Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3b/4 > Urology > Flashcards

Urology Flashcards

1
Q

weight of a healthy prostate?

A

20grams

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

where is the prostate located anatomically?

A

Inferior to the bladder neck

anterior to the rectum

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

what is the arterial supply of the prostate?

A

internal iliac artery -> inferior vesical artery -> prostatic arteries -> urethral and capsular arteries

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

venous drainage of the prostate?

A

prostatic plexus near dorsal vein -> internal iliac vein-> IVC

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

lymphatic drainage of the prostate?

A

obturator and internal iliac channels

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

which part of the prostate is the origin for most prostate cancers?

A

peripheral zone of prostate

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

which part of the prostate is responsible for BPH?

A

transitional zone of prostate

where increased number of cells in BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the physiological function of the prostate?

A

to make seminal fluid to aid sperm passage

prevents retrograde ejaculation by acting like a sphincter

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

what are the properties of seminal fluid that aid it in assisting passage of sperm?

A

alkaline
contains fructose
prostaglandins
clotting factors

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

LUTS symptoms refer to symptoms caused by pathology from which part of the urethral tract?

A

from the bladder down

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

what are the 2 categories of LUTS symptoms?

A

storage

voiding

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

what are the storage symptoms of LUTS?

A

Frequency
Urgency
Nocturia

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

What are the voiding symptoms of LUTS?

A

Weak stream
Intermittency
Straining
Emptying incompleteness

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

BPH red flags/other sx:

A 
bone pain
weight loss
haematuria 
infection 
incontinence 
pain 
sexual dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why is family history important when suspected BPH?

A

BRCA gene linked

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

3 times when you wouldn’t do a DRE:

A

no consent
,<16yo
neutropenic sepsis

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

what is the difference between hyperplasia and hypertrophic?

A

hyperplasia - increased number of cells - increased size of tissue
hypertrophic - increased size of cells

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

definition of BPH:

A

histological diagnosis reflecting:

  • hyperplasia/hypertrophia
  • bladder outlet obstruction
  • LUTS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

aetiology of BPH:

A

age-related hormone changes
hyperplasia of transitional zone cells
vascular/inflammatory event
metabolic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pathophysiology of BPH:

A

mechanical fault or smooth muscle pathology -> detrusor overactivity (bladder smooth muscle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which category of LUTS is commoner?

A

voiding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the complications of BPH?

A

persistent UTIs
incontinence
urinary retention

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

what investigations would you do for BPH:

A

bloods - glucose, HbA1c, PSA
urinalysis
?USS
special tests

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

what special tests would you do to ix BPH?

A 
flow studies
frequency-volume chart
IPSS score - sx, QOL score -> mild/mod/sev
cystoscopy 
Urodynamics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

management options for BPH:

A

conservative
medical
surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the conservative mx for BPH:

A 
fluid intake manipulation 
caffeine reduction and other trigger reduction 
bladder training
tx constipation 
meds rec (diuretics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the 3 main medication classes for BPH?

A
  1. alpha 1 blockers (Tamsulosin)
  2. 5a-reductase inhibitors (Finasteride)
  3. Anticholinergics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some sfx of tamsulosin (2):

A

orthostatic hypotension

retrograde ejaculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the benefit of using tamsulosin to tx BPH?

A

works fast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are some sfx of Finasteride?

A

mood
sex dysfunction
gynaecomastia
tx for hairloss!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

mechanism of action of finasteride?

A

prevents the conversion of testosterone to dihydrotestosterone (DHT) so less serum DHT
less proliferation of prostate
less mechanical pinching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are the benefits of using finasteride to treat BPH?

A

halves PSA

30% reduction if prostate size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how long does finasteride take to work fully

A

6/12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

name some surgical options for BPH?

A 
TURP 
Urolift
Steam treatment 
Holep laser / green light laser 
open prostatectomy
prostatic artery embolisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is TUR syndrome and what causes it?

A 
absorption of glycine in too high a concentration 
triad:
-hyponatraemia
-fluid overload
-glycine toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are the symptoms of TUR syndrome?

A

CNS - blindness, confusion, coning
Heart - arrhythmias, SOB, pain
Abdo - n/v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what type of cancer are most prostate cancers?

A

adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

which races are at higher risk for prostate cancer?

A

black>white>asian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the risk factors for prostate cancer?

A

congen- fhx, age, race

acquired - metabolic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

signs and sx of prostate cancer?

A 
asx
non-spec ca sx
bone/back pain 
LUTS
haematuria 
incidental finding from TURP for BPH
abnormal DRE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how does prostate feel on DRE in BPH?

A

smooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

how does prostate feel on DRE in prostate cancer?

A

hard, craggy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is PSA?

A

prostate specific antigen

protein made by prostate epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what are normal PSA levels for different ages?

A

50-60 - <3ng/ml blood
60-70 - <4ng/ml blood
70-80 - <5ng/ml blood
80+ - no limit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

if PSA > 50, what does this usually indicate?

A

usually prostate cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

is PSA > 100, what does this usually indicate?

A

metastatic prostate cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

is PSA used to screen for prostate cancer?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how many PSA’s are needed to confirm suspicion and prompt further tests?

A

2 separate high PSA scores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what imaging is done to ix prostate cancer?

A
  • MP-MRI - look for high grade prostate cancer, measure size of prostate
  • CT abdo/pelvis
    NM bone scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

special tests done to ix prostate cancer? (and methods of doing this)

A

prostate biopsy - transrectal v transperineal**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are the benefits of doing a transperineal prostate biopsy?

A

fewer risks and increased accuracy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what does staging of prostate cancer tell us?

A

how far ca spread from origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what staging system is used for prostate cancer?

A

TNM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what does grading tell us about prostate cancer?

A

how well differentiated cells are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what score indicates the grading?

A

Gleason score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what 3 features make up the risk stratification of prostate cancer?

A

Gleason score
initial PSA
T score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

general management of prostate cancer?

A

mdt
specialist nurse
lower RFs
ca support groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are the 4 treatment options for prostate cancer?

A

watchful wait
active surveillance
surgery
medicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what is the difference between watchful wait and active surveillance?

A

watchful wait - defer further tx til metastasis or PSA increase - palliative
active surveillance - chance to cure active disease - watched more regularly like a hawk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what are the surgical options for prostate cancer and what are the indication for doing ?

A
  1. RALP (robot assisted Laproscopic Prostatectomy) - da vinci machine
    radical (T3+)
  2. RT +/- brachytherapy. oncologists
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

during a RALP, what anastamosis is formed?

A

bladder neck - urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

side effects of RALP?

A 
infertility 
erectile dysfunction 
incontinence 
bleeding
infection 
catheter
conversion to open 
leaking anastamosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what is the name of the type of drug used to treat prostate cancer - who gets this?

A

Androgen Deprivation Therapy (ADT)

If metastatic, with oncology input

64
Q

how does ADT work?

A

fast acting anti-androgen given on day 1 (acts on testes to decrease testosterone)
slower acting LHRH analogue/antagonist (acts on hypothalamus)

65
Q

what types of anti-androgen drugs are there (give commonest eg)

A

steroidal

non-steroidal (bicalutamide)

66
Q

ADT side effects?

A

manopause

gynaecomastia, loss libido, OP, fatigue, erectile dysfunction. flushes, metabolic syndrome

67
Q

what other prostate cancer treatments are there?

A

RT to bone lesions
chemo
trials - atlanta

68
Q

67yom ED with PSA 150, incontinence, leg weakness - dx

A

SC compression from metastasis

leading to corda equina syndrome (plus saddle anaethesia) URGENT

69
Q

what is investigation for ?corda equina syndrome in prostate cancer?

A

MRI whole spine

70
Q

what is the treatment of corda equina syndrome?

A

high dose steroids
ADT to decrease prostate cancer size - degarelix - fast acting
onc/surg input

71
Q

Prostate cancer emergencies:

A

SC compression
ureteric compression
#
retention

72
Q

66-M go to the toilet more often than usual and that he can not control the desire to urinate. Bathroom 4 times in the night to urinate. Otherwise fit and well. Normal sized prostate. Which ix would be most appropriate to demonstrate the aetiology of this gentlemen’s problem?

A

urodynamic studies

for voiding problems

73
Q

38-M 3 month history of scrotal swelling and discomfort. Unilateral swelling in the left scrotum which transilluminates. The swelling is soft and non-tender. Due to the presence of fluid, the testis is not fully palpable. Most appropriate next course of action?

A

urgent uss testes

in hydrocele could be tumour

74
Q

60-M BPH lower abdominal pain and inability to urinate. After inserting a catheter, >2L of clear urine drained, with immediate relief of the pain.
Three hours later you are asked to review the patient as his urine is now a pale pink colour. The patient feels well in himself, and his observations are stable.
What is the most appropriate management?

A

no mx - obs are stable

decompression haematuria caused this

75
Q

20M severe pain and swelling of the scrotum after a cystoscopy. He had mumps as a child. The testis is tender. The urine dipstick is positive for leucocytes. dx?

A

epididymo-orchitis

76
Q

20-M severe pain in the right scrotal area after jumping onto his moped. He has also noticed discomfort in this area over the past few months. Swollen, painful testis that is drawn up into the groin. dx?

A

torsion

ass with retracted testes

77
Q

8M scrotal swelling. He has just recovered from an acute viral illness with swelling of the parotid glands. On examination both testes are tender and slightly swollen. dx?

A

orchitis

78
Q

44-F 32/40, nephrology consultant ?renal stones. PMH HTN. IHD. CT-KUB report shows a renal stone, 1.5cm in size. mx?

A

ureteroscopy

79
Q

stone burden of less than 2cm, the preferred definitive option of management would be:

A

lithotripsy

80
Q

Complex renal calculi and staghorn calculi mx:

A

percutaneous nephrolithotomy

81
Q

ureteric calculi <5mm mx?

A

expectant mx

82
Q

69M haematuria. He worked in the textile industry. He has a left flank mass. CT IVU shows a lesion of the left renal pelvis.
dx?

A

renal transitional cell ca

83
Q

2M right renal mass. Irregular mass arising from the right flank and is hypertensive. A CT scan shows a non calcified irregular lesion affecting the apex of the right kidney and the right adrenal gland. dx?

A

nephroblastoma

84
Q

35M haematuria. He is found to have bilateral masses in the flanks. He has a history of epilepsy and learning disability. dx?

A

angiomyelipoma

tuberous sclerosis

85
Q

What is the most common organic cause of erectile dysfunction in otherwqise fit male?

A

vascular causes

86
Q

drugs that cause Erectile dysfunction?

A

alcohol,
BBs
SSRIs

87
Q

35M ED->12 hour history of abdominal pain. The pain is on his right side and he feels it shooting from the side of his abdomen down into his groin. Urine dipstick is positive for blood and leucocytes. He asks for pain relief. What would be the most appropriate analgesic given the likely diagnosis?

A

IM diclofenac

nsaids

88
Q

67-M-> GP urine does not flow as well as it used to. He does not report any strong urges to urinate and no nocturia. Some post-terminal dribbling and feels he does not empty his bladder fully. He is troubled by these symptoms as this has never happened before.
PMH heart failure and smokes 10 cigarettes a day.
On digital rectal examination, his prostate feels hard and irregular. serum prostate-specific antigen 2.0 ng/ml. Managed?

A

urgent 2ww referral

regardless of PSA score - DRE findings like that need further ix in secondary care

89
Q

Gynaecomastia may be a presenting feature of?

A

testicular ca

90
Q

33M -> ED suspected renal colic. He has a ultrasound that shows a probable stone in the left ureter. What is the most appropriate next step with respect to imaging?

A

Non-contrast CT KUB

91
Q

Epididymo-orchitis in individuals with a low STI risk (e.g. married male in 50s, wife only partner) is likely due to?

A

e coli

92
Q

A 72-year-old man is diagnosed with prostate cancer and goserelin (Zoladex) is prescribed. Which one of the following is it most important to co-prescribe for the first three weeks of treatment?

A

cyproterone acetate

decreases risk of tumour flare

93
Q

A 67-year-old man presents with painless frank haematuria. He recently began complaining of a mild testicular ache and describes his scrotum as a ‘bag of worms’. He is a heavy smoker smoking 60 cigarettes a day for 47 years. On examination he is cachectic. His left testicle appears to have a tortuous texture. His blood reveals anaemia and polycythemia. dx?

A

rcc left kidney

94
Q

commnenest rcc subtype?

A

clear cell

95
Q

A 56-year-old man presents with lethargy, haematuria and haemoptysis. On examination he is hypertensive and has a right loin mass. A CT scan shows a lesion affecting the upper pole of the right kidney, it has a small cystic centre. dx?

A

renal adenocarcinoma

commonest type. cannonball mets -> haemoptysis

96
Q

cx of radical prostatectomy?

A

incontinence

ED

97
Q

62-M 4/12 hx worsening LUTS and nocturnal enuresis. Painless distended bladder. DRE: smoothly enlarged prostate. Bladder scan shows 1.2L residual. US KUB shows bilateral hydronephrosis.
UE normal except: Creatinine 290 µmol/L(55 - 120)
diagnosis?

A

chronic high pressure urinary retention

If renal function impaired or hydronephrosis present

98
Q

What is the mechanism of action of tamsulosin?

A

alpha-1 antagonist

99
Q

what is a contraindication to circumcision in infancy?

A

hypospadias

as the foreskin used in the repair

100
Q

two most common reasons why children in the UK have medical circumcisions?

A

phimosis
balantis xerotica obliterans (can also cause phimosis, SCC)
recurrent balantitis also

101
Q

first-line investigation in suspected prostate cancer?

A

multiparametric MRI

102
Q

mx torsion?

A

surgical fixation of both testes emergent

other one at risk too following first one

103
Q

A 23-year-old male is admitted with left sided loin pain and fever. His investigations demonstrate a left sided ureteric calculi that measures 0.7cm in diameter and associated hydronephrosis. mx?

A

percutaneous nephrostomy

broad spectrum abx

104
Q

A 23-year-old man is admitted with left sided loin pain that radiates to his groin. His investigations demonstrate a 1cm left sided ureteric calculus with no associated hydronephrosis. mx?

A

extra corporeal shock wave lithotripsy

105
Q

Stag-horn calculi are composed of?

A

struviate and form in alkaline urine (ammonia producing bacteria predispose) - proteus mirabilis

106
Q

66 M undergone TURP. The operation notes describe using 1.5% glycine as the irrigation fluid. A prolonged operative time (1 hour 30 minutes) occurred due to the size of the resection required to optimise flow from the gland. The patient has now become agitated, confused and developed worsening of his breathlessness. You conduct a venous blood gas which demonstrates the patient to be hyponatraemic (118mmol/l). dx?

A

turp syndrome

107
Q

Complications of Transurethral Resection: TURP

A

T ur syndrome
U rethral stricture/UTI
R etrograde ejaculation
P erforation of the prostate

108
Q

acute upper urinary tract stone mx?

A

nephrostomy

109
Q

better prognosis for testicular ca - teratoma or seminoma?

A

seminoma

110
Q

A 6-year-old boy presents to the emergency department with his father with a persistent painful penile erection lasting 5 hours. According to his father, the boy has a history of sickle cell disease.
Which initial action is most appropriate?

A

Cavernosal blood gas analysis is a useful investigation for priapism

111
Q

55M oil rig worker ->ED with new frank haematuria. Passing blood and clots when urinating for 2/7. He has no dysuria or abdominal pain. He is apyrexial, hr 83, bp 132/84. Abdomen is soft and he has no abdominal tenderness and no palpable masses in the abdomen or renal angles. 25 pack-year history. appropriate in the first instance to investigate the cause of his haematuria?

A

felxible cystoscopy

bladder ca r/o

112
Q

how long before vasectomy is an effective contraception?

A

until clear semen analysis
male more effective than female sterilisation
chr pain seen in >5%

113
Q

26-M->ED with general malaise and pain in his perineum and scrotum. 2/7. Increased urinary frequency and some burning pain on passing urine. HR75, RR16, BP118/80, t37.6ºC. On DRE prostate is tender and there is boggy enlargement.
What is an appropriate investigation?

A

STI screening
in young male with acute prostatitis

ecoli commonest overall cause just not in young male

114
Q

Patients with chronic urinary retention should be managed?

A

intermittent self catheterisation first

then long term catheter

115
Q

Scrotal swelling you can’t get above:

A

inguinoscrotal hernia

116
Q

low grade prostate ca mx:

A

watchful wait

117
Q

What is the most common type of renal stone?

A

calcium oxalate

118
Q

haematuria and ballotable mass and renal angle tenderness are more in keeping with ?

A

a renal cell carcinoma than a bladder tumour.

119
Q

what might give false high PSA?

A

ejaculation (ideally not in the previous 48 hours)
vigorous exercise (ideally not in the previous 48 hours
prostatitis (wait a month)
DRE (wait 1 week)
UTI (4 weeks)
6 weeks - prostate biopsy

120
Q

A 43-year-old man is admitted with severe, episodic pain in his right loin region. Urine dipstick is positive for blood and a KUB x-ray shows a probable stone in the ureter. He is given intramuscular diclofenac for pain relief. Which one of the following types of medication may also be beneficial in this scenario?

A

alpha adrenergic blocker

also ccb

121
Q

Periureteric fat stranding may indicate?

A

recent ureteric stone passage

122
Q

78M unable to pass urine for the last 5 hours. He is extremely uncomfortable. You insert a catheter, which drains 1 litre of urine. Feels much better. PR exam: enlarged, hard nodular prostate. Urology Registrar recommends to admit + observe for 24 hours; he warns that following an episode of acute urinary retention a complication may occur. Which test is most important to (re)check in the next 12 hours to help identify such a complication?

A

serum creatinine
AKI
always do U+Es after catheter for retention

123
Q

Rhabdomyolysis can cause AKI due to???

A

acute tubular necrosis

124
Q

tumour maker for testicular cancer?

A

HCG

125
Q

An 28-year-old man presents with pain in the testis and scrotum. It began 10 hours previously and has worsened during that time. On examination he is pyrexial, the testis is swollen and tender and there is an associated hydrocele. dx?

A

acute infective epididymo-orchitis

126
Q

A 15-year-old boy develops sudden onset of pain in the left hemiscrotum. He has no other urinary symptoms. On examination the superior pole of the testis is tender and the cremasteric reflex is particularly marked. dx?

A

torsion of testicular appendage

127
Q

A 14-year-old boy develops sudden onset severe pain in the left testicle radiating to the left groin. He is distressed and vomits. On examination the testis is very tender and the cremasteric reflex is absent.
dx?

A

torsion of spermatic cord

128
Q

most effective management option in renal cell carcinoma - >?

A

radical nephrectomy

rcc usually resistant to chemo and radio

129
Q

risk factors for testicular ca?

A 
infertility
cryptorchidism
family history
Klinefelter's syndrome
mumps orchitis
130
Q

any man presenting with erectile dysfunction - ix?

A

testosterone level

if abnormal -> FSH, LH, prolactin along with repeat testosterone ix

131
Q

22M RTA. Pelvic fracture. While on the ward the nursing staff report that he is complaining of lower abdominal pain. On examination you find a distended tender bladder. What is the best management?

A

suprapubic catheter

132
Q

which testicular pathology associated with infertility?

A

variciocele

133
Q

radiotherapy for prostate cancer increases risk of?

A

bladder, colorectal ca

134
Q

Acute epididymo-orchitis is most commonly caused by ?

A

chlamydia <35

ecoli >35

135
Q

bladder ca (TCC) associated with which occupational hazard?

A

aniline dye - textile, rubber

136
Q

granular, muddy-brown urinary casts??

A

acute tubular necrosis

137
Q

hydrocele in infants - mx?

A

likely resolve by 1yr old - reassure

communicating ones >3% newborns

138
Q

prostatitis mx?

A

14-day course of ciprofloxacin 500mg BD

139
Q

Having a normal libido is suggestive of ?

A

organic cause of ED

140
Q

A 32-year-old male presents to the GP with a painless lump in his testicle. On examination, it is possible to get above the lump, the testicle does not transilluminate and is found on the posterior side of the testicle and is separate from the body of the testicle. dx?

A

epididymal cyst

cyst is separate from the body of the testicle and typically found posterior to the testicle.

141
Q

A 50-year-old woman presents with a dragging sensation that she feels comes from the lump in her groin. On examination, there is a palpable lump in the groin that is below and lateral to the pubic tubercle. It is not possible to get above it and it has a cough impulse.
dx?

A

femoral hernia

commonly in females. On examination, it is not possible to get above a palpable lump

142
Q

A 40-year-old male presents to the GP complaining of a painless lump in his groin. On examination, the lump is medial and superior to the pubic tubercle. The size of the lump is approximately 3cm and it is smooth and mobile. There is no cough impulse. dx?

A

lipoma

143
Q

A 22-year-old man attends an appointment with his general practitioner. He has noticed a non-tender lump in his scrotum. He is concerned that he is developing bilateral breast enlargement. ix?

A

USS testicle - ca?

144
Q

mild varicocele mx?

A

reassure and observe

80% left sided

145
Q

A 56-year-old man is involved in a road traffic accident. He is found to have a pelvic fracture. He reports that he has some lower abdominal pain. He has peritonism in the lower abdomen. The nursing staff report that he has not passed any urine. A CT scan shows evidence of free fluid. dx?

A

bladder rupture

pelvic fracture and lower abdominal peritonism should raise suspicion

146
Q

A 52-year-old man falls off his bike. He is found to have a pelvic fracture. On examination he is found to have perineal oedema and on PR the prostate is not palpable. A urine dipstick shows blood. dx?

A

membranous urethral rupture

147
Q

A 46-year-old African gentleman presents with painless haematuria. Whilst taking a urological history he mentions that he has had Schisotosoma haematobium infection in the past. What malignancy is he at increased risk of developing as a result?

A

squamous cell ca bladder

148
Q

Patients with obstructive urinary calculi and signs of infection require?

A

urgent iv abx and renal decompression (nephrostomy)

149
Q

A 56-year-old man is admitted with acute retention of urine. He has had a recent urinary tract infection. An USS shows bilateral hydronephrosis. What is the best course of action?

A

urethral catheter

retention often caused by UTI

150
Q

von hippel-lindau =

A

cysts

151
Q

which testicular ca can have normal markers?

A

seminomas

152
Q

A 22-year-old man is involved in a road traffic accident. He is found to have a pelvic fracture. While on the ward the nursing staff report that he is complaining of lower abdominal pain. On examination you find a distended tender bladder. What is the most likely diagnosis?

A

urethral injury

153
Q

A 31-year-old man presents as he and his partner have been having problems conceiving. On examination there is a diffuse lumpy swelling on the left side of his scrotum. This is not painful and the testicle, which can be felt separately, is normal. dx?

A

varicocele

154
Q

best ix for hydronephrosis

A

USS

155
Q

A 65-year-old man presents with lower urinary tract symptoms. For the past few months, he has had problems with urinary urgency and has had several episodes of incontinence when he could not reach the toilet in time. He describes good urinary flow with no hesitancy or straining. Urinalysis and prostate examination are unremarkable. mx?

A

antimuscarinics

overactive bladder

156
Q

Renal stones on x-ray:

A

cystine - semi-opaque

urate and xanthine stones - radio-lucent

157
Q

Following neobladder reconstruction, patients are at increased risk of?

A

adenocarcinoma

3b/4 (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions