Urology

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Author:
mewinstanley@googlemail.com
ID:
260996
Filename:
Urology
Updated:
2014-02-09 09:08:22
Tags:
Urology
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Description:
All the penis you want for finals. All the penis!
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  1. Give 4 CF of Ureteric stones?
    • Incidental on XR
    • Loin - groin pain [Ureteric/Renal Colic]
    • Painful passage of stones via urethra
    • Cystitis
    • Pyelonephritis
    • Haematuria
  2. Give 3 risk factors for Ureteric stones?
    • Urinary stasis
    • Chronic UTI -> Proteus
    • Foreign body -> Catheter
    • Fragments of diseased tissue
    • ^^PTH
  3. Mx of ureteric stones?
    Conservative

    Surgical

    Extraction -> cystoscopically, open pyelolithotomy, percutaneous nephrostomy

    Lithotripsy
  4. For renal cell carcinoma give;
    -3CF
    -2 RF
    -Mx
    Pc -> Haematuria, mass, flank pain

    RF -> smoking, HTN, obese, LT NSAIDs

    Mx = nephrectomy
  5. Transitional Cell Cancer [Of urothelum];
    -CF
    -RF
    -Mx
    CF -> Painless haematuria, clot problems [ureteric colic, hydronephrosis]

    RF -> Smokers, workers in rubber industry [dye + printing]

    Mx

    • Bladder -> transurethral resection, intravesicular chemo, total cystectomy
    • Upper tract -> uncommon, excision of tract + kidney
    • Lower tract -> Urethroscopic coagulation
  6. What is the empirical Mx for UTI?
    • Trimethoprim
    • Nitrofurantoin

    await C+S
  7. Causes of Painless Testicular swelling?
    • Malignancy [germ cell tumours]
    • Chronic orchitis -> MTB/Syphillis
    • Epidydmal cyst
  8. Causes of Painful testicular swelling?
    • Torsion
    • Epidydmo-Orchitis -> STI
    • Acute Orchitis -> Mumps
  9. Causes of scrotal swelling?
    • Hydrocele -> abn collection of fluid around testis -> Painless, transilluminatees
    • Haematocele -> doesnt transilluminate
    • Varicocele -> bag of worms, separate from epid/Test, disappears lying down
    • Epidydmal cyst -> scrotal swelling
  10. Outline the Pathophysiology of BPH?
    nodular hypertrophy of para-urethral glands -> partial urethral obstruction
  11. What symptoms indicate BPH?
    • incomplete emptying after urination
    • frequency
    • intermittent flow
    • urgency
    • weak stream
    • dificult initiation
    • nocturia
  12. Mx of BPH?
    Finasteride -> 5a-reductase inhibitor, decreases testosterone -> Check PSA

    Tamsulosin -> A1 alpha blocker, relax bladder neck -> only if prostate <50/bladder neck hypertrophy = problem

    Surgical -> TURP -> transurethral resection of prostate
  13. Outline the pathophysiology of PrCa?
    • Peripheral glands tumour -> invasion of capsule + venous plexus
    • loss of median grove
  14. Pc for PrCa?
    • Asymptomatic
    • Symptoms of outfloww obstruction [weak stream, dificult initiation etc]
    • Symp of mets [change in bowel habit, back pain, recent impotence, #s]
  15. Why is the PSA not useful?
    Sensitive, but not specific. Raised in;

    BPH, PrCa, recent ejaculation, recent PR, prostatitis, UTI
  16. Mx of early PrCa?
    Active monitoring -> rising PSA + PR exam

    Surgical -> TURP, radical prostatectomy

    Radiotherapy -> external beam, monitor PSA after
  17. Mx of Metastatic PrCa?
    Subcapsular orchidectomy

    Monthly Gosarelin depot -> LHRH agonist, anorchic state

    Flutamide -> testosterone receptor blocker

    Radiotherapy -> Palliative for bone mets

    NSAIDs for bone pain
  18. What are the signs of rethral trauma?
    • Blood at meatus
    • swelling + butterfly perineal haematoma
    • penile haematoma
    • high riding boggy prostate on PR
    • sensation of voiding w/o urination

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