 
Family hx
65
Q

TCC presentation

A 
Painless haematuria 
Sx suggestive of UTI:
- Frequency 
- Urgency 
- Dysuria 
Pain
Voiding irritability
66
Q

TCC investigation

A
  • Cystoscopy with biopsy

- CT

67
Q

TCC tx

A
  • Transurethral resection of
    the bladder
  • Chemo
68
Q

Which cells do testicular tumours arise from and what are the 2 different forms

A

Germ cells

  • Seminomas
  • Teratomas
69
Q

Testicular tumour presentation

A
  • Painless lump in testicle
  • Haemospermia
  • Hydrocele
70
Q

Testicular tumour investigations

A
  • Biopsy + histology
  • US
Serum tumour markers
AFP
B-hCG
 -Raised AFP and B-hCG -->
Teratoma
- Raised B-hCG --> Seminoma
- No AFP in pure seminoma
71
Q

Testicular tumour tx + what should be offered

A
  • Radical orchidectomy
  • Chemotherapy
  • Sperm banking should be offered
72
Q

Prostate cancer

- What is the cancer that arises from the peripheral zone

A

Adenocarcinoma

73
Q

what mutation results in prostate cancer

A

BRAC1

BRAC2

74
Q

Name sites of prostatic cancer metastatic spread

A
  • Lymph nodes
  • Bone (sclerotic lesions)
  • Brain
  • Liver
  • Lung
75
Q

Name the predisposition gene for prostatic cancer

A

HOXB13

76
Q

Prostatic cancer presentation

A
  • Nocturia
  • Hesitancy
  • Poor stream
  • Terminal dribling
  • Obstruction –> Urinary
    retention
77
Q

Prostatic cancer investigations

A

1st = DRE

  • Hard irregular lump
  • nobbly
  • loss of central culcus

2nd = PSA

3rd = DIAGNOSTIC
trans-rectal US + biopsy
- multiple biopsies required as multifocal tumour

78
Q

Grading trans-rectal US abd biopsy for prostatic cancer

A

Gleason grading

79
Q

What is BPH

A
  • Transitional zone enlargement
  • Hyperplasia of glandular and musculofibrous elements
  • Normal process in ageing males
80
Q

Function of 5 - alpha reductase

A

Conversion of testosterone to dihydrote..

- More potent

81
Q

How does ageing lead to BPH

A
  • Increase 5-alpha reductase activity
  • Increase dihydrotestosterone
  • cells is transitional zone grow in response to androgens
  • leads to LUTS sx
82
Q

BPH presentation

A 
sx - SHED + FUND
S - stream changes 
H - Hesitancy
E - Emptying incomplete
D - Dribbling

F - Frequency
U - Urgency
N - Nocturia
D - Dysuria

  • Overflow incontenence
  • Haematuria
  • Loin/Pelvic pain
83
Q

BPH Investigations

A

DRE
- Enlarged but smooth

PSA

Midstream urine sample

  • infection
  • Urine flow rates
  • Frequency volume chart

Transrectal US + biopsy

84
Q

What urinary flow rate indicates outflow obstruction

A

Max rate < 10ml/sec

85
Q

Non pharmacological tx for BPH

A
  • Avoid caffine
  • Void 2x in a row to aid
    emptying
  • Relax when voiding
  • Bladder training
86
Q

BPH Pharmacological tx

A

1st = Tamsulosin

  • Alpha 1 antagonist
  • Relax SM in bladder neck and prostate increasing flow rate
2nd = Finasteride 
- 5 alpha reductase 
  inhibitor 
- Inhibits 
  dihydrotestosterone 
  conversion 
- excreted in semen so wear 
  condom

Surgery

87
Q

Surgery for BPH indications

A

Recurrent haematuria

Acute urinary retention

88
Q

What is TURP

- name 4 complications

A

Transurethral resection of the prostate

  • Bleeding
  • Infection
  • Incontinence
  • erectile dysfunction
  • Urethral strictures
89
Q

LUTS red flags

A
  • Lower back pain
  • Back pain that disrupts
    sleep
  • Frank haematuria
  • Blood in ejaculate
  • Family hx
  • weigth loss
90
Q

LUTS voiding sx

A 
SHED
S - Stream changes 
H - hesitancy 
E - Emptying incomplete 
D- Dribblling
91
Q

LUTS storage sx

A 
FUND 
F - Frequency
U - Urgency
N - Nocturia
D - Dysuria
92
Q

What type of incotenence is assosciated with LUTS

A

Overflow

- Leaking urine during day and night

93
Q

Acute urinary retention causes

A
  • Alcohol
  • Urethral strictures
  • BPH
  • Anti-cholinergics
  • Constipation
  • Infection
94
Q

Acute urinary retention tx

A

Catheter
Tamsulosin
Finasteride

95
Q

Describe chronic urinary retention

A

Insidious + painless

- Incomplete bladder emptying so increased infection risk

96
Q

Chronic urinary retention causes

A

BPH
Prostatic cancer
Pelvic malignancy
Rectal surgery

97
Q

Chronic urinary retention presentation

A

Overflow incontinence
- Leaking/wetting bed

Loss of appetite

Constipation

Distended abdo

Increased UTI risk

98
Q

What is pyelonephritis

A

Infection of renal pelvis

99
Q

What bacteria are assosciated with pyelonephritis

A
  1. E.coli - Bowel flora

2. S.aureus - Infective endo

100
Q

Pyelonephritis presentation

A

Triad:

  • Loin pain
  • Fever
  • Pyuria
Rigors
Tenderness
Nausea + vomitting 
Frequency 
Elderly --> Confusion
101
Q

Pyelonephritis investigation

A

Abdo exam: Tender loin

Bloods: FBC,U+E,CRP

MSU
Microscopy + culture
- Cloudy 
- Leukocytes
- Blood 
- Nitrate 
- Protein

USS
- rule out obstruction

102
Q

CKD investigations

A

Bloods

  • eGFR
  • Creatnine ratio
  • U+E
  • PTH
  • Glucose
  • Hb

Urine

  • dipstick
  • MC&S
  • A:Cr

Imaging
- US –> Small

103
Q

Rule of thumb + generalised cancer sx

  • bladder
  • RCC/stones
  • Testicular tumour
A
  • Painless haematuria
  • Haematuria + loin pain
  • Testicle lump + pain
104
Q

Pyelonephritis tx

A 
Fluids 
Abx: Broad spectrum 
- Co-amoxiclav
- Ciprofloxacillin
\+/- Genatmicin
105
Q

Pyelonephritis complications

A
  • Renal abscess
  • Emphysematous
    pyelonephritis
106
Q

Name the anatomical predisposition to have chronic pyelonephritis

A

Vesicoureteric reflux

107
Q

UTI causes

A
  • E-coli
  • Klebsiella pneumoniae
    (hospital catheter)
  • Proteus mirabillis
    (renal stones)
108
Q

UTI risk factors

A 
Female 
Previous UTI
Sexual activity
Pregnancy
Catheter
Obstructed urinary tract
109
Q

UTI location
LUTI
UUTI

A

LUTI

  • Cystitis
  • Prostatitis
  • Urethritis
  • Epididymo-orchitis

UUTI
- Pyelonephritis

110
Q

Examples of complicated UTIs

A

Male
Immunocompromised
Pregnancy
Children

111
Q

Lower UTI presentation

A 
Frequency 
Dysuria
Haematuria
Suprapubic pain 
Tenderness
Smelly urine
112
Q

Upper UTI presentation

A 
Loin pain 
tenderness
nausea
vomitting
fever
113
Q

UTI investigations

A

MSU
- MC&S
- Dipstick:
blood/nitrates/leucocytes

Bloods - if systemically unwell

  • FBC
  • U+E
  • CRP
  • Blood cultures
114
Q

UTI management

A

fluids

Uncomplicated UTI
1st = Trimethoprim
2nd = Co-amoxiclav
Ciprofloxacin

Complicated UTI
- Nitrofurantoin

115
Q

What is cystitis

  • chief organism
  • Risk factors
A

urinary infection of the bladder

E.coli

  • Urinary stasis
  • Bladder stones
  • Incomplete bladder emptying
116
Q

What is prostatitis

  • investigations
  • tx
A

Infection and inflamm of prostate gland

Investigations

  • DRE (hot + tender prostate)
  • Dipstick
  • MC&S

Tx
Acute:
-IV gentamicin/co-amoxiclav
- Trimethoprin

117
Q

STI general rule of thumb

  • Urethral discharge
  • Genital ulcers
  • Vaginal discharge
A
  • Chlamydia
    Gonorrhea
  • Syphillis
    Herpes
  • Chlamidya
    Gonorrhea
118
Q

What is gonorrhoea

- presentation

A

Neisseria gonorrhoea
- Intracellular gram -ve
diplococcus

  • Green vaginal discharge
  • lower abdo pain
  • post-coital/inter-menstrual
    bleeding
119
Q

Gonorrhoea tx

  • normal
  • pregnant
A

1g IM Ceftriaxone + Azithromycin

Pregnancy:
- Enthromycin

120
Q

STI Investigations

A

Nucleic acid amplification test
Female - vaginal swab
Male - first pass urine

MC&S - genital secretions

Blood cultures

Urine dipstick
- excludes UTI

121
Q

Gonorrhoea tx

A
  • IM Ceftriaxone with oral Azithromycin
  • contract tracing
  • educate pts
122
Q

syphillis tx

A

penicillin IM

123
Q

what is the only glomerular disease that doesn’t progress to kidney failure

A

Minimal change disease

- Children

124
Q

What is glomerulonephritis
and what is its link to:
- nephrotic syndrome
- nephritic syndrome

A

Glomerulonephritis is a spectrum of diseases and presentation could be:

Proteinuria side - nephrotic

Haematuria side - nephritic

125
Q

Glomerular disease aetiology

A

Inflammation:
SLE
Anti-GBM
Small vessel vasculitis

Infection:
Streptococcus

Metabollic
DM - nephropathy

126
Q

What is the nephrotic syndrome presenting triad

A
  • Proteinuria
    >3.5g/24hrs (Frothy urine)
  • Hypoalbuminaemia
    <30g/L
  • Oedema
    Periorbital
    Ascites
    Peripheral
127
Q

How does hyperlipidaemia occur in a pt with nephrotic syndrome

A

Liver goes in to overdrive due to protein loss
- Increase cholesterol
production
- Hyperlipidaemia

128
Q

Nephrotic syndrome pathophysiology

A

Structural and functional podocyte abnormalities

  • loss of podocytes
  • loss in filtration barrier
  • proteinuria
129
Q

Nephrotic syndrome aetiology

  • primary
  • Adults
  • Children
A

Idiopathic

Adults 
- Membranous nephropathy
- Focal segmental 
  glomerulosclerosis 
- Minimal change disease

Kids
- Minimal change disease

130
Q

Secondary causes of nephrotic syndrome

A

DDANI

D - Diabetes
D - Drugs - NSAIDs
A - Autoimmune - SLE
N - Neoplasia - myeloma 
I - Infection - Hep B/C
131
Q

Nephrotic syndrome presentation

A
  • pitting oedema
  • frothy urine
  • tiredness
  • xanthelasma
132
Q

Nephrotic syndrome differential diagnosis

A

CCF
But no
- No increase JVP
- Pulmonary oedema

133
Q

Nephrotic syndrome investigations

A
  • Renal biopsy

- Urine dipstick

134
Q

Nephrotic syndrome complications and tx

A

Thromboembolism

  • LMWH
  • Warfarin

Infection
- Vaccinations

Hyperlipidaemia
- Statins

135
Q

Nephrotic syndrome tx

A
  1. Reduce oedema
    - Furosemide
    - Salt + fluid restriction
  2. Tx underlying cause
  3. Reduce proteinuria
    - Ramipril
    - Decrease protein in diet
136
Q

What is the charecteristic triad presentation of Nephritic syndrome

A
  • Haematuria
    visible or non visible
  • Proteinuria
    < 2g in 24hrs
  • HTN
    Glomerulus damaged restricts blood flow leads to compensatory High BP
137
Q

Nephrotic syndrome aetiology

A
  • IgA nephropathy
    IgA deposition in
    mesangium
  • Post streptococcal GN
    Strep pyogenes
  • Good pastures disease
    Anti-GBM
  • SLE
  • Systemic sclerosis
138
Q

Nephritic syndrome presentation

A 
Haematuria
Proteinuria
HTN
Oedema
Oligouria
Uraemia
- Pruritus
- Lethargy 
- Nausea
139
Q

Nephritic syndrome investigations

A

Urinalysis

  • Dipstick
  • RBC casts in urine

Bloods

  • FBC
  • U&E
  • LFT
  • CRP
  • Ig

Renal biopsy - DIAGNOSTIC

140
Q

Nephrotic syndrome tx

A
  • Tx underlying cause
  • ACEi
    Reduce proteinuria
  • Cortiocsteroids
141
Q

4 types of incontenence

A

urgency
stress
overflow
neurological

142
Q

Urgency incontenece

  • Pathophsiology
  • sx
  • investigation
  • tx
A

Detrusor instability
- uninhbited detrusor muscle
contraction leads frequent
urination

Sx -
Nocturia

Investigations -
Bladder diary - Urodynamics

Tx - 
1. Bladder retaining 
2. Oxybutynin
     - Anticholinergics
3. Cut out caffine and 
    alcohol
143
Q

Stress incontinence

  • pathophysiology
  • aetiology
  • tx
A

Increase abdo pressure leads to urine leakage

  • cough
  • sneeze
  • laugh
  • standing up

Sphincter weakness

  • post - prosatectomy
  • post - childbirth

Keegle excercises

144
Q

Overflow incontenence

  • Aetiology
  • Sx
  • Tx
A

Emptying issues

  • BPH
  • Urethral strictures
  • Ineffective detrusor

Sx:

  • Hesitancy
  • Poor stream
  • Straining
  • Dribbling

Tx:

  • Catheter
  • Alpha blocker (BPH)
145
Q

Neurological causes of incontinence

A

Parkinsons
Multiple sclerosis
- Damage nerves of
mictruiton reflex

146
Q

How does DM lead to incontinence

A
  • Autonomic neuropathy
  • Decreased detrusor
    excitability
  • Distended atonic bladder
  • Large residual volume
  • Infection risk
147
Q

PCKD complications assosciated with disease

A

PKD = SAH + MVP

  • Subarachnoid
    haemorrhage
  • Mitral valve prolapse
  • Liver cysts
148
Q

PCKD presentation

A

Asymptomatic until cysts increase size or haemorrhage

  • Loin pain
  • Haematuria (visible)
  • Cyst infection
  • HTN
  • Renal failure
149
Q

Tamsulosin S/E

A 
Drowsiness
Dizziness
Reduced BP
Dry mouth 
Ejaculatory failure
150
Q

Finasteride S/E

A
  • Reduced libido

- Impotence

151
Q

Non malignant scrotal disease

  • separate + cystic
  • seperate + solid
  • Testicular + cystic
  • Testicular + solid
A
  • Epididymal cyst
  • Epididymitis
    Varicocele
  • Hydrocele
  • Tumour
    Orchitis
    Haematocele
152
Q

Epididymal cyst

  • fluid apperance
  • location in relation to testis
A
  • Clear and milky
  • Above and behind testis
  • Palpable quite separetly
    from cyst
  • Transilluminate

Phase 2a (11 decks)

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