Urology

Question 1

hydrocele

Answer 1

serous fluid

tunica vaginalis

surrounds testes - non palpable

Question 2

most common type of renal stones?

Answer 2

calcium oxalate

Question 3

which renal stones are radio lucent

Answer 3

xanthine
urate

Question 4

men with ED?

Answer 4

bloods
Hba1c
lipids

testosterone

> DM, CVD, Hypogonadism

Question 5

if free testosterone is low or borderline?

Answer 5

repeat

measure FSH/LH and prolactin

Question 6

prehns sign?

Answer 6

elevation of testis does no ease the pain

Question 7

epididymitis

Answer 7

elevation eases the pain

Question 8

in testicular torsion how do you manage?

Answer 8

both testes are fixed as both sides have future risk

Question 9

testicular lump suspicious of tumour

Ix?

Answer 9

referral to 2WW urgent urology

USS
Bloods > LDH, bHCG, FBC, AFP

Question 10

BPH
mx?

Answer 10

tamsulosin and finesteride

alpha1 antagonist and 5alpha reductase inhibitor

Question 11

LUTS
voiding symptoms?

Answer 11

weak / intermittent flow
strain

dribble
incomplete emptying

Question 12

LUTS storage

Answer 12

urgency
frequency
urgency incontinence
nocturia

Question 13

Ix BPH?

Answer 13

dipstick urine
u&E
PSA

IPSS

Question 14

5 alpha-reductase inhibitors

Answer 14

finesteride

Question 15

alpha-1 antagonists

Answer 15

tamsulosin

Question 16

surgical mx of BPH?

Answer 16

TURP

Question 17

first line Ix for bladder cancer?

Answer 17

flexible cystoscopy

Question 18

Bladder cancer subtypes?

which one associated w schistosomiasis?

Answer 18

SCC

Question 19

suspected testicular torsion?

Answer 19

urgent surgical exploration

Question 20

what is testicular torsion surgery called?

Answer 20

bilateral orchidopexy

Question 21

Testing PSA

refrain from exercise and ejaculation - how long?

Answer 21

48 hours

Question 22

how long after prostate biopsy can you test PSA?

Answer 22

6 weeks

Question 23

prostate cancer findings?

Answer 23

weight loss
systemic features

exam findings hard, irregular / unsmooth

Question 24

suspected epididymo-orchitis mx?

Answer 24

ceftriaxone 500mg IM

oral doxycycline 100mg twice daily 10-14 days

Question 25

causative agents of epididymo-orchitis?

Answer 25

Chlamydia trachomatis Neisseria gonorrhoea E.coli - if not STI

Question 26

S/E of tamsulosin?

Answer 26

alpha 1 adrenergic receptor antagonist > dizziness >postural hypotension systemic vasodilation

Question 27

S/E 5-alpha reductase inhibitors?

Answer 27

block the conversion of testosterone to dihydrotestosterone ED reduced libido ejaculation problems gynaecomastia

Question 28

Bladder Cancer RF?

Answer 28

smoking aniline dyes rubber

Question 29

normal age-appropriate range PSA

Answer 29

3ng/ml

Question 30

NICE guidelines for suspecting prostate cancer?

Answer 30

'If a hard, irregular prostate felt on examination 2WW' PSA high

Question 31

prostate cancer Dx

Answer 31

PSA measurement DRE transrectal USS / biopsy MRI /CT and bone scan to stage

Question 32

normal upper limit for PSA?

Answer 32

4ng/ml

Question 33

lymphatic spread of prostate cancer is usually to?

Answer 33

obturator nodes seminal vesicles

Question 34

suspected renal colic IX?

Answer 34

non contrast CT KUB

Question 35

Mx of renal colic?

Answer 35

diclofenac alpha blocker > watchful waiting active management >5mm

Question 36

5-10mm renal stones?

Answer 36

shockwave lithotripsy

Question 37

10-20mm?

Answer 37

shockwave lithotripsy / uretroscopy

Question 38

why is varicocele a sign of malignancy?

Answer 38

compression of renal vein between abdo aorta and superior mesenteric artery

Question 39

RCC - most common subtype?

Answer 39

clear cell > arises in proximal renal tubular epithelium

Question 40

first line investigation for prostate cancer?

Answer 40

multiparameteric MRI

Question 41

TURP syndrome?

Answer 41

venous destruction and absorption of the irrigation fluid resultant hypernatraemia