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Finals Studying - Condensed > Urology > Flashcards

Urology Flashcards

(78 cards)

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1
Q

most common composition of renal stone

A

calcium oxalate

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2
Q

composition of struvite stones

A

magnesium
ammonium
phosphate

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3
Q

types of renal stone

A 
calcium oxalate 
struvite 
uric acid 
calcium phosphate 
cystine
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4
Q

predisposition to renal crystal formation

A

altering pH

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5
Q

what pH condition causes struvite stones

A

alkali

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6
Q

stag-horn calculi

A

large calculi that extend into at least 2 calyces

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7
Q

Ix of renal stone

A

CT KUB (CT stone search)

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8
Q

most common type of stone to form stag horn calculi

A

struvite

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9
Q

Mx renal stone <5mm

A

conservative Mx
increase fluid intake
analgesia (diclofenac)
alpha-blockers

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10
Q

Mx renal stone <2cm

A

extracorporeal shock wave lithotripsy (ECSWL)

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11
Q

Mx renal stone <2cm + pregnant

A

ureteroscopy

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12
Q

Mx renal staghorn calculi

A

Percutaneous nephrolithiotomy

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13
Q

Mx renal stone if evidence of ureteric obstruction or infection

A

nephrostomy + stent

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14
Q

types of bladder cancer

A

transitional cell (papillary vs non-papillary)

squamous cell

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15
Q

main risk factor for squamous cell bladder ca

A

schistosomiasis

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16
Q

Ix bladder cancer

A

cystoscopy + biopsy

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17
Q

Mx superficial bladder cancer

A

transurethral resection of bladder (TURB)

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18
Q

Mx high grade bladder cancer

A

TURB + intra-vesical chemo

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19
Q

haematuria in someone just back from lake malawi

A

schistosomiasis

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20
Q

role of PSA

A

liquification of semen

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21
Q

is there a screening programme for prostate Ca

A

no - but pt can request PSA but must be counselled about risk of false positive and negatives

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22
Q

upper limit of normal PSA

A

(age-20)/10

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23
Q

cause of BPH

A

natural ageing process - imbalance of androgen/oestrogen

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24
Q

g/s Ix of BPH

A

Rectal USS with biopsy

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25
Mx of BPH
1. alpha blocker (tamsulosin) 2. + 5 alpha reductase inhibitor (finasteride) 3. transurethral resection of prostate (TURP)
26
s/e of alpha blockers
``` drowsiness depression dry mouth low BP ejaculatory failure increased weight ``` (relief on stopping drug)
27
s/e of 5 alpha reductase inhibitors
excreted in semen impotence reduced libido gynaecomastia (no relief on stopping drug - 3-6m later)
28
most common type of prostate ca
adenocarcinoma
29
most common area for prostate cancer
peripheral zone
30
most common place for prostate ca mets
bone - sclerotic lesions
31
Ix prostate Ca
rectal USS + biopsy
32
gleason score
used from prostate biopsies 5-6 biopsies taken from each side of prostate 2 grades assigned to each pt - primary grade is largest area of tumour, secondary grade is next largest area
33
Mx prostate ca
``` any of: active surveillance radical prostatectomy +/- lymph node dissection radical XRT hormone therapy ```
34
how does hormonal Tx used in prostate Ca work
prostate ca depends on testosterone for growth, so depriving ca cells of testosterone delays tumour progression circulating testosterone exerts -ve feedback on pituitary LH secretion
35
hormonal Tx used in prostate Ca
Androgen deprivation therapy - LHRH agonists (Leuprorelin, Goserelin) Anti-Androgens - Steroidal (cyproterone acetate) - Non-steroidal (bicalutamide, flutamide)
36
risk of starting LHRH agonists in prostate Ca
they initially stimulate LH and FSH, so more testosterone. need to give anti-androgen cover for 3d. risk of spinal cord compression
37
Mx of man with prostate ca and back pain
radical prostatectomy + dexamethasone for spinal cord compression
38
balanitis
inflammation of the glans penis
39
most common cause of balanitis
candida
40
Mx balanitis
improve hygiene gentle saline washes if severe discomfort - 1% hydrocortisone
41
presentation of epididymal cyst
posterior to testicle | can get above it
42
man with swollen testis but it can be felt -Dx?
epididymal cyst
43
Mx epididmyal cyst
supportive
44
presentation of hydrocele
non-tender swelling transilluminates can get above it
45
hydrocele can be the presenting feature of - ?
testicular ca
46
Ix hydrocele
Doppler USS with colour
47
presentation of varicocele
left side | "bag of worms"
48
varicocele can be the presenting feature of - ?
renal cell carcinoma
49
Ix varicocele
Doppler USS
50
paraphimosis
foreskin can't be pulled back over glans - most commonly due to foreskin being pulled back for catheterisation and not placed back prevents venous return leading to oedema
51
Mx paraphimosis
iced glove | manual decompression
52
phimosis
the foreskin can't be retracted past the glans
53
mx phimosis
daily gentle traction | topical steroid to soften foreskin
54
Ix of ?renal injury
CT with contrast
55
Ix ?bladder injury
CT cystography
56
Ix ?urethral injury
retrograde urethrogram
57
classification of testicular tumours
germ cell (95%) - seminoma - non-seminoma (yolk sac, teratoma, choriocarcinoma)
58
tumour marker for non-seminoma testicular tumour
AFP
59
tumour marker for seminoma testicular tumour
PLAP, hCG
60
Ix testicular ca
USS
61
Mx testicular ca
orchidectomy (inguinal approach)
62
1st Ix of frank haematuria, pt >50
CT urogram
63
1st Ix of frank haematuria, pt <50
USS
64
2nd Ix of frank haematuria
cystoscopy
65
Microscopic haematuria (+) and no symptoms - Ix?
no Ix
66
Microscopic haematuria (++) and no symptoms - Ix?
no Ix
67
Microscopic haematuria (++) and symptoms - Ix?
``` <50 = USS >50 = CT urogram ```
68
man with macroscopic haematuria + on on warfarin - what do u do?
Urgent referral to urology for Ix
69
woman aged 23 with microscopic haematuria in urine. check in 2w time and no haematuria. check again and haematuria. Ix?
cystoscopy
70
man with dark urine, muscle pain and difficulty getting out chair - Dx? Ix?
rhabdomyolysis | CK
71
alpha-1-adrenoceptors - role?
contraction of smooth muscle
72
alpha-2-adrenoceptors - role?
release of noradrenaline
73
man taking methotrexate but wants to conceive - how long should he wait after stopping Tx?
at least 6m
74
<65 y/o normal post-void volume
50ml
75
>65y/o post-void volume
100ml
76
Ix recurrent UTI
1. urine analysis 2. FVC 3. Flow + Scan 4. US KUB & post-void scan 5. cystoscopy (rule out bladder ca)
77
Ix hydronephrosis
USS
78
drugs causing erectile dysfunction
SSRIs | Beta blockers

Finals Studying - Condensed (22 decks)

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