Urological Conditions Flashcards

(43 cards)

1
Q

What is Hypospadias?

A

Hypospadias is a congenital abnormality of the penis which occurs in approximately 3/1,000 male infants.

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2
Q

What are characteristic features of Hypospadias?

A
  • a ventral urethral meatus
  • a hooded prepuce
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3
Q

What is the management of Hypospadias?

A

Management:

  • once hypospadias has been identified, infants should be referred to specialist services
  • corrective surgery is typically performed when the child is around12 monthsof age
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4
Q

What urological condition is a complete contra-indication for circumcision?

A

Hypospadias- ventral urethral meatus

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5
Q

What is circumision?

A

removal of the foreskin

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6
Q

What is Paraphimosis?

A

This is the inability to pull forward a retracted foreskin over the glans penis.

(*saw this in clinic)

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7
Q

what is the cause of paraphimosis?

A

Cause:

It is most often caused due to the presence of atight constricting bandas part of the foreskin thatprevents the retractionover the glans

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8
Q

What clinical procedure increases the risk of paraphimosis?

A

Phimosis, indwellingurethral catheter(due to non-replaced foreskin),poor hygiene, and prior paraphimosis.

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9
Q

What is the management of Paraphimosis?

A

Management:

1st line- reduction surgery (ASAP) as can lead to urological emergency if untreated

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10
Q

What is Phimosis?

A

Non-retractile foreskin and ballooning during micturition

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11
Q

What is balantitis?

A

This is inflammation of the glans penis.

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12
Q

What is Priapism?
b) how many hours is it needing to be sustained for to be diagnosed

A

This is an uncontrolled erection for > 4 hours and is not associated with sexual stimulation

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13
Q

What are the X2 types of priapism?

A

Ichaemic priapism is typically due to impaired vasorelaxation and therefore reduced vascular outflow resulting in congestion and trapping of de-oxygenated blood within the corpus cavernosa.

Non-ischaemic priapism is due to high arterial inflow, typically due to fistula formation often either as the result of congenital or traumatic mechanisms.

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14
Q

Which type of priapism is a urological emergency?

A

ischaemic- necrosis risk

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15
Q

excessive consumption (e.g. Sildenafil) increases the risk of what urological condition?

A

priapism- sustained erection >4 hours without sexual stimulation

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16
Q

What is the 1st line gold standard investigation for Priapism?

A

Investigations:

1st line- Cavernosal Blood Gases (this differentiates between ischaemic and non-ischaemic types)

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17
Q

What is the management of priapism?
a) ischemic (urological emergency)
b) non-ischemia

A

Ischaemic Priapism (medical emergency)- as can cause necrosis

1st line- aspiration of blood from the cavernosa, this is often combined with injection of a saline flush to help clear viscous blood that has pooled.

Non-Ischaemic (Not medical emergency)
1st line- observation

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18
Q

What is Peyronie’s disease?

A

Peyronie’s disease: Presents with a significant BEND in the penis during erection, which can interfere with sexual function.

19
Q

Urethral opening located at - ‘distal VENTRAL surface of the penis’ is buzzword for?

A

Hypospadias (congenital defect)

20
Q

What condition is known to present alongside Hypopsodias?

A

Cryptorchidism (present in 10%) and inguinal hernia.

This is known as ‘undescended testes’ due to one embyological malformation increasing the risk of others developing.

21
Q

Cryptorchidism is associated with which congenital condition?

A

hypopsodias - distal ventral urethral opening

Cryptorchidism - this is undescended testes

22
Q

What are the medical benefits of circumcision?

A

Medical Benefits:

  • reduces the risk of penile cancer
  • reduces the risk of UTI
  • reduces the risk of acquiring sexually transmitted infections including HIV
23
Q

What is the most common type of prostate cancer

A

adenocarcinoma

24
Q

What lump can feel posterior but ‘seperate’ to the testicle

A

epididmycal cysts

25
What is the biggest risk factor for bladder cancer?
smoking dye and rubber risk factors- not as big as smoking
26
What is the management of kidney stones? (*specify size and management for each)
<5mm- watchful waiting 5-10mm- shockwave lithrotipsy 10-20mm- shockwave lithotripsy or uteroscopy (best if pregnancy) >20mm- nephrostomy
27
Prehn's Sign: What condition is indicated -pain is NOT relieved upon elevation of the testes -pain is relieved upon elevation of the testes
-pain is NOT relieved upon elevation of the testes- testicular torsion -pain is relieved upon elevation of the testes- epididymitis
28
What is the management of simple and communicating hydrocele?
simple hydrocele (No connection with peritoneal cavity)- self resolving communicating hydrocele (is connection with peritoneal cavity)- surgery
29
What is the 1st line management of testicular torsion
1st line- surgical exploration
30
Absent of the cremasteric reflex indicates
testicular torsion
31
What nerve roots and nerves are present in the Cremasteric reflex?
-L1 and L2 -genito-femoral nerve
32
What is a complication of prostate radiotherapy
proctitis- pain on defecation
33
What is the gold standard investigation for priapism? (uncontrolled erection > 4 hours(
1st line- cavernous blood Samping (*this determines whether ischaemic or non ischmaeic) ischaemic is an emergency
34
What medications can act as prophylaxis to calcium oxalate kidney stones?
potassium citrate thiazide diuretics (indapemide)
35
What is the management of testicular torsion?
1st line- surgical exploration (ALWAYS BILATERAL orchoidectomy to reduce risk of re-occurring on other teste)
36
What is the 1st line management of renal cell carcinoma? (*most common type in adults- Clear cell)
1st line- radical nephrectomy
37
What is 'nut cracker angle' in varicocele, what vessels is it associated with? b) what malignancy is associated
a) this is a tumour compressing on the superior mesenteric artery and abdominal aorta b) renal cell carcinoma- most common type
38
What are the x2 classifications of erectile dysfunction?
**X2 Main Classifications:** - Organic Cause - Psychogenic Cause
39
What are the main factors which favours organic and psychogenic erectile dysfunction?
**Organic:** - normal libido - gradual onset **Psychogenic:** - Sudden onset - Decreased libido - Major life event or stresses - Relationship problems - Premature Ejaculation
40
What is the 1st line investigation for erectile dysfunction?
**Investigations:** 1st line- free testosterone
41
What is the 1st and 2nd line management in erectile dysfunction?
**Management:** 1st line- PDE-5 inhibitors (such as sildenafil, 'Viagra') have revolutionised the management of ED] if PDE-5 inhibitors are contra-indicated 1st line- vacuum erection devices
42
What is 'boggy prostate' associated with
bacterial prostatitis -e.coli is the most common cause
43
What is the management of bacterial prostatitis?
Management the BNF recommends a 14-day course of a quinolone (ciprofloxacin etc) consider screening for sexually transmitted infections