urology

Question 1

management of benign prostate hyperplasia

Answer 1

voiding symptoms: tamsulosin (Alpha blocker)
Prostatic enlargement: Finasterine (5 alpha reductase inhibitor
surgical TURP

Question 2

Testicular torsion: Definition

Answer 2

Twisting of the spermatic cord causing testicular ischaemia and necrosis

Question 3

Testicular torsion: Peak incidence

Answer 3

Males aged 13-15 years (range 10-30)

Question 4

Testicular torsion: Pain

Answer 4

Sudden onset, severe; may radiate to lower abdomen

Question 5

Testicular torsion: Associated symptoms

Answer 5

Nausea and vomiting may be present

Question 6

Testicular torsion: Examination findings

Answer 6

Swollen, tender, high-riding testis with reddened skin

Question 7

Testicular torsion: Cremasteric reflex

Answer 7

Absent

Question 8

Testicular torsion: Prehn’s sign

Answer 8

Elevation of testis does not relieve pain

Question 9

Testicular torsion: Management

Answer 9

Urgent surgical exploration

Question 10

Testicular torsion: Intraoperative step

Answer 10

Fix both testes (bilateral orchidopexy) due to risk of bilateral bell clapper deformity

Question 11

What was the traditional first-line investigation for suspected prostate cancer?

Answer 11

Transrectal ultrasound-guided (TRUS) biopsy.

Question 12

What is now the first-line investigation for suspected clinically localised prostate cancer?

Answer 12

Multiparametric MRI.

Question 13

How are multiparametric MRI results reported?

Answer 13

Using a 5-point Likert scale.

Question 14

What is the next step if the MRI Likert score is ≥3?

Answer 14

Offer a multiparametric MRI-influenced prostate biopsy.

Question 15

What is recommended if the MRI Likert score is 1–2?

Answer 15

Discuss the pros and cons of having a biopsy with the patient.

Question 16

Name 4 complications of TRUS biopsy.

Answer 16

Sepsis, pain, fever, haematuria/rectal bleeding.

Question 17

What is the risk of sepsis after TRUS biopsy?

Answer 17

Around 1%.

Question 18

How long does pain persist in 15% of TRUS biopsy patients?

Answer 18

≥2 weeks.

Question 19

What percentage of patients develop fever after TRUS biopsy?

Answer 19

5%

Question 20

Treatment of stress incontinence

Answer 20

Pelvic floor muscle training
Surgery
Duloxetine

Question 21

Treatment of urgency incontinence

Answer 21

Bladder training minimum 6 weeks
Antimuscarinics: oxybutynin, tolterodine, darifenacin
Mirabegron alternative is antimuscarinics contraindicated

Question 22

Testicular cancer high beta hcg with normal afp

Answer 22

Seminomas

Question 23

Cannon ball mets of cxr think

Answer 23

Rcc

Question 24

Penile ulcer and hpv history think

Answer 24

Access of penins

Question 25

Management of epidydimalorchitis

Answer 25

Young less than 35 ceftriaxone and doxycycline Greater than 35 ofloxacin or levofloxacin