Urinary Tract Pathologies

Question 1

What are the two types of urethritis?

Answer 1

Gonococcal and non-gonococcal.

Question 2

Name three causes of urethral stricture.

Answer 2

Iatrogenic, traumatic, inflammatory/infective.

Question 3

What controls smooth muscle tone in the prostate?

Answer 3

⍺-1a adrenergic receptors.

Question 4

What are the three associated sex glands of the prostate?

Answer 4

Seminal vesicles, Cowper’s glands, glands of Littre.

Question 5

What are the two main cell types in the prostate?

Answer 5

Epithelial cells (90%) and stromal cells (10%).

Question 6

What is the aetiology of BPH?

Answer 6

Ageing and family history.

Question 7

What zone of the prostate does BPH typically affect?

Answer 7

Transitional zone and peri-urethral tissue.

Question 8

What is the pathophysiology of BPH?

Answer 8

Increased cell proliferation and/or decreased apoptosis.

Question 9

Name 5 factors contributing to BPH development.

Answer 9

Androgens, oestrogens, growth factors, inflammation, genetics.

Question 10

Name 5 complications of BPH.

Answer 10

Lower urinary tract symptoms, urinary retention, UTIs, bladder stones, bladder failure.

Question 11

What is the most common cancer in men in the UK?

Answer 11

Prostate cancer.

Question 12

What is the lifetime risk of developing prostate cancer?

Answer 12

1 in 9.

Question 13

Which zone is most prostate cancer found in?

Answer 13

Peripheral zone (75%).

Question 14

What are 4 key risk factors for prostate cancer?

Answer 14

Age, ethnicity (Afro-Caribbean), family history, obesity.

Question 15

What is the key pathological feature of prostate cancer?

Answer 15

Absence of the basal cell layer.

Question 16

How does prostate cancer spread locally?

Answer 16

Along autonomic nerves.

Question 17

Where does prostate cancer metastasize early?

Answer 17

Bone (sclerotic lesions).

Question 18

What is the Gleason grading system used for?

Answer 18

Prognosis in prostate cancer.

Question 19

How is the Gleason score calculated?

Answer 19

Sum of the most common and highest grade.

Question 20

What is PSA and its function?

Answer 20

Prostate specific antigen; liquefies seminal coagulum.

Question 21

Name 4 causes of false positive PSA levels.

Answer 21

UTI, prostatitis, recent instrumentation, BPH.

Question 22

What are the three anatomical regions of the bladder?

Answer 22

Dome, body, and trigone.

Question 23

What is the function of the bladder?

Answer 23

Urine storage and excretion.

Question 24

Name the four histological layers of the bladder.

Answer 24

Mucosa, submucosa, muscle, adventitia.

Question 25

What is the most common histological type of bladder cancer?

Answer 25

Transitional cell carcinoma (95%).

Question 26

What cancer is associated with schistosomiasis?

Answer 26

Squamous cell carcinoma of the bladder.

Question 27

Name 4 risk factors for bladder cancer.

Answer 27

Smoking, age, aromatic amines, chronic inflammation.

Question 28

What is the most common bacterial infection?

Answer 28

Urinary tract infection (UTI).

Question 29

What is the route of infection in most UTIs?

Answer 29

Ascending infection.

Question 30

Name the types of UTI by location.

Answer 30

Cystitis, prostatitis, orchitis/epididymitis, pyelonephritis.

Question 31

Name 3 bacterial virulence factors in UTIs.

Answer 31

Fimbriae, polysaccharides, flagellum, toxins.

Question 32

Name 4 host defenses against UTIs.

Answer 32

Urine flow, glucosamines, Tamm-Horsfall protein, epithelial exfoliation.

Question 33

What is the length and diameter of the ureter?

Answer 33

25 cm long, 3–4 mm wide.

Question 34

What are the three natural narrowing sites of the ureter?

Answer 34

PUJ, crossing of iliac vessels, VUJ.

Question 35

What is the histology of the ureter?

Answer 35

Urothelium, 2 muscle layers, adventitia.

Question 36

What organs are near the ureters?

Answer 36

Aorta, caecum/sigmoid colon, ovaries/uterus.

Question 37

What causes congenital PUJO?

Answer 37

Crossing vessels (extrinsic) or hypoplastic PUJ (intrinsic).

Question 38

What is Dietl’s crisis?

Answer 38

Flank pain after drinking large volumes of fluid.

Question 39

How is PUJO treated if the kidney is functional?

Answer 39

Pyeloplasty.

Question 40

What is the lifetime risk of urinary stones in men?

Answer 40

10%.

Question 41

What is the most common type of urinary tract stone?

Answer 41

Calcium oxalate.

Question 42

Name 4 intrinsic risk factors for stone formation.

Answer 42

Genetic conditions, Crohn’s disease, PUJO, UTIs, meds.

Question 43

: Name 3 extrinsic risk factors for stone formation.

Answer 43

High salt/protein diet, dehydration, hot climate.

Question 44

What are the functions of the testicles?

Answer 44

Sperm production (FSH) and androgen production (LH).

Question 45

Describe sperm flow from testicle to urethra.

Answer 45

Seminiferous tubules → epididymis → vas deferens.

Question 46

What is the most common solid cancer in men aged 30–45?

Answer 46

Testicular cancer.

Question 47

What percentage of testicular cancers are germ cell tumours?

Answer 47

95%.

Question 48

Name two types of germ cell tumours.

Answer 48

Seminomatous, non-seminomatous.

Question 49

Name three risk factors for testicular cancer.

Answer 49

Undescended testes, HIV, family history.

Question 50

What are the two age peaks for testicular torsion?

Answer 50

First year of life and age 12–18.

Question 51

What is the cause of intravaginal torsion?

Answer 51

Bell-clapper deformity.

Question 52

What is the treatment for testicular torsion?

Answer 52

Urgent surgical detorsion.

Question 53

What are the main types of urethritis?

Answer 53

Gonococcal and Non-gonococcal urethritis.

Question 54

What are common causes of urethral stricture?

Answer 54

Iatrogenic injury, trauma, and infection/inflammation.

Question 55

What are the zones of the prostate?

Answer 55

Peripheral, central, transitional, and anterior fibromuscular zones.

Question 56

What adrenergic receptor type controls smooth muscle in the prostate?

Answer 56

α-1a adrenergic receptors.

Question 57

What are the main histological cell types in the prostate?

Answer 57

Epithelial (90%) and stromal cells (10%).

Question 58

What causes BPH?

Answer 58

Ageing, family history, and hormonal/metabolic changes.

Question 59

What zone does BPH primarily affect?

Answer 59

Transitional zone and peri-urethral tissue.

Question 60

What is the key pathophysiological process in BPH?

Answer 60

Increased cell proliferation and/or decreased cell death.

Question 61

What factors contribute to BPH pathogenesis?

Answer 61

Androgens, oestrogens, growth factors, inflammation, genetics.

Question 62

What are complications of BPH?

Answer 62

LUTS, urinary retention, UTIs, bladder stones, bladder failure.

Question 63

What is the most common type of prostate cancer?

Answer 63

Adenocarcinoma.

Question 64

Where in the prostate does cancer most commonly originate?

Answer 64

75% in the peripheral zone.

Question 65

What is a critical histological feature of prostate cancer?

Answer 65

Absence of the basal cell layer and basement membrane invasion.

Question 66

How does prostate cancer typically spread?

Answer 66

Local: along nerves; Lymph: obturator → iliac → para-aortic; Bone: sclerotic metastases.

Question 67

What is the most important prognostic indicator in prostate cancer?

Answer 67

Gleason score.

Question 68

How is the Gleason score calculated?

Answer 68

Sum of the two most dominant histological patterns.

Question 69

What is the function of PSA?

Answer 69

Liquefies seminal coagulum to aid fertilization.

Question 70

What conditions can falsely elevate PSA levels?

Answer 70

BPH, UTI, prostatitis, recent instrumentation.

Question 71

What are the three physiological narrowings of the ureter?

Answer 71

PUJ, crossing iliac vessels, and VUJ.

Question 72

What is the histology of the ureter?

Answer 72

Urothelium, two muscle layers, adventitia.

Question 73

What congenital condition can affect the PUJ?

Answer 73

PUJ obstruction from crossing vessels or intrinsic hypoplasia.

Question 74

What is Dietl's crisis?

Answer 74

Flank pain after drinking large volumes, seen in PUJO.

Question 75

What is the typical cause of VUR?

Answer 75

Congenital lateral ureteral insertion into the bladder.

Question 76

What law explains ureteral insertion anomalies in VUR?

Answer 76

Paquin’s law.

Question 77

What are the most common types of urinary stones?

Answer 77

Calcium oxalate stones.

Question 78

What are extrinsic risk factors for stones?

Answer 78

Geography, season, diet (high salt/protein, low fluid).

Question 79

Which stones are radiolucent?

Answer 79

Uric acid stones.

Question 80

What is the most common solid cancer in men aged 30–45?

Answer 80

Testicular cancer.

Question 81

What are risk factors for testicular cancer?

Answer 81

Caucasian race, undescended testes, HIV, family history.

Question 82

What are the main types of germ cell tumors?

Answer 82

Seminomas and non-seminomas (e.g., embryonal, yolk sac, choriocarcinoma).

Question 83

What are the two types of testicular torsion?

Answer 83

Extravaginal (neonates), intravaginal (bell-clapper deformity).

Question 84

What is the management for testicular torsion?

Answer 84

Urgent surgical detorsion—time critical.