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FINALS: PASSMED/QUESMED > Urology > Flashcards

Urology Flashcards

(103 cards)

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1
Q

What marker is associated with testicular seminomas?

A

hCG

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1
Q

What is a common complication of radiotherapy for testicular cancer?

A

Proctitis

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2
Q

What are patients at increased risk of following radiotherapy for prostate cancer?

A

Bladder, colon and rectal cancer

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3
Q

What is the management of hard, irregular prostate felt on DRE?

A

2 week wait referral to urology alongside measuring PSA

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4
Q

What is important to exclude before circumcision can take place?

A

Hypospadias

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5
Q

What are the side effects of tamsulosin?

A
  • dizziness
  • postural hypotension
  • dry mouth
  • depression
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6
Q

Ongoing loin pain, haematuria, pyrexia of unknown origin suggests what?

A

Renal cancer

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7
Q

What does circumcision help to reduce?

A

Rates of HIV transmission

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8
Q

What is the first line investigation for prostate cancer?

A

Multiparametric MRI

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9
Q

What is the investigation of choice for renal stones?

A

Non contrast CT KUB

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10
Q

What is the most common form of prostate cancer?

A

Adenocarcinoma

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11
Q

What is the referral criteria for bladder cancer?

A

A patient >= 60 years of age with unexplained non-visible haematuria and either dysuria or a raised white cell count on a blood test

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12
Q

What is the analgesia of choice in renal colic?

A

IM Diclofenac

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13
Q

What is the mode of action of tamsulosin?

A

Alpha-1 antagonists which promote relaxation of the smooth muscle of the prostate and the bladder

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14
Q

schistosomiasis is a major risk factor for what?

A

Squamous cell carcinoma of the bladder

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15
Q

What is the treatment of choice for renal stones in pregnant women?

A

Ureteroscopy

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16
Q

Adult patients with hydroceles should have what?

A

Ultrasound scan

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17
Q

How are infantile hydroceles managed?

A

Surgical repair if not resolved spontaneously by ages 1-2

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18
Q

What is the management of epipidimo-orchitis with no known organism?

A

ceftriaxone 500mg intramuscularly single dose, plus oral doxycycline 100mg twice daily for 10-14 days

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19
Q

What are the investigations of choice for epipdidimo-orchitis?

A

Younger adults with sexual history - NAAT
Older adults - MSSU

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20
Q

What should be sent for all women with suspected UTI and haematuria?

A

MSU

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21
Q

Acute vs chronic urinary retention

A

Chronic will have much larger volumes (1.5L) and be painless

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22
Q

What is a complication of losing too much fluid following catheterisation?

A

Post-obstructive diuresis: monitor urine output + replace fluids

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23
Q

How do Tamsulosin and finasteride work?

A

Tamsulosin - alpha blocker - relaxes smooth muscle
Finasteride - 5-alpha reductase inhibitor - inhibits conversion of testosterone to dihydrotestosterone

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24
What are risk factors for bladder cancer?
- Smoking - Aromatic amines (paint and dye workers) - Schistosomiasis
25
What is treatment for TCC of bladder?
TURBT
26
Where can bladder tumours metastasize to?
- Uterus, rectum, iliac lymph nods, liver, lungs, bone
27
Management of ureteric stone + signs of infection?
Surgical decompression + IV Abx
28
What do you call a hernia which cannot be reduced and is painless?
Incarcerated
29
What can a left sided varicocele be a complication of?
Renal cell carcinoma due to venous congestion of the left testicle
30
What is the scoring system used to assess prostate cancer severity?
Gleason
31
What is the management options for prostate cancer?
Low grade - active surveillance Radical prostatectomy - robotic in younger/fitter patients Open prostatectomy
32
What are causes of urinary retention?
- Stones - BPH, Prostate cancer - UTIs - Post surgery - Constipation in elderly - Medications such as anticholinergics, benzos
33
Management of urinary retention
- Bladder scan/renal US - Post void residual volume - Catheterisation - Treat cause
34
What scoring system can be used to assess prostate symptoms?
International Prostate Symptom Score
35
How should bladder cancer be investigated?
Flexible cystoscopy with biopsy CT urogram for staging
36
What are causes of epididymo-orchitis
STI - Chlamydia/Gonorrhoea UTI - E coli in older adults
37
What are signs of epididymo-orchitis?
- Acute scrotal pain/swelling - Fever - Dysuria - Prehn's positive: lifting up testicle relieves pain - Present cremasteric reflex
38
Management of epidiymo-orchitis
- Analgesia - Scrotal elevation - Abx to treat underlying cause (Ceftriaxone + Doxy if any STI, Doxy if chlamydia)
39
What are some causes of erectile dysfunction?
- Vascular disease - Autonomic neuropathy (diabetes, alcohol excess0 - Drugs - Psychogenic - Pelvic surgery
40
What is the management of erectile dysfunction?
- Psychosexual therapy - Sildenafil/Tadalafil which increase blood flow to penis (can cause blue vision) - Injections
41
What is the referral criteria for haematuria?
Bladder/Renal - >45 with unexplained haematuria/haematuria which persists after UTI treatment - >60 with haematuria + dysuria/raised WCC
42
What causes a hydrocele?
Processes vaginalis does not obliterate complete during foetal development causing abdominal fluid to accumulate in scrotum
43
Phimosis vs paraphimosis
Phimosis - foreskin too tight to be retracted over the glans of the penis Paraphimosis - inability to replace foreskin to its original position
44
What is the management of phimosis vs paraphimosis?
Phimosis - steroid creams/surgery Paraphimosis - manual pressure/dorsal slits
45
What is priapism?
Painful erection which continues over 2 hours after sexual activity
46
What causes priapism?
Ischaemic - lack of venous drainage Non-ischaemic - often due to trauma
47
What is management of priapism?
Aspiration of blood within corpus cavernosa and fluid irrigation Adrenaline injections
48
What causes prostatitis?
Acute - often due to bacterial infection Chronic - recurrent/persistent prostatitis usually caused by E coli
49
How will prostatitis present on DRE?
Tender, warm, swollen prostate
50
How is prostatitis managed?
2 weeks of ciprofloxacin
51
What are the 2 types of renal cancer?
- Clear cell carcinoma - TCC
52
What the 2 most common types of testicular cancer?
- Seminoma - Teratoma
53
What are risk factors for testicular cancer?
- Younger age - HIV - Undescended testes
54
What is the management of testicular cancer?
- Scrotal US - Tumour markers: hCG, AFP, LDH - Radical orchidectomy (+ radio/chemo)
55
What is testicular torsion?
Twisting of the testicle around the spermatic cord -> obstruction of blood flow to testicle
56
How does testicular torsion present?
- Sudden onset severe pain - Absent cremasteric - Negative Prehns - Following trauma
57
What is the management of torsion?
- Surgical exploration - Bilateral orchidopexy: fix both testicles
58
What is the management of undescended testes?
Bilateral: refer to paeds to rule out genetic causes then surgery at 6 months Unilateral: review at 6-8 weeks with referal at 3 months
59
What are causes of raised PSA?
- UTI - BPH - Prostate cancer - Retention - Catheterisation
60
Why are Abx given following prostate biopsy?
Minimise risk of infection where bowel flora can move into the prostate
61
Indications that a mass is renal
Moves up and down with respiration, mass palpable on bimanual palpation, able to get above mass
62
Why does ureteric obstruction cause pain?
Ureteric spasm arises from peristalsis attempting to push the stone and relieve obstruction. This causes local ischaemia and hence pain
63
What are common sites for ureteric stones?
- Renal pelvis - Pelvic-ureteric junction - Vesico-ureteric junction
64
What immediate test should be done with painless scrotal swellings?
Trans-illumination: illumination suggests hydrocele
65
Where are prostate cancers likely to originate?
Peripheral zone
66
Which drugs can cause priapism?
Trazadone
67
What are the most common causes of pyelonephritis?
- E coli: gram negative pink rod shaped bacteria - Klebsiella - Proteus - Enterococcus
68
What are the common components of renal stones?
- Calcium oxalate (most common) - Calcium phosphate
69
Patients with signs of chronic retention should not have what?
TWOC - this can exacerbate renal impairment so they need a long term catheter
70
Lifestyle interventions for stress incontinence
- Stop smoking - Lose weight - Avoid alcohol/caffeine - Avoid drinking at nightime
71
Causes of recurrent UTI in men
- Bladder outflow obstruction - Urinary tract surgery - Immunosuppression
72
Common organisms which cause UTI
- Escherichia coli - Klebsiella - Enterococcus - Proteus sp
73
What are causes of urethral strictures?
- Pelvic trauma - Perineal trauma - Urethral instrumentation - Long term catheter
74
Investigations for urethral strictures
- Cystoscopy - U+E - Urinalysis - Urodynamic testing
75
What are complications of urethral strictures?
- Calculus formation in the urinary tract - Chronic infection - Bladder diverticula
76
What causes bladder diverticula?
- Chronic increase in intravesical pressure causing mucousa to push through the muscle layer -> risk of chronic infection
77
What is the management of urethral strictures?
- Internal urethrotomy - Urethroplasty - Graft reconstruction
78
Men with erectile dysfunction should have what tests
Glucose, lipid profile, testosterone
79
What is the most common testicular tumour in younger men?
Non-seminomatous germ cell tumours
80
What is a Wilms tumour?
Nephroblastoma
81
What is the most common organic cause of erectile dysfunction?
DM
82
Where are staghorn calculi found?
Renal pelvis
83
What are the 2 broad classes of testicular cancers?
Seminomas and non-seminomatous germ cell tumours
84
How do testicular cancers metastasize?
Para aortic lymph nodes
85
How to classify LUTS?
Storage: frequency, urgency, nocturia, dysuria Voiding: hesitancy, poor stream, dribbling
86
What is a common complication of radical prostatectomy?
Erectile dysfunction
87
How long can finasteride treatment take?
6 months
88
Risk factors for testicular cancer?
- Infertility - FH - Cryptorchidism
89
What usually precedes development of a urethral stricture?
Urethral inflammation often due to infection
90
Tumour containing different types of tissue e.g. cartilage?
Teratoma
91
What is the management of neuropathic bladder?
Intermittent self catheterisation
92
Management of mixed colonisation of urinary catheters?
No changes needed - mixed growth bacteria is very common and does not cause symptoms usually
93
Cystocele vs Rectocele
Cystocele - prolapse of anterior vaginal wall containing bladder Rectocele - Prolapse of posterior vaginal wall containing rectum
94
What are lifestyle modifications for urge incontinence?
Avoid caffeine Pelvic floor excercises Bladder retraining Avoid alcohol/smoking Weight loss
95
Abx of choice for prostatitis?
Ciprofloxacin
96
What is sometimes on present on standing?
Varicocele
97
What is an epidydimal cyst?
Painless nodule at the head of the epididymis adjacent to inferior pole of testis
98
Gynaecomastia can be a presenting feature of what?
Testicular cancer
99
terminal, painful haematuria
Think bladder calculi
100
What can present with recurrent balanitis and ballooning around the penis?
Phimosis
101
Bell clapper deformity (testis is not fixed) increases the risk of what?
Testicular torsion
102
What is an electrolyte complication of TURP?
Hyponatraemia

FINALS: PASSMED/QUESMED (22 decks)

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