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MBBS - Year 3 > Urology - LUTs, Scrotum and Genitalia > Flashcards

Urology - LUTs, Scrotum and Genitalia Flashcards

1
Q

how common is prostate cancer

A

very
most common cancer in men 50+ peak at 65-70

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2
Q

what is the function of the prostate

A

produces 30% ejaculate volume

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3
Q

what is PSA

A

prostate specific antigen

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4
Q

what are key risk factors for prostate cancer

A

age
FHx
genetics
ethnicity - afrocarribean
diet - sat fat and dairy

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5
Q

how does localised prostate cancer present

A

PSA, incidental symptoms

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6
Q

how does locally advanced prostate cancer present

A

bleeding, local pain, priapism, rectal obstruction

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7
Q

how does metastatic prostate cancer present

A

fracture, leg swelling, DVT, pain, weight loss, cord compression

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8
Q

diagnosis of prostate cancer

A

history
DRE
PSA
biopsy

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9
Q

what does a normal prostate feel

A

small, smooth, rubbery

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10
Q

how does an abnormal prostate feel

A

asymetrical, craggy, noduler

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11
Q

what 2 things should the person avoid before PSA

A

no sex
no bike riding

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12
Q

what system is used to grade prostate cancer

A

gleason score

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13
Q

what is the staing of prostate cancer

A
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14
Q

what is the scoring of low, intermediate and high risk prostate cancer

A

Low risk
PSA < 10 ng/ml
Gleason 6
Clinical stage T1c-T2a
Active surveillance may be appropriate treatment option

Intermediate risk
PSA 10-20 ng/ml
Gleason 7-8
cT2b

High risk
PSA > 20 ng/ml
Gleason 9-10
>cT2c

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15
Q

what is treatment for localised prostate cancer

A

surgery - to remove it - radical resections
watch and wait

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16
Q

what are other treatment methods for prostate cancer

A

radical radiotherapy
Cryotherapy
High intensity ultrasound
Brachytherapy – less good

17
Q

list drugs that improve survival of metastatic prostate cancer

A

Docetaxel
Cabazitaxel
Abiraterone
Enzalutamide
Sipuleucel-T
Alpharadin

18
Q

what is the bladder made of

A

detrusor muscles

19
Q

where does spinal cord finish

A

L2 (Below this is corda equina)

20
Q

what are the 2 parts of the autonomic nervous system

A

sympathetic T10-L2
parasympathetic S2-S4

21
Q

where in the brain does realisation of need to pee happen

A

cerebral cortex - doesnt really work before potty trained

22
Q

what does parasympathetic nerves causes

A

detrusor contraction
relaxation of outflow tracs

23
Q

what does sympathetic nerves cause

A

relaxation of detrusor contraction
contraction of outflow traks

24
Q

why do you pee yourself when scare

A

sympathetic - fight or flight (storage)
lymbic system can turn messages to cortex off - back to prepotty training

25
Q

What can go wrong with The Detrusor Muscle if the neurology is disrupted?

A

DETRUSOR CONTRACTS TOO MUCH
Failure of Detrusor to store at low pressure
Sustained high pressure throughout filling – POOR COMPLIANCE
Phasic rise in detrusor pressure – DETRUSOR OVERACTIVITY; Neurogenic vs. Idiopathic
Leakage, high pressure transmitted to upper tracts

DETRUSOR DOESN’T CONTRACT ENOUGH
Failure of Detrusor to contract during emptying
Incomplete emptying
Urinary Retention
LUTS, UTI’s, high pressure retention

26
Q

What can go wrong with urethral sphincter mechanism if the neurology is disrupted?

A

DOESN’T CONTRACT ENOUGH
Failure / inadequate contraction during storage phase
Leakage – STRESS URINARY INCONTINENCE

SPHINCTER DOESN’T RELAX
Failure of sphincter to relax adequately/ in a co-ordinated fashion during emptying phase
Detrusor contracts against a closed sphincter – CONTRACTS AT WRONG TIME
DETRUSOR-SPHINCTER-DYSSYNERGIA
Incomplete emptying (inefficient), high pressure transmitted to upper tracts

27
Q

what causes inflammtion and stiff bladder

A

ketamine
radiotherapy
surgery and scar tissue

28
Q

what nerve sensation for urology

A

S4

29
Q

ureteric colic how do you image - good osce Q

A

USS - cheap, harmless - see if theres a stone ureter if blocking)
x ray - lower dose - radioopaque calcium stones

30
Q
A

MBBS - Year 3 (13 decks)

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