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Urology extra Flashcards

(73 cards)

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1
Q

Gold standard bladder cancer investigation

A

Cystoscopy

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2
Q

Gold standard renal stone investigation

A

USS followed by Non-contrast CT KUB

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3
Q

What risks being damaged with carotid endarterectomy?

A

Ipsilateral hypoglossal nerve - supplies ipsilateral motor to the tongue therefore when pointing out tongue it will deviate towards the affected side

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4
Q

Monitoring of therapeutic efficacy of LMWH

A

No monitoring needed

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5
Q

Monitoring of therapeutic efficacy of unfractionated heparin

A

APTT

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6
Q

Most common hyperechoeic liver lesion on USS

A

Normal AFP - always likely to be hemangioma (tumours are also hyperechoeic but HCC will cause raised AFP)

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7
Q

Treatment of liver amoebic abscess

A

Metronidazole

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8
Q

Scan of liver amoebic abscess

A

Ill defined boundaries

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9
Q

Features of benign adrenal adenoma

A

Lipid core

Less than 3cm

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10
Q

What is Waterhouse- Friderichsen syndrome?

A

Adrenal gland failure due to bleeding into the adrenal glands, caused by severe bacterial infection - normally meningococcus

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11
Q

Which kidney stones are radiolucent

A

Xanthine and urate

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12
Q

What can happen with medical prostate cancer treatment

A

On starting goserelin can get initial flare up of prostate cancer symptoms causing by initial increase in LH production
This can be prevented with pre-treatment with flutamide - synthetic antiandrogen

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13
Q

What is Leriche syndrome

A

Triad of buttock + thigh claudication, erectile dysfunction, thigh muscle wasting
Caused by atheromatous disease of iliac vessels
Patients with CV risk factors
Treat with angioplasty and stents

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14
Q

What do raised fibrin degradation products imply

A

Disseminated intravascular coagulation

Especially if low platelets

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15
Q

Virus related to development of nasopharyngeal carcinoma

A

EBV

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16
Q

Management of kidney stone if infection

A

Percutaneous nephrostomy or ureteroscopy

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17
Q

Management of a kidney stone if smaller than 2cm

A

ESWL

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18
Q

Management of a small kidney stone if pregnant

A

Ureteroscopy

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19
Q

Management of a kidney stone if larger than 2cm

A

Percutaneous nephrolithotomy

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20
Q

How long before operation should antiplatelets be stopped

A

7 days

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21
Q

How do juvenile polyps present?

A

Haematomas
Rectal bleeding
Cherry red lesion on anal verge

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22
Q

Painful defecation and bright red anal bleeding in 4yr old boy

A

Anal fissure

Hx of constipation

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23
Q

Reed- Sternberg cells?

A

Hodgkins lymphoma

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24
Q

Abdo xray in hirschsprungs

A

Dilated bowel loops - air fluid levels

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25
X ray in necrotising enterocolitis
Air in bowel wall | Continuum of mesenteric ischaemia
26
Features of meconium ileus
newborn with abdominal distention and billous vomiting | xray shows dilated bowels and mottled ground glass appearance
27
Addisonian crisis features
Hyponatraemia Hyperkalaemia Hyperglycamia i
28
What are post-splenectomy patients at risk of
Encapsulated bacterial infection eg. pneumococcus and meningococcus therefore pneumovax every 5 years and 2weeks before surgery Should also be given influenza vaccination
29
Type of cancer underlying pagets disease
Ductal Carcinoma In Situ - 70% | Invasive carcinoma - 30%
30
What is needed to confirm diagnsois of achalasia
Manometry
31
What is needed in oesophageal cancer diagnosis
CT scan - staging | Endoluminal ultrasound - looking for signs of irreducibility such as invasion into the pericardium or pleura
32
Difference between type 1 and type 2 respiratory failre
Type 1 - low po2 + low/normal co2 | Type 2 - low po2 - high co2
33
Treatment of pseudomembranous colitis following antibiotics etc causing c-diff infection
Fluids +oral metronidazole for 10 days | If not treated then vancomycin
34
Signs of neurogenic shock
Bradycardia and profound hypotension
35
Metabolic features of pyloric stenosis
Hypochloraemic hypokalaemic metabolic alkalosis
36
Which is autoimmune PBC or PSC
Both PBC more in women - associated with RA and Sjogrens PSC more in men - associated with UC
37
What is Buerger disease
Vasculitis of medium-sized vessels - progressive obliteration of distal arteries in upper and lower limbs
38
Who is Buerger disease most common in?
Asians and Ashkenazi Jews Young men (under 45) who smoke heavily HLA-B12
39
Symptoms of Buerger disease
Pain | Can also get chronic inflammation, thrombosis, ulceration and gangrene
40
Arteriography in Buerger disease
Normal proximal vessels | Distal occlusions with multiple 'corkscrew' collaterals
41
Management of Buerger disease
Stopping smoking | Analgesia
42
What is gunstock deformity
Deformity resulting from mal-union of supracondylar fractures leading to a cubitus varus deformity
43
What is Chagas disease?
Parasitic disease of the tropics caused by protozoan Trypanosoma - has different stages of inection
44
Where is Chagas disease endemic?
Central america and south america
45
Acute stage symptoms of Chagas disease
Skin nodule - chagoma - at site of inoculation associated with non-specific symptoms eg. fever, malaise, anorexia and lymphadenopathy these resolve spontaneously
46
Second stage of Chagas disease
Occur after many years in 30% of patients Presenting complaint is dysphagia - destruction of myenteric plexus with subsequent disruption of peristalsis - leads to oesophageal dilatation Also dementia and cardiomyopathy
47
What is seen on imaging with second stage of Chagas disease
Megaoesophagus on Barium swallow
48
Treatment of Chagas disease
Anti-parasitic medication | Management of secondary manifestations
49
What is Rosving sign
Palpation in left iliac fossa with appendicitis causing pain in right iliac fossa
50
Why might you get headache with symptoms of acromegaly
SOL from pituitary tumour growing (GH secreting) | As well as standard symptoms from GH secretion
51
Symptoms of acromegaly
Excessive sweating, headaches, thick oily skin, hypertrophy of tissues Prognathism
52
What do you get increased risk of with acromegaly
Atheromatous disease and colon cancer
53
What is cholangiocarcinoma associated with
UC, PSC and lesser extent Crohns | will present with Courvoisiers law
54
What happens with Brown Sequard syndrome
Unilateral transection of spinal cord Ipsilateral motor loss (+ proprioception and vibration) Contralateral sensory loss for pain + temp
55
DDX for jaundice, hepatomegaly, ascites and malaise, with neuropsychiatric features in a 12 yr old boy
Wilsons - CAUSES JAUNDICE!
56
Gastrochisis vs exomphalos
Gastroschisis herniation of abdominal contents with no coverage Exomphalos lies in a sac with two membranes
57
What viruses is anal carcinoma associated with?
HPV 16, 18, 31 and 33
58
When is surgery indicated for infant umbilical hernia
If persist after 1st 2 years of life
59
Type of polyps in IBD
Pseudopolyps (pseudo because areas of swollen bowel mucosa)
60
What are false aneurysms
Collection of blood lying outside but communicating with vessel - does not include vessel wall Also called pseudoaneurysm Commonly occur after trauma or iatrogenic injury ie. angiography Will be pulsatile i.e if in groin
61
AFP tumour indicators for?
HCC and testicular tumours
62
First step in managing an open fracture
IV antibiotics and debridement of tissue
63
Features of discoid lupus
``` Cutaneous manifestations only Cheeks and other skin exposed areas Scalp leading to alopecia Palms and soles can be affected Avoid UV light exposure ```
64
What is seen on xray in posterior dislocation
Light bulb sign - abnormally rounded appearance of the humeral head Diagnosis confirmed on lateral view
65
What is acral lentiginous melanoma
Rare but 1/2 of melanomas in dark skinned people. Typically in 60s Found on hairless areas (palsm, soles, nails etc) May be mistaken for bruises
66
Most common type of malignant melanoma
Superficial spreading type
67
Most aggressive type of melanoma
Nodular melanoma - present as pigmented nodular lesion - grow rapidly
68
Features of lentigo maligna melanoma
Develop within an area of sun-damaged skin, progress over a period of years into malignant lesion
69
Do branchial cysts transilluminate?
No
70
Immediate treatment of acute closed angle glaucoma
Pilocarpine eye drops to constrict pupil an cause miosis
71
What is Tensilon test
Mysasthenia gravis test - edrophonium bromide - short-acting anti-cholinesterase
72
What is Milroy disease
Congenital primary lymphoedema - failure of lymph vessels to develop in utero Primary lymphoedema is called called lymphoedema praecox if presents over 35yrs and lympheodema tarda if after 35 years
73
Features of psoas abscess presentation
Non-specific Flank, abdo. hip and thigh pain Fever + limp Any action requiring movement and flexion of hip causes pain Treat with incision and drainage and IV antibiotics

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