Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Specialties > Urology > Flashcards

Urology Flashcards

(92 cards)

Start Studying
1
Q

At what spinal levels do the kidneys sit?

A

T12-L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What 3 layers surround the kidneys?

A

Renal capsule
Perinephric fat
Renal fascia (Gerota’s fascia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 2 actions of ADH?

A

Reabsorption of solute free water in the nephron to concentrate urine.
Constriction of arterioles, increasing peripheral vascular resistance and increasing BP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an end artery? Give an example of one.

A

An artery which is the only supply of oxygenated to blood to a tissue.
Renal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is ADH produced?

A

Posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What receptors and cells of the kidney does ADH bind to?

A

V2 receptors of the epithelial cells lining the collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

6 functions of the kidneys?

A 
Production and concentration of urine
Electrolyte regulation
Renin production/BP regularion
Erythropoietin production
Conversion of Vit D to hydroxylated form
Acid-base regulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

5 key functions of angiotensin II

A

Increase sympathetic activity
Increase reabsorption of Na and Cl in tubules (+ excretion of K) → water retention
Increase aldosterone secretion from adrenal glands
Arteriolar vasoconstriction → increase BP
Stimulate ADH secretion from posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

4 functions of hydroxylated vitamins D

A

Increase absorption of Ca in gut
Increase reabsorption of Ca in kidneys
Increase resorption of Ca from bones
Negative feedback on PTH from parathyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a Page kidney?

A

Chronic long standing compression of the renal parenchyma causing hypertension, most commonly due to a post-traumatic sub capsular haematoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 narrowing in the renal tract

A

Pelvicoureteric junction
Pelvic brim
Vesicoureteric junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What 2 arteries run in close proximity to the ureters?

A

Ovarian and uterine arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What sensory nerves innervate the ureters?

A

T10-L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What nerves innervate the bladder? Which causes contraction and which causes relaxation?

A

Relaxation - Sympathetic system, hypogastric nerve releases noradrenaline which binds to beta-3-adrenergic receptors.
Contraction - Parasympathetic system, pelvic nerve releases acetylcholine which binds to muscarinic (M3) receptor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which neurotransmitters cause contraction of internal urethral sphincter, contraction of detrusor muscle and relaxation of detrusor muscle?

A

Noradrenaline causes contraction of internal urethral sphincter and relaxation of detrusor muscle, acetylcholine causes contraction of detrusor muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 parts of the male urethra?

A

Prostatic
Membranous
Bulbar
Penile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Batson’s plexus? Why is it relevant?

A

The veins that link the internal iliac veins to the veins that lie front of the vertebral bodies.
It drains the blood from the urinary bladder, breasts and prostate to spine. Responsible for haematogenous spread ot cancer to bone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name 4 storage urinary symptoms

A

Frequency
Urgency
Urge incontinence
Nocturia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name 6 voiding urinary symptoms

A 
Hesitancy
Poor stream
Post-void dribbling
Incomplete voiding
Urinary retention
Overflow incontinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Red flag symptoms that you should look for in a patient presenting with LUTS.

A 
Haematuria
Persistance UTI
Constitutional symptoms eg weight loss
Poor renal function
Abnormal neurology 
Recent back trauma
Recent pelvic surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Investigations for BPH

A 
Urine dipstick
Flow meter
Post-void residual volume
Bloods: FBC, U&Es, PSA
US - KUB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

1st line treatment of BPH

A

Lifestyle advice eg drink plenty of water, reduce caffeine consumption, smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Medications to treat BPH

A

Alpha blockers eg Doxazosin, Tamsulosin.

5-alpha-reductase inhibitors eg Finasteride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do alpha blockers work to reduce the LUTS in BPH?

A

They relax the smooth muscle of the prostate, reducing it’s contracting effects on the prostatic urethra.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do 5-alpha-reductase inhibitors work in BPH?
The stop the conversion of testosterone to dihydrotestosterone which drives hyperplasia in the prostate gland.
26
What surgical treatment is there for BPH?
Transurethral resection of prostate (TURP)
27
What receptors does doxazosin act upon?
Alpha 1 receptors
28
What are 2 side effects of Tamsulosin?
Postural hypotension, retrograde ejaculation
29
What is TUR syndrome?
A potentially life-threatening syndrome due to absorption of the fluid used to irrigate the bladder into the prostatic venous sinuses. It can result in fluid overload and electrolyte imbalance including hyponatraemia. Fluid absorption leads to rapid volume expansion, which causes hypertension and reflex bradycardia.
30
7 causes of increase PSA
``` BPH Prostate cancer Infection Exercise Age PR exam Ejaculation ```
31
Symptoms of prostate cancer
``` LUTS (Hesitancy, poor stream, post-void dribbling, incomplete voiding, frequency, retention, nocturia) Back pain (spinal metastases) Constitutional symptoms (weight loss, anorexia) ```
32
What is the difference between a prostate felt on digital rectal examination in BPH and prostate cancer?
BPH - enlarged but smooth | Prostate cancer - hard an craggy
33
Investigations for prostate cancer
Bloods: FBC, U&Es, LFTs, PSA Needle biopsy of prostate CT/MRI Bone scan
34
What grading system us used to describe the histology of prostate cancer?
Gleason grading
35
What is pyelonephritis?
infection of the renal cortex and medulla
36
What are the 2 main routes through which the kidney can become infected?
Ascending route - via urethra, bladder and ureter | Haematogenous route
37
Which group of patient are more likely to acquire pyelonephritis via the haematogenous route?
IVDU
38
2 common organisms that cause pyelonephritis?
e.coli and klebsiella
39
Describe anatomically where the renal angle is
between the lower border of the 12th rib and the lateral border of the erector spinae muscle
40
8 symptoms of pyelonephritis
``` Constant dull ache pain (bilateral in 5-10%), worse on palpation N+V Fever Visible haematuria Headache (often due to dehydration) Dysuria Urgency/frequency ```
41
What patients typically get pyelonephritis?
Young females aged 18-19
42
Risk factors for pyelonephritis
``` Mechanical: - Blockage of urinary tract eg stone, stricture, enlarged prostate, pregnancy - Catheterisation - Vesicoureteric reflux - Neurogenic bladder Constitutional eg immunosuppression due to HIV, diabetes, medication Behavioural: - Recent change in sexual partner - Spermicide use - +ve family history ```
43
Complications of pyelonephritis
Sepsis | Irreversible kidney damage (xanthogranulomatous pyelonephtitis)
44
What is pyelonephrosis?
An obstructed, infected kidney with a collection of pus proximal to the obstruction.
45
How is pyelonephritis diagnosed?
Urine dipstick and MC+S Bloods (FBC, U+E, cultures, lactate, CRP) US kidneys
46
How do you manage pyelonephritis?
Sepsis 6 within 1 hour if patient is septic (Oxygen, fluids, Abx, lactate, cultures, urine output) Analgesia (regular paracetamol +/- NSAIDs +/- codeine) Fluids Antibiotics (Gentamycin/Tazocin)
47
4 main substances that renal stones can be made from
Calcium oxalate Calcium phosphate Urate Struvite
48
Symptoms of renal colic
Sudden, sharp, unilateral, loin to groin pain (10/10 pain) N+V (same onset as pain) Haematuria LUTS Referred pain to unilateral testis, tip of penis, unilateral vulva Waxes and wanes (due to peristalsis)
49
How do you diagnose renal stones? Including gold standard test
Urine dipstick Bloods (FBC, U+Es, serum calcium and urate levels) Abdominal x-ray CT-KUB
50
What diagnosis is important to exclude in a patient presenting with loin to groin pain?
Ruptured AAA
51
Management of renal calculi
Analgesia (NSAIDs - typically diclofenac PR +/- IV paracetamol +/- opiates) <7mm stone - typically left to pass naturally >7mm stone - typically removed surgically - Lithotripsy - Lithoplaxy - Percutaneous nephrolithotomy If patient has developed pyelonephritis/pyelonephrosis, they should have a nephrostomy to drain infected urine. Then return 6 weeks later to remove obstruction.
52
What is the most common histological type of bladder cancer?
Transitional cell carcinoma
53
Risk factors for bladder cancer
``` Male Increasing age Smoking Exposure to aromatic amines (rubber industry) Risk factors specific for squamous cell carcinoma: - schistosomiasis infection - long-term catheter - recurrent bladder stones ```
54
Most common presentation of bladder cancer
Painless haematuria (assumed to be bladder cancer until proven otherwise)
55
Symptoms of bladder cancer
``` Painless haematuria Passing of clots (if causing obstruction can present with acute urinary retention) LUTS eg urgency, frequency, dysuria Anaemia Weight loss ```
56
Investigations for bladder cancer
Bloods (FBC, U+Es, PSA?) Urine dipstick (+/- MC+S) Cystoscopy CT/MRI bladder (+/- intravenous urogram)
57
Management of bladder cancer
Transurethral resection of bladder tumour (TURBT) Intravesical immunotherapy Intravesical/systemic chemotherapy Radical cystectomy and lymphadenectomy (gold standard) Radiotherapy
58
What is the cause of urge incontinence?
Detrusor over activity
59
What is the cause of stress incontinence?
Leakage of urine with increased intraabdominal pressure due to either intrinsic sphincteric deficiency (ISD) or urethral hypermobility (due to weakened pelvic floor muscles)
60
How will residual volume differ between obstructive cause of LUTS and bladder over activity?
Residual volume is normal (<50ml) in bladder over activity and increased when there is an obstructive cause
61
What investigation will give a definitive diagnosis of bladder over activity?
Urodynamic studies
62
What is urge incontinence?
Sudden urge to urinate followed by uncontrolled emptying of bladder
63
Symptoms of urge incontinence
``` Urge incontinence Frequency Nocturia Nocturnal enuresis ‘Key in the door’ –the sensation of coming home into the house and large urge to urinate ```
64
Risk factors for stress incontinence
Increasing age (post-menopausal women) Obesity Pregnancy and childbirth
65
Management of urge incontinence
1.Lifestyle advice eg decrease caffeine consumption, smoking cessation, weight loss etc, reassurance, support, containment eg pads Bladder training 2.Anticholinergics eg oxybutynin, fesoterodine, solifenacin, tolteradine (antimuscarinics which block the M3 receptor in the bladder) 3.Beta 3 agonists eg mirabegron 4.Surgical: Botox injections
66
Management of stress incontinence
1. Pelvic floor exercises (trial >3 months) 2. Surgical options eg colposuspension, intrmural bulking agent, mesh, tension free vaginal tape 3. Duloxetine
67
Causes of haematuria
``` Infection (bladder, kidney, prostate) Vigorous exercise Contamination from PV bleed Malignancy Renal calculi Inflammation of urinary tract BPH Renal disease Medications ```
68
What structures are in the spermatic cord?
``` Testicular artery Cremasteric artery Artery to vas deferens Genital branch of gentiofemoral nerve Autonomic nerves Vas deferens Pampiniform plexus Lymphatics Processus Vaginalis ```
69
3 fascial coverings of the spermatic cord
External spermatic fascia Cremaster muscle and fascia Internal spermatic fascia
70
Risk factors for testicular torsion
``` Bell-clapper deformity Large testicular size Sudden change in temperature Undescended testis Pervious torsion ```
71
Main differential for testicular torsion
Epididymitis
72
Symptoms of testicular torsion
Acute onset of testicular pain Swollen testis Fever N+V
73
Investigations for testicular torsion
US | Diagnosis is clinical and management should not be delayed waiting for investigations
74
Management of testicular torsion
3 point fixation
75
Causes of urinary retention
Obstruction eg BPH, stricture, stones, tumour, constipation, prolapse, extrinsic causes eg pregnancy, fibroids, ovarian cyst Nerve problems eg MS, brain/spinal cord injury, diabetes, stroke Medications eg anticholinergics (for overactive bladder), antidepressants (amitriptyline), antihistamines (cetirizine) Weakened bladder muscles
76
Symptoms of urinary retention
Acute: Oligo/anuria, dysuria, lower abdo pain, bloating Chronic: Frequency, hesitancy, poor stream, urgency, incomplete emptying, discomfort in lower abdomen
77
Investigations for urinary retention
Urine dipstick and MC+S Bloods: U+E US-KUB (or post-void bladder scan)
78
Which cells do renal cell carcinoma originate from?
Renal tubular epithelium (proximal convoluted tubule)
79
Symptoms of renal cell carcinoma
``` Haematuria Loin pain Abdominal mass Anorexia Malaise Weight loss PUO ```
80
Appearance of renal cell carcinoma on x-ray
Cannonball metastases
81
Investigations for renal cell carcinoma
Bloods (FBC, U+E, LFTs, ALP, ESR) USS CT/MRI
82
Which 3 types of medications can cause acute urinary retention
Anticholinergics eg oxybutynin - used for overactive bladder Antidepressants Antihistamines
83
What is intravenous urography?
AKA intravenous pyelography Contrast dye is injected into a vein which is concentrated in the kidneys and passed into ureters. The dye blocks x-rays, so kidney, ureters and bladder show up well. Used to help diagnose infection, obstruction, malignancy and stones.
84
What do the testicular veins drain into?
Left into left renal vein | Right into inferior vena cave
85
What is the most likely cause of left sided varicocele?
Dilation of the superior mesenteric artery, crushing the left renal vein and increasing left testicular vein pressure.
86
Where do the testicular arteries arise from?
Aorta at the level of L2
87
Most common part of prostate to develop prostate carcinomas
Peripheral zone - posterolateral
88
How can you tell the difference between a Hydrocele and an Epididymal cyst?
Epididymal cyst sits superior to testis, hydrocele surrounds the testis Differentiated with USS
89
Layers of the scrotum
``` Skin Dartos fascia and muscle External spermatic fascia Cremasteric fascia Internal spermatic fascia Tunica vaginalis Tunica albuginea ```
90
Serological | markers of testicular tumour
AFP bHCG LDH
91
Which testicular cancer causes extremely elevated hCG?
Testicular choriocarcinoma - most aggressive
92
Most common type of testicular tumour
Seminoma

Specialties (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions