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MBBS / MBChB finals > Urology > Flashcards

Urology Flashcards

(44 cards)

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1
Q

Most common cause of epididymo-orchitis

A

If >35yo - gram -ve enteric organisms - E. Coli, pseudomonas

If <35yo - STIs - chalmydia, gonorrhoea

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2
Q

Causes of acute orchitis

A

Viral : mumps, coxsackie A, varicella, echovirus
Bacterial : E. Coli, Klebsiella, Pseudomonas, Staphylococcus, Streptococcus
Granulomatous : Syphillis, TB, Leprosy, Actinomyces,
Fungal - rare
Trauma
Idiopathic

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3
Q

Syx of epididymo-orchitis

A

Unilateral scrotal pain + swelling - acute onset
Bilateral in 10%
If STI - discharge, urethritis
Syx suggesting UTI
Systemic syx of mumps (headache, fever, parotid swelling)

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4
Q

Signs of epididymo-orchitis

A 
Tenderness on plantation
Palpable swelling of epididymis 
\+/- Urethral discharge 
\+/- secondary hydrocele 
Erythema of scrotum
Pyrexia
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5
Q

What is the time limit for testicular salvage in testicular torsion

A

6 hours

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6
Q

What age is testicular torsion most common

A

<20 years

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7
Q

Differential diagnosis of epididymo-orchitis

A 
testicular torsion 
Trauma
Abscess formation
Testicular tumour
Epididymal tumour
Hydrocele
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8
Q

Painless haematuria suggests what?

A

Bladder cancer

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9
Q

Presentation of acute bacterial prostatitis

A 
Systemically unwell
Lethargy 
Fever
Perineal pain
Lower back pain
(if severe-Urinary retention, urethral discharge, anal discharge)
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10
Q

What might suggest acute prostatitis on digital rectal examination

A

Inflamed and painful prostate

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11
Q

Common pathogens in acute bacterial prostatitis

A

E. coli

Strep faecalis

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12
Q

What conditions predispose to pyelonephritis

A

Urinary reflux
Anatomical abnormality
Urinary stasis

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13
Q

Presentation of acute pyelonephritis

A 
Malaise
Fever
Rigors
Vomiting
Dysuria
Haematuria
Loin pain
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14
Q

Treatment of pyelonephritis

A

Cefuroxime
+/- gentamicin
Up to 14d

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15
Q

Presentation of epididymo-orchitis

A

Acutely painful and swollen testicle
Scrotal discolouration

+/- urethral discharge + hx of unprotected sex

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16
Q

Causes of bladder stones

A

Usually due to another urinary System problem

  • Bladder diverticulum
  • Enlarged prostate
  • Neurogenic bladder
  • Urinary tract infection

Almost all bladder stones occur in men.

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17
Q

Symptoms of bladder stones

A 
Abdominal pain / pressure
Abnormally coloured / dark-colored urine
Haematuria
Difficulty urinating
Frequency
Inability to urinate except in certain positions
Interruption of the urine stream
Dysuria
discomfort in the penis
Urinary tract infection
Fever
urgency
Loss of control over urine.
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18
Q

Management of bladder stones

Study These Flashcards
A

Drinking more water to help pass small stones
cystoscopy to remove stones

Open surgery to remove large stones

Tx cause of bladder stones.

19
Q

Indications the short term catheterisation

Study These Flashcards
A
  • Treatment of acute urinary retention.
  • Preoperative prophylactic emptying of the bladder prior to urological or pelvic surgery
  • Monitoring urine output in critically ill patients.
  • Checking urinary residual volumes.
20
Q

Features of a hydrocele

Study These Flashcards
A

Tense, smooth, fluctuant, trans-illuminating swelling around the testicle

21
Q

Management of Testicular torsion

Study These Flashcards
A

Surgical emergency
Surgery within six hours
Reduce and Fix the testis

22
Q

What is an irregular testicular lump likely to be?

Study These Flashcards
A

Testicular cancer

  • seminoma (60%)
  • teratoma (40%)
23
Q

What patients typically get testicular seminomas

Study These Flashcards
A

30-40yo M

Arise from seminiferous tubules

24
Q

What patients typically get testicular teratomas

Study These Flashcards
A

20-30yo M

arise from germ cells

25
Management of testicular tumour
Radical inguinal orchidectomy + radiotherapy for LN involvement (not teratomas) + chemotherapy for extensive node involvement
26
Indications for long-term catheterisation
Treatment of chronic urinary retention due to bladder outlet obstruction Neuropathic bladder. Intractable skin breakdown exacerbated by incontinence. Terminally ill or very frail incontinent patients where repeated bedding changes would be distressing. Patient preference after failure of continence interventions.
27
Management of epididymo-orchitis
Bed rest Scrotal support Antibiotics (e.g. Ciprofloxacin+doxycycline)
28
Most common type of bladder cancer
Transitional cell carcinoma | Squamous cell due to schistosomiasis
29
Presentation of a varicocele
``` Scrotal swelling Does not transilluminate No cough impulse Usually L sided 'Bag of worms' ```
30
What is a hydrocele
Collection of fluid in the tunica vaginalis
31
Tumour markers of testicular cancer
Alpha fetoprotein Beta-HCG Both suggest teratoma
32
Management of testicular teratoma
Orchidectomy | Chemotherapy
33
Management of testicular seminoma
Orchidectomy | Radiotherapy
34
Presentation of testicular cancer
``` Painless lump Testicular pain +/- abdominal pain. Dragging sensation. Recent trauma Hydrocele Gynaecomastia Metastasis--> back pain / liver, lung, brain. ```
35
What may haematuria after trauma suggest
Renal injury | Needs CT scan
36
What does blood at the urinary meatus following trauma suggest
Urethral injury | If suspected do anterograde urethrogram
37
Normal prostate specific antigen levels
<4
38
What increases prostate specific antigen
``` Increasing age Prostate cancer Benign prostatic hypertrophy Urinary tract infection Urethral instrumentation Recent ejaculation ```
39
What is brachytherapy
Implantation of radioactive seeds in the prostate gland. | For localised prostate cancer
40
2 drugs used to manage benign prostatic hypertrophy
Doxazosin (or alfuzosin) | Finasteride
41
Symptoms of phimosis
Non-retraction of the foreskin E.g. Congenital / scaring / lichen sclerosis / fibrosis Foreskin becomes white and fixed to glans The prepuce may balloon on micturation - circumscion not needed. If urinary obstruction - circumcise
42
What is Peyronie's disease + symptoms
Progressive fibrosis of tunica albuginea covering corpus cavernosum. Pain on erection Deviation of erection / ventral curvature Pain on intercourse / becomes impossible
43
When does priapism become painful | What are possible complications
Pain after 3/4 hrs Ischaemia + interstitial oedema after 12 hrs Smooth muscle necrosis after 24 hrs Can cause long term ED - risk relative to duration
44
Managment of priapism
Exercise + ice Oral terbutaline Intracavernosal phenylephrine

MBBS / MBChB finals (25 decks)

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