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Block 34 Metabolic Flashcards > Urology > Flashcards

Urology Flashcards

(47 cards)

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1
Q

Background facts about stone disease

A

10% incidence

50% recur in 10 years

Can occur anywhere in the renal tract

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2
Q

What is the presentation of patients with renal stones

A

Renal colic
Loin to groin pain
Haematuria

Look for changes to GFR, creatinine and WCC
Low urine pH suggests Uris acid component

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3
Q

What is the gold standard. Investigations for renal stones

A

CT KUB

X-ray and ultrasound are also useful

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4
Q

What are the risk factors for developing renal stones

A

High protein intake
High salt intake
White ethnicity
Dehydration
Obesity
Hypercalcemia secondary to hypepraarhyroidism and sarcoidosis
Fhx

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5
Q

What is the conservative management of renal stones

A

Hydration
NSAIDs for pain relief
Anti-emetics

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6
Q

What other management options are available for stones

A
  • medical expulsion therapy via tamsulosin which is an alpha blocker.
  • shockwave lithotripsy - uses focused sound waves to break stone into smaller pieces which makes it easier to pass through
  • ureteroscopy + can be used in combination with laser lithotripsy
  • percutaneous neprholithotomy
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7
Q

What are the different types of renal stone compositions

A

Calcium oxalate

Calcium phosphate

Uric acid (only one that is radiolucent)

Struvite

Cysteine

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8
Q

What are the risk factors for UTIs in women

A

Sexually active
Post menopause
History of recurrent UTis
Diabetes
Increasing age

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9
Q

Investigations for UTI

A

Urine dipstick - nitrites and leukocyte esterase

Urine microscopy

Urine cultures

Ultrasound and CT KUB

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10
Q

Treatments for UTIs

A

Nitrofurantoin

Trimethoprim + sulfamethoxazole

Co-amoxiclav

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11
Q

What are the risk factors for UTIs in men

A

BPH
Urinary tract stones
Urethral strictures
Increasing age
Catheterisation

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12
Q

Treatment for UTI in men

A

Ciprofloxacin or levofloxacin

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13
Q

What are the risk factors for prostate cancer

A

Age
Black ethnic background
Family history

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14
Q

Investigations for prostate cancer

A

PSA testing
Prostate biopsy
Bone scan -
X-rays - lytic lesions

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15
Q

What zone do most prostate cancers occur in

A

Peripheral zone 75%
Transitional zone 20%
Central 5%

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16
Q

What treatment options are available for prostate cancer

A

Watchful waiting and active surveillance

Brachytherapy - low dose radiation close to source

External beam radiotherapy daily for 6- 8 weeks

Radical prostatectomy

Androgen deprivation therapy - bicalutamide

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17
Q

What drug is used as androgen deprivation therapy in prostate cancer

A

Bicalutamide - blocks the action of androgens on its receptor preventing growth. Does not alter amount of androgens produced

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18
Q

What scoring scale is used for prostate cancer

A

Gleasons

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19
Q

What types of histological types are there in bladder cancer

Study These Flashcards
A

Transitional cell

Squamous cell

Adenocarcinoma

20
Q

What are the risk factors for bladder cancer

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A

Smoking
Azo dyes
Age
Pelvic radiation
Schistosoma infection
Chemo drugs - cyclophosphamide
Family history

21
Q

What investigations to consider for bladder cancer

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A

Urinalysis for haematuria

Urine Cytology - looks for any abnormalities under microscope

Cystoscopy - allows to see tumours

CT urogram - images any tumours

22
Q

What treatment options are available for bladder cancer

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A

For non invasive cancer - transurethral resection of the cancer is done but this has a high recurrence rate
Chemotherapy - mitomycin C

Immunotherapy

Radical cystectomy

Radiotherapy

23
Q

What immunotherapy is used in bladder cancer:

Study These Flashcards
A

BCG bacillus calmette guerin

24
Q

What chemo is used n bladder cancer

Study These Flashcards
A

Mitomycin C

Alkylating agent which inhibits DNA replication and synthesis

25
Types of kidney cancer
Renal cell: (affects the PCT ) - clear cell - papillary - chromophobe -collecting duct - unclassified Sarcoma Transitional cell - upper urothelial cancer (affects the renal pelvis and ureter) Wilm’s tumour in children
26
Risk factors for renal cancer
Male Smoking Increasing age Obesity Hypertension Cystic disease +ve FHx
27
Symptoms of renal cancer:
Asymptomatic Flank pain Palpable mass Hameutria Red flag symtoms Fever
28
What imaging is done for renal cancer
Ultrasound CT with contrast MRI CT chest - mets possible Bone scan - bone mets possible Biopsy
29
Treatment for renal cancer
Surgery to remove tumour Immunotherapy
30
Presentation of wilms tumour
Age less than 5 usually Abdominal pain Hypotension or hypertension Haematuria Palpable mass Varicoele Anaemia Lack of appetite
31
Treatment of wilms tumour
Surgical removal - Systemic chemo and radiotherapy
32
Investigations for testicular cancer
Ultrasound Doppler CT of abdomen and pelvis MRI for staging
33
Treatments for testicular cancer
Radical orchiectomy External beam RT and chemo post surgery
34
Risk factors for testicular cancer:
White background Undescened testes Previous history Family history HIV
35
What can cause ED
Diabetes Atherosclerosis Obesity Smoking Pelvic radiotherapy and prostate surgery Low testeosteorne MS Peyronies disease Meds: Alpha blockers Anti-hypertensives
36
Examples of storage symptoms
Urgency Frequency Nocturia Incontinence
37
Examples of voiding symptoms
Slow stream Straining Intermittency Hesitancy Terminal dribbling
38
Inconticne symptoms can be measured using which symptom index
IPSS International prostate symptom score 1-7 mild 8-19 moderate 20-35 severe
39
LUTS can be caused by pathology in which dimensions
Prostate Urethra Bladder Pelvic organs Neurological disease (cauda equina or pelvic/sacral tumours)
40
Symptoms that indicate that LUTS might be because of something neuro
Back pain Sciatica Ejeaculatiry disturbance Sensory changes in perineum, legs or feet
41
Acute loin pain but no stone. Differentials…
1) clot or tumour colic 2) PUJO 3) pyelonephritis
42
Acute loin pain - non uro causes
AAA MI or pneumonia Ectopic or ovarian cyst rupture Appendicitis, IBD flare Intestinal obstruction Testicular torsion Prolapsed intervertebral disc
43
Chronic loin pain causes
Cancer Renal stones Renal infection PUJO Ureteric reflux or stone
44
Types of incontinence
Stress Urge Mixed Overflow Maybe be caused by internal sphincter weakness (neuromuscular defect) Or bladder overactivity (infection, tumour or stone may also irritate bladder
45
Causes of an enlarged liver
Infection Congestion Amyloid Cancer + mets Hydatid cysts Cirrhosis Abscess
46
Causes of abdominal distension 5Fs
- foetus - flatus - faeces - fat - fluid as it’s
47
Treatments for incontinence
Lifestyle changes Pelvic floor exercises Sling Collagen injections Weight loss and smoking cessation Oxybutynin Alpha agonists Botulinum injections into wall of detrusor

Block 34 Metabolic Flashcards (6 decks)

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