MSRA > Urology > Flashcards

Urology Flashcards

(65 cards)

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1
Q

catheter choice if associated pelvic fracture

A

suprapubic catheter

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2
Q

Most common cause of scrotal swellings in primary care

A

epididymal cyst

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3
Q

features of epididymal cyst

A

separate from body of testicle
posterior to testicle

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4
Q

3 associated conditions epididymal cyst

A

PKD
CF
Von Hippel Lindau

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5
Q

How to confirm diagnosis of epididymal cyst

A

USS

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6
Q

2 types of hydrocoele

A

communicating and non-communicating

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7
Q

communicating hydrocoele

A

patency of processus vaginalis

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8
Q

What group are communicating hydrocoeles common in?

A

newborn males

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9
Q

Timeline of communicating hydrocoele in newborn

A

resolve in a few months usually

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10
Q

non-communicating hydrocoele

A

excess fluid production within tunica vaginalis

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11
Q

What may hydrocoeles develop secondary to?

A

epididymo-orchitis
testicular torsion
testicular tumour

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12
Q

features of hydrocoele

A

soft, non-tender
anterior and below testicle
can get above mass
trasillumonates

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13
Q

When are hydrocoeles in infants repaired?

A

do not resolve by 1-2yrs

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14
Q

hydrocoele in adults management

A

conservative
get USS to exclude underlying tumour

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15
Q

What side are varicocoeles more common on?

A

left

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16
Q

diagnosis of varicocoele

A

USS with doppler studies

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17
Q

treatment obstructive urinary calculi

A

IV antibiotics and urgent renal decompression

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18
Q

medication for renal colic

A

NSAID - im diclofenac
IV paracetamol
alpha blocker

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19
Q

Initial investigations renal stones

A

Urine dip and culture
Bloods - Cr and U+E, calcium, urate
stone analysis

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20
Q

Imaging renal stones - first line

A

non contrast CTKUB

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21
Q

Who to use USS for in suspected renal stones

A

children and pregnant women

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22
Q

Simplified management renal stones

A

<5mm +asymptomatic = watch and wait
5-10mm = shockwave lithotripsy
10-20mm = SWL or ureteroscopy
>20mm = percutaneous nephrolithotomy

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23
Q

managing ureteric stones

A

shockwave lithotripsy and alpha blockers <10mm
10-20mm ureteroscopy

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24
Q

preventing calcium renal stones

A

high fluid intake
avoid carbonated drink
limit salt
thiazide diuretic

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25
empirical treatment epididymoorchitis
im ceftriaxone and doxy
26
organisms Epididymo-orchitis
Chlamydia trachomatis and Neisseria gonorrhoeae or E coli
27
Features Epididymo-orchitis
unilateral testicular pain and swelling urethral discharge
28
Epididymo-orchitis most important differential
testicular torsion
29
enteric organism causing Epididymo-orchitis and treatment ie low STI risk
Ecoli and ofloxacin for 14 days
30
type of cancer - penile
SCC
31
features penile cancer
penile lump penile ulceration
32
Risk factors penile cancer
HIV or HPV genital warts, phimosis, balantitis, age >50
33
hypercalciuria and renal stones - medication to decrease stones
thiazide like diuretic
34
Risk factors BPH
Age ethnicity black>white>asian
35
BPH symptoms
Storage - urgency, frequency, nocturia voiding - hesitancy, terminal dribbling, straining, weak flow complication - retention, UTI
36
Assessing BPH
urine dip U+Es, PSA urine frequency volume chart IPSS
37
IPSS - what is it for
severity of LUTS
38
Managing BPH
tamsulosin finasteride antimuscarinic TURP
39
First line BPH
alpha blocker
40
Side effects tamsulosin
dizziness, postural hypotension, dry mouth
41
What should testicular torsion surgery involve?
fixation of both testicles
42
What is testicular torsion?
twist of spermatic cord resulting in testicular ischaemia and necrosis
43
age - testicular torsion
10-30 usually peak 13-15
44
features testicular torsion
severe and sudden onset pain lower abdo pain N+V swollen, tender testis no cremasteric reflex
45
Why are both testicles fixed in testicular torsion surgery?
bell clapper deformity usually bilateral
46
What may raise PSA?
BPH prostatitis and UTI ejaculation vigorous exercise urinary retention
47
95% of testicular cancers are...
germ cell tumours
48
germ cell testicular tumours
seminomas non seminomas
49
Risk factors testicular ca
infertility cryptorchidism FH klinefelters mumps orchitis
50
Presenting symptom testicular ca
painless lump hydrocoele gynaecomastia
51
seminoma and non-seminoma testicular tumour markers
seminoma - hcg non seminoma - AFP
52
first line investigation suspected prostate ca
multiparametric MRI
53
How long does finasteride take to be effective for BPH?
up to 6 months
54
what is priapism?
erection lasting longer than 4 hours
55
2 types of priapism
ischaemic and non-ischaemic
56
causes of ischaemic and non ischaemic priapism
ischaemic - impaired vasorelaxation, trap deoxygenated blood non ischaemic = high arterial flow eg fistula
57
causes priapism
sickle cell idiopathic sildenafil cocaine, ecstacy trauma
58
Investigations priapism
cavernosal blood gas analysis doppler USS FBC, toxicology
59
cavernosal blood gas analysis in ischaemic priapism
PO2 and PH low, PCO2 increased
60
Managing priapism
aspiration of blood from cavernosa inject phenylephrine surgery non ischaemic = observe
61
Timings of PSA after certain procedures/activities
prostate biopsy 6wks UTI 4wks DRE 1 week exercise and ejaculation 48hrs
62
What medication in BPH with predominant storage symptoms?
anti-muscarinic
63
Which has the better prognosis - seminoma or teratoma?
seminoma (germ cell tumours)
64
Risk factor TCC bladder
smoking aniline dyes rubber manufacturer cyclophosphamide
65
Risk factors SCC bladder
schistosomiasis smoking
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