Surgery 3B - Urology Flashcards Preview

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Flashcards in Surgery 3B - Urology Deck (105):
1

Renal fxns

FIltration
Reabsorption
Secretion
x phagocytosis

2

Ureteral blood supply

Abdominal aorta
Renal artery
Illiac artery
x thoracic artery

3

Endocrine organs

Kidneys
Testes
x ureters
x bladder

4

Male urethra

Prostatic
Bulbous
Penile
x vas deferens

5

Areas of narrowing in ureter

Uretrovesical jxn
Area crossing iliac vessels
Uretero pelvic jxn
x Fossa navicularis

6

Contained w/in gerota's gascia

Adrenal glands
Kidney
Perinephric fat
x Psoas muscle

7

Renal lymphatic drainage

Perihilar nodes
Interaortocaval nodes
Paraaortic nodes
x internal iliac nodes

8

Urinary bladder structures

Detrussor m
Trigone
Transitional cell epithelium
x seminal vesicles

9

Prostate gland consists of

Sm muscle
Glandular structures
Fibrous tissue
x Seminiferous tubues

10

Penile structures

Corpora cavernosa
Urethra
Corpora Spongiosa
x Epididymis

11

Obstructive urinary tract symptoms

Dec of uninary caliber
Terminal dribbling
Urinary retention
x dysuria

12

Irritative urinary symptoms

Dysuria
x Hesitancy
x Terminal dribbling
x Urinary retention

13

Bloody urine

Hematuria
x Chyluria, pneumaturia, dysuria

14

Blood in semen

Hematospermia
x Hematuria, pneumaturia, chyluria

15

Exam urilized for renal dse

Palpation
Kidney Punch
x vaginal exam, rectal exam

16

UA components

Pus cells
RBC
pH
x Creatinine

17

UTI

WBC: 20-30/hpf
>100k colonies of E. coli
x pH 6, SG 1.010

18

Imaging studies for renal stones

UTZ
CT
XRay
x Angiography

19

Evaluate renal fxn

Renal scan

20

Acute prostatitis

Enlarged tender prostate
Dysuria
Fever
x hard nodular prostate

21

Kidney produces

Renin
Angiotensin
Erythropoietin

22

1' physical characteristic of high osmolar contrast agents is that responsible for their toxicity

Hyper-tonicity

23

Contrast agent-induced reactions including urtricaria, edema, hypotension, are thought to be

Anaphylactoid

24

Agent of choice for renal cortical imaging

Tc99m DMSA

25

WAGR syndrome most freq associated w/

deletion of chromosome 11

26

Risk factors associated w/nephrotoxicity in patients receiving high osmolar contrast media include ff except

renal insufficiency
diabetic nephropathy
multiple administrations w/short interval
hyperuricemia
x hypoalbuminemia

27

MC non invasive dx workup used for urological pt

UTZ

28

MC dx GU carcinoma in males

prostate CA

29

Tx for prostate CA

Ext beam radiation
Radical prostatectomy
Brachytherapy
Chemotherapy

30

Radical nephrectomy includes

Kidney
Gerota's fascia
Hilar LN
Contralateral adrenal glands

31

Straddle injury includes

Corpus spongiosum
Bulbous urethra
x prostatic urethra, bladder

32

Radical cystectomy in men includes

Perivesical fat

33

Complications of ureterolithiasis

Hydronephrosis
Pyonephrosis
Pyelonephritis
x UB diverticulum

34

Radioluscent stones

Uric acid
Cystine
x Struvite Ca phosphate

35

Hematogenous route of infection

Tuberculous orchitis
Tuberculous nephritis
x pyelonephritis epididymitis

36

Asc route of infection

Pyelonephritis
Cystitis
x Tuberculous orchitis, Diverticulitis

37

Multiple scrotal sinuses

Actinomycosis
Tuberculosis (testicular)
x prostatitis, cystitis

38

Struvite stones/Staghorn calculi

Mg
NH4
PO4
x cystine

39

Tx for renal calculi

ESWL
Open nephrolithotomy
Percutaneous nephrolithotomy
Medical therapy

40

Major renal injury

Contusion
1cm parachymal laceration
x urinary extravasetion, renal artery avulsion

41

Posterior urethral injury

Floating prostate
Blood per urethral meatus
Bladder distension
Pelvic fracture

42

Ant urethral injury

Straddle injury
Bulbous urethra
x pelvic fracture, prostatic urethra

43

Distal third urethral injury

Ureteroscopic injury
Pelvic Sx
x Deceleration injury, Blunt injury

44

Stage B UB tumor includes

Mucosa
Muscularis
x Illiac LN, Adventia

45

Stage A prostatic CA involves

Peripheral zone of prostate
x illiac LN, seminal vesicles, bladder neck

46

REnal cell CA metastasizes to

Lung
Liver
Bones
LN

47

Radical nephrectomy includes

Gerota's fascia
Perinephric fat
Kidneys
Adrenal glands

48

Radical cystectomy for males includes

Prostate
Seminal vesicles
U bladder
Distal part of vas deferens

49

Radical prostatectomy

Prostate
Seminal vesicle
Distal part of vas deferens
Illian LN

50

Treatment for acute prostatitis

Antimicrobials
Alpha blocker
Anti inflammatory
x finasteride

51

Tx for symptomatic BPH

5 alpha reductase inh
Alpha blocker
TURP
Open prostatectomy

52

Tx for organ confied prostatic CA

Low dose rate brachytherapy
Radical prostatectomy
High dose rate bradytherapy
Ext beam radiation

53

Immediate tx/mgt for urethral injury

Cystostomy
x primary anastomosis, urethral catherization, observation

54

Tx modalities for RCC

Radical nephrectomy
Biologic response modifiers
x simple nephrectomy, chemotherapy

55

Tx modalities for bladder malignancies

Radical cystectomy
Intra-vesical chemo
Radiation
Bladder replacement

56

Where are renal pyramids

Inner medulla

57

Apices of renal pyramids project into

renal sinus

58

Urine in the renal papillae drain into

minor calices

59

Where are pacemaker muscle cells of kidney that initiate and exert peristalic activite

minor calices

60

Which part of kidney is not covered by renal fascia

hilum ?

61

R internal spermatic v drains

IVC

62

L gonadal vein drains

L Renal vein

63

Area of prostate traversed by ejaculatory ducts is known as the

central zone

64

Lower UT symptoms in BPH

Urgency
Frequency
Nocturia

65

What causes the pain assoc w/stone in the ureter

Obstruction of urine flow w/distension of renal capsule

66

Site where BPH arises

transitional zone

67

Colic caused by ureteral stone and RLQ pain in appendicitis

referred pain

68

MCC pain w/gross hematuria

ureteral obstruction d/t blood clots

69

MCC continuous incontinence

Vesiculovaginal fistula

70

Info from pelvic bimanual exam not obtained in radiologic eval

mobility/fixation of pelvic organs

71

MCC cloudy urine

alkaline

72

Hematuria distinguished from hemoglobinuria or myoglobinuria by

microscopic presence of RBC

73

Chronic scrotal pain most often d/t

hydrocoele

74

Terminal hematuria is usually seen in

prostatic inflammation

75

Enuresis is physiologic until

1-3

76

Measurement for catheters

French

77

1 mm in diameter = __ French

3 French

78

What is unique of obstructive nephropathy compared to hydronephrosis

Renal fxn impairment

79

Chance of renal recovery after ureteral obstruction most influenced by

early relief of obstruction

80

Characteristic of hydronephrosis of pregnancy

R side more affected

81

Male urethra corresponds to posterior urethra

Prostatic urethra

82

What part of the male urethra is longest

spongy penile urethra

83

Bilateral obstruction of UT what is noticed

max fxns excerted by both kidneys

84

Normal excusion of kidneys during respiration

4cm

85

Abnormal loc of kidneys are noted in

nephroptosis

86

Stress incontinence is common seen in

laxed pelciv floor musculature

87

CVA tenderness is elicited in

Pyelonephritis

88

Presence of gas (pneumaaturia) in UT is seen in

Sigmoid CA

89

Initial hematuria seen in ff

Meatal stricture

90

Condition assoc w/exstrophy of the bladder

epispadias

91

Oliguria =

< 400cc/day

92

Imaging of choice in scrotal pathology

UTZ

93

Calculi composed of what are not seen on plain radiographs

Uric acid

94

Absolute indication for open repair of blunt bladder rupture injury

sig intraperitoneal bladder rupture

95

Blunt trauma pt w/pelvic fracture was seen at the ER. No urine output, hypogastric area distended. Blood coming out of meatus. Dx choice?

Retrograde urethrography

96

Which environmental factor is most generally accepted as a risk factor for RCC

tobacco

97

Suppressor gene for Wilm's tumor

11p13

98

Voiding cystourethropgraphy shows reflux of contrast to upper tract, dilation of calyceal system, marked tortuosity of ureter. What grade

Grade V

99

Histologic type of bladder CA from remnant of urachus

adenocarcinoma

100

Incidence of prostatic CA strongly assoc w/

family history

101

what structure w/in renal hilum divides renal artery into ant and post

renal pelvis

102

Best renal imaging protocol for living renal donor to define renal anatomy and vasculature and to rule out renal stone

helical CT w/out and w/ IV contrast and a KUB radiograph

103

Risk of hyperacute rejection after kidney transplant is high when which of the ff crossmatch is (+)

B cell micro-lymphocyto-toxicity

104

Total hematuria is noted in

passage of ureteral stone

105

Assoc w/ extrophy of the bladder

Epispadias