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41 Cards in this Set
- Front
- Back
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BPH originates from |
Transition Zone and peri urethral Gland |
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Strong correlation exists between prostate and |
Serum PSA |
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Primary role of DRE ( digital Rectal Examination )in Evaluation of LUT symptoms in men is: |
§ Prostatic nodules |
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59 years old man with long history of irritative and obstructive voiding symptoms He was diagnosed as having BPH and he is on medical therapy. Follow up investigation that's Crazy. 1.8 mg/D/L, PSA 2.8 ng/ml. Urine analysis: Ph 6 , WBC 0-5, RBC 20 -15, Qmax: 8 ml/sec with 300ml postvoiding residual. What is the next step |
Upper Urinary Tract Imaging |
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A 63 years old man, k.c.o BPH & he is on tramsulasin 0.4 mg OD He has three attacks of UTI in last few months which need two weeks antibiotics treatments S.Cr: 1.2 mg/dL. B.Glucose 110 mg/D/L, PSA 1.7 ng/ml, USS normal kidneys, trabeculated bladder 60 ml homogenous prostate, Next step in management |
TURP Transurethral resection of the prostate |
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In the informed written consent taken from the pt for TURP , what is the most common post-operative complication needs to inform the patient about in a 57 years old male: in short TURP Most common post op Comlication? |
Infertility & Retrograde ejaculation |
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66 years old male known to have DM & HTN, with long history of obstructive voiding symptoms. Examination revealed stable vitals, normal abdominal examination & hard nodule on DRE S.Cr1.4 mg/dl, B.glucose (or 179?)139mg/dl PSA 2.3 ng/ml. Urine PH5.1. WBC 5-10 Protein +1 USS:mild Rt hydronephrosis, normal UB, 55ml homogenous prostate. Next step in management |
TRUSS guided prostate biopsy |
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The best urinary indication of UTI on urine analysis are positive findings of the following |
Macroscopic bacteria, Leukocyte Esterase & nitrite |
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A 28 years old male with recurrent UTI. He is complaining of chronic Constipation . Ex: showed increased body weight and normal genitalia with unccricumsised penis. USS 3.5cm LT renal calculus and 150 ml postvoiding urine residual. Best treatment option to avoid UTI will include |
Surgical removal of renal calculus |
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A 12 years old boy, presented to A/E with four hr hx of Rt scrotal pain followed by slight Rt scrotal swelling & difficulty in voiding. There was unsure hx of trauma in the school Ex: tender Rt scrotal & mild swelling Cremasteric reflex is negative on the rt side CBC : Normal U/E normal, urine Ph 5.5 WBC 0.5 RBC0.5 Epith.Cells Proper next step will be |
Scrotal Exploration |
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One of the best indicative of the torsion of spermatic cords is |
Absence of cremasteric reflex |
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21 years old male presented to A/E with features of torsion of permatic cord. After manual detorsion, Which of the following is appropriate management |
Immediate scrotal Exploration |
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63 years old female who is known to have DM on oral hypoglycemic agent. Has few months hx of LT Loin pain and mild irritative voiding Dx. Ex: Normal, pallor & lower limb edema. CBC Hb 10.2 , WBC11.0x10^3 HCT30% platelet 202x10^3. S.Cr: 0.7 mg/dl BUN 22 mg/dl Urine pH: 6.0 WBC 10-15 RBC10.15 USS 4x3 cm LT upper pole renal mass. The next step |
CT scan with & without contrast ( solid mass is tumor till proven otherwise) |
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A pt with hematuria undergoes cystoscopy and lesion of low grade superficial papillary urotherlial tumor is identified. Main benefit for sending bladder wash specimen for cytology is |
To identify invisible high grade cancer |
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What is the most useful first line test for the diagnosis of Pca |
DRE PSA |
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60 years old male taking finasteride for two years with PSA of 4 ng/ml. What is his serum PSA value if he is not taking finasteride |
8 ng/ml |
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A 26 years old man with pelvic fracture in whom urine is not returned after catheter replacement. Appropriate next step |
Retrograde pyelography |
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A 26 years old man presented with one week history of recurrent attacks of RT Loin & upper abdominal pain associated with vomiting. Stable vitals . Abdomen Rt Loin & hypochondrial mild tenderness S.Cr 1.8 BUN 33mg/dl CBC Hb13.0 WBC 14x10^3 HCT 37.3^96 urine PH 5.5 WBC:0-5 RBC 5-10, protein +1 Best initial evaluation will be |
CT scan |
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Most COMMON cause of hematuria in pt older than 50 y old is
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infection
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Most common cause of pain with gross hematureia
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Simultaneous passage of renal stones
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Least likely LUT sx due to BPH is
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dysuria
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Most SIGNIFICANT cause of gross hematuria in a pt older than 50 y
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Bladder cancer
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Most common cause of cloudy urine is
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Normal urine
Phosphaturia ( all can cause , but MOST COMMON is phophoturia ) |
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Low urine specific gravity can be due to
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SEARCH IT
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Hematuria is distinguished from hemoglobinuia by
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Microscopic presence of erythrocytes
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A millimeter in diameter is approx how many Frennce
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3 Fr
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Catheter designed to help negotiate the make urethra when catherization is difficult is
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Code'
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The catheter material best suited for long term urethral catherization
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Silicon
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Pt taking metformin and should receive IV contrast :
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Discontinue 48 hr before injection
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Posterior urethra is best visualized by
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Voiding cystogram
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38 years old lady diagnosed as having acute pyelonephritis .
After 24 hr of medical therapy , still has persistent fever and flank pain This warrants |
Observation
(Relax and wait , Ab need time to work ) PS: changing ABtherapy is not recommended |
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52 year old man continues to have high spiking fever despite Suprapubic catherterization and 36 hr of treatment with wide spectrum IV aB . TRUSS shows prostatic abscess.
Next Step |
Transurethral Drainage
PS: NEVER EVER transracial drainage ( causes a fistula ) |
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48 y woman with hx of seizure and recurrent gross hematuria and left plank pain
CTscan shows large left perinephric hematoma and 3 cm left renal angiomyolipoma. There are also multiple right angiomyolipomas. Best Mx? |
(Dx: TB )
ANS)Selective Embolization (LEAST invasive) 2nd )Partial nephroctomy (?) PS: In a progressive disease : Mx LEAST INVASIVE as possible , to save as much organs ) |
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Paraneoplastic syndrome assx with RCC includes all the following EXCEPT
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Options:
A) Polycithemia B) Stauffer's Sy ( hepatic dysfunction ) C) Neuropathy D)Hyper Calcemia E) Venous Thrombosis Ans) HYper Calcemia –( gives impression of Bone metastasis PS rest is true for paraneoplastic sn |
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Regarding bilharzial squamous cell CA of urinary bladder .
True statement is |
Less frequently has less metastasis than TCC
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66 male know to have DMn HTN with long hx of obstructive voiding............
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TURP
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72 male with BPH and bothersome symptoms of bladder outlet obstruction presents with 6 cm painless right sided testicular mass and hyrocele confirmed by USS. Which statement true
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Radical inguinal Orchidectomy
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Serum PSA level s vary with which factor
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Age, Volume,
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What is percentage of urinary oxalate is derived from endogenous production in liver
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80%
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Types of hypercalciuria
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SEARCH IT
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Three days after percutanious renal procedure and during removal of tube , there is a secondary bleeding from nephrostomy tract.
Best treatment |
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