Urology

Question 1

30 y/o M presents c/o testicular swelling and pain. PE shows unilateral scotal pain, erythema, and swelling. + Prehns signs. US shows increased testicular blood flow. Tx?

Answer 1

Rocephin and Doxy for epididymitis

Question 2

15 y/o M presents c/o lower abd pain radiating to left testicle onset 1 hour with worsening. Negative creamsteric reflex. Next best step?

Answer 2

Surgical consult

Question 3

What condition increases risk of testicuar cancer

Answer 3

Cryptochordism

Question 4

Pt presents with testicular nodule. PE shows no tenderness to palpation. Inital dx?

Answer 4

Testicular cancer

Question 5

Painless scrotal swelling that transilluminates on PE

Answer 5

Hydrocele

Question 6

MCcause of male infertility

Answer 6

varicocele

Question 7

Increased stesticular pain with valsalva and pt is upright. Improved when supine.

Answer 7

Varicocele

Question 8

Pt 32 weeks gestation presents for dysuria, increased frequency, and urgency. What abx can you use?

Answer 8

1. Amoxicillin
2. Macrobid
3. Keflex

Question 9

Is phimosis or paraphimosis an EC?

Answer 9

Paraphimosis- foreskin becomes trapped behind the corona of glans and cuts off blood supply

Question 10

Pt presents with fever, chills, increased frequency, incomplete emptying, and increased time to start urinary stream. and perineal pain. What should you avoid?

Answer 10

Avoid prostatic massage as you can introduced more bacteria

Question 11

Tx for acute prostatitis

Answer 11

1. Quinolones or Bactrim, but if less than 35 than rocephin plus doxy

Question 12

Which class of drugs reduces progression of BPH

Answer 12

5 alpha reductase inhibitors-ie Finasteride

Question 13

Risk factors for prostate cancer

Answer 13

1. genetics
2. diet
3. high fat diet

Question 14

MC type of bladder cancer

Answer 14

transitional cell

Question 15

MC modifiable risk factor for bladder cancer

Answer 15

Smoking

Question 16

Pt comes in c/o blood in urine. Denies any pain. What do you order?

Answer 16

Cystoscopy with biopsy

Question 17

Pt comes in c/o abd pain, hematuria, andmass on kidney. Labs show hypercalcemia. What do your order? Dx?

Answer 17

1. CT scan

2. Renal cell carcinoma

Question 18

Pt comes in c/o abd pain, hematuria, andmass on kidney. Labs show hypercalcemia. What do your order? Dx?

Answer 18

1. CT scan

2. Renal cell carcinoma

Question 19

What is the screening test of choice for nephrolithiasis

Answer 19

UA and CT

Question 20

Stones greater than what require surgical removal

Answer 20

7 mm

Question 21

Management of stones less than 5 mm

Answer 21

1. IVfluids
2. analgesic
3. antiemetics
4. Flomax

Question 22

Pt with hx of renal artery stenosis presents for evaluation. What circiumstances is angioplast with stent preferred?

Answer 22

1. increased Cr greater than 4
2. Increased Cr with ACEI
3. Greater than 80%stenosis
4. bilateral stenosis
5. one kidney

Question 23

Pt presents with hx of cryptochordism. What is he at increased risk for and what type

Answer 23

Testicular cancer -semimoma is mc and usually right sided

Question 24

Painless scrotal swelling differentials

Answer 24

1. Hydrocele

2. Testicular cancer

Question 25

Sudden left sided painful mass to the left testicle (Left sper,magic vein enters left renal vein at 90) worse with valsalva and improved with laying flat should make you consider what two correlations

Answer 25

Renal cell carcinoma in older patients with varicoceles