Urology Flashcards
(34 cards)
What can raise PSA levels?
- Benign prostatic hypertrophy
- Older age
- Prostatitis
- Recent ejaculation
- Prostate cancer
- Obesity
- Drugs (e.g. 5ARIs, Aspirin, Statins, Thiazides)
5ARIs refers to 5-alpha-reductase inhibitors, such as finasteride, which can affect PSA levels.
What factors can lower PSA levels?
- 5ARIs (e.g. finasteride)
- Aspirin
- Statins
- Thiazides
These medications can influence PSA test results, leading to lower detected levels.
How quickly must a PSA test sample reach the lab?
Within 16 hours for serum to be separated
Timely processing is crucial for accurate PSA level measurements.
True or False: Men can exercise vigorously before a PSA test.
False
Vigorous exercise can affect PSA levels and lead to inaccurate test results.
What is the recommended waiting period after ejaculation before a PSA test?
48 hours
This waiting period helps to avoid falsely elevated PSA levels.
What type of urological interventions should be avoided before a PSA test?
- Prostate biopsy
- Cystoscopy
These procedures can temporarily elevate PSA levels, affecting test accuracy.
Prior to doing a PSA test men must not have..
An active urine infection within last 6/52
Urological intervention in previous 6/52
Ejaculated or exercises vigorously in previous 48h
What are the daytime urinary symptoms associated with Lower Urinary Tract Symptoms (LUTS)?
Daytime urinary symptoms, nocturia, urgency, incontinence
These symptoms are typical of Overactive Bladder (OAB).
List the voiding symptoms associated with LUTS.
- Slow stream
- Splitting or spraying
- Intermittency
- Hesitancy
- Straining
- Terminal dribble
These symptoms indicate potential issues with urinary flow.
What are post micturition symptoms?
Sensation of incomplete emptying, post micturition dribble
These symptoms occur after urination and may indicate underlying urinary tract issues.
What percentage of LUTS are caused by BPH?
50%
Benign Prostatic Hyperplasia (BPH) is a common cause of LUTS in men.
What is the purpose of the International Prostate Scoring Symptoms (IPSS)?
Assessing symptoms of LUTS
The IPSS is a standardized tool used to evaluate the severity of urinary symptoms.
State the criteria for performing a PSA test.
Do if LUTS may be caused by BPH, symptoms of cancer, prostate feels abnormal on DRE, or patient significantly concerned about cancer
PSA testing is indicated based on specific symptoms and concerns regarding prostate health.
What are the symptoms of prostate cancer?
- ED
- Haematuria
- Low back pain
- Weight loss
- Bone pain
These symptoms are distinct and not typical of LUTS.
Name some management strategies for LUTS.
- Bladder training
- Pelvic floor exercises
- Alpha blockers (e.g., tamsulosin)
- Anticholinergics (for storage symptoms)
- 5 alpha reductase inhibitors (e.g., finasteride)
- Tadalafil
These strategies can alleviate symptoms associated with LUTS.
What is the role of desmopressin in LUTS management?
No evidence and unlicensed but can be trialled
Desmopressin is not officially approved for LUTS but may be considered in specific cases.
When should referrals be made for LUTS?
- Bothersome LUTS
- LUTS with recurrent UTIs
- Urinary retention
- Renal impairment
- Suspected urological cancer
- Stress urinary incontinence
These conditions warrant further evaluation and potential specialist intervention.
What are the surgical options for managing LUTS?
- Voiding: TURP, TUVP, HoLEP
- Storage: Cystoplasty
Surgical interventions can be necessary for severe cases of LUTS.
What is the best predictor for the presence of prostate cancer?
Abnormal digital rectal examination
A DRE can provide critical insights into prostate health and potential malignancy.
What are the four stages of syphilis?
Primary, Secondary, Latent, Tertiary
These stages represent the progression of the disease over time.
What is the timeframe for the Primary stage of syphilis?
3 weeks after exposure
This stage occurs shortly after infection.
What are the clinical features of Primary syphilis?
Painless genital ulcer (chancre), non-tender inguinal lymphadenopathy
Chancre is the hallmark of primary syphilis.
What time period does Secondary syphilis occur?
Weeks to months later
Typically follows untreated primary syphilis.
List some clinical features of Secondary syphilis.
- Rash (including palms and soles)
- Mucous patches
- Condylomata lata
- Fever
- Malaise
- Lymphadenopathy
Symptoms can vary and may include systemic issues.
