Urology Ck

mikenakhla's version from 2016-05-19 21:45


Question Answer
• Epididymitis in men under 50? Older than 50?under 50 usually called by STDs, chalmydia or gonorrhea. Treat accordingly. Older is caused by E coli (UTI). Treat with bactrim or cipro
• Swollen testes, urethral discharge or urethritis, and prostatitis. What is this?epididymitis, treat with ABX depending on underlying infection (STD or UTI)
• Diagnostic test of choice in the setting of testicular/scrotal pain?ultrasound, differentiate between epididymitis and testicular torsion
• Treatment for RCC if confined to kidney or renal vasculature? If widespread?surgery, immunotherapy (eg IL-2)
• First step in acute urinary retention?empty bladder, cath. Usually hx of BPH. Usually do TURP if underlying cause is BPH
• Boggy, moveable prostate on exam, blood at urethral meatus, or bruising at scrotum or tainturethral injury. Might be in the context of a severe pelvic fracture
• Treatment of hydroceles? Varicoceles?nothing, surgery
• Diagnostic test of choice for kidney stones?noncontrast CT scan
• You can use this to induce testicular descent in cryptorchidismIM hCG. If not descended by one year, do surgery. Bringing it down doesn't decrease risk of cancer, just allows for examining it
• What causes hyperacute rejection?cytotoxic PREFORMED antibodies to donor kidney, occurs with ABO blood type mismatch or other preformed antibodies. Treat by removing the kidney
• How does acute kidney rejection present and how do you treat?T cell medited. Days or weeks after with fever, oliguria, weight gain, tenderness, increased creatinine. Steroids, and immunosupressents
• Chronic rejection of kidneys? Treatment?T cell or antibody mediated, gradual decline in renal function. Treatment is supportive until it gives out then new kidney transplant
• What do you do if a transplant patient is taking cyclosporine and appears to be rejecting?cyclosporine is a well known cause of nephrotoxicity, so to tell if that's what's going on or they're actually rejecting the kidney, do a percutaneous biopsy to tell histologically.
• Epispadias is associated withexstrophy of the bladder (protruding through abdominal wall)
• Potter syndromebilateral renal agenesis causing oligohydramnios in utero, then causing abnormal facies, limb deformities, hypoplastic lungs, incompatible with life
• Immunosuppressant mechanism of action of steroidsinhibit IL-1 production
• Immunosuppressant mechanism of action of methotrexatefolate acid antagonist
• Immunosuppressant mechanism of action of cyclosporineinhibits IL-2 production
• Immunosuppressant mechanism of action of tacrilomusinhibits signaling through T cell receptor
• Immunosuppressant mechanism of action of mycophenolateprevents T cell activation
• Immunosuppressant mechanism of action of azathioprineinhibits DNA/RNA synthesis and decreases production of B and T cells
• Immunosuppressant mechanism of action of OKT3antibody to CD3 receptor on T cells
• Immunosuppressant mechanism of action of hydroxychloroquineinteferes with antigen presentation
• Basiliximab or daclizumabmonoclonal antibody to IL-2 receptor
• If someone has a solid testicular mass and ultrasound suggests cancer, what do you do?take it out (radical orchiectomy)
• Mediastinal tumor with elevate b HCG and AFP?germ cell tumor (nonseminomatous). Does not have to be metastatic from testicle, it can be alone and often is
• Mucopurulent urethral discharge in sexually active male with no bacteria seen on gram stain. How do you diagnose this?chlamydial urethritis. Nucleic acid amplification
• Treatment of urge incontinence? Overflow incontinence? Stress incontinence?oxybutynin, bethanechol/alpha blockers, kegel exercises and urethropexy if that doesn't work and angle is > 30

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