Flashcards in Fiser: Subspecialties (urology, ortho, gyn) Deck (52)
which nerve is most at risk for injury in the lithotomy position?
anterior to posterior of renal structures?
renal vein (anterior)
renal pelvis (posterior)
which renal vein can be ligated?
the left can b ligated from the IVC 2/2 increased collaterals
what is the most common type of kidney stone?
which type of kidney stone do pts get who have had their TI resected?
calcium oxalate: due to increased oxalate absorption in colon
what are and what causes struvite stones?
magnesium ammonium phosphate stones, cause staghorn calculi, occur w infections (proteus mirabilis) that are urease producing
which kidney stones are radiolucent?
uric acid and cysteine
which patients (3) are more at risk for uric acid stones?
- ileostomies, gout and myelopoliferative disorders
what drug is used to prevent cysteine stones?
how do you resect testicular cancer?
inguinal incision- scrotal incisions will disrupt the lymphatics
what level correlates with testicular ca tumor bulk ?
MC types of testicular ca
germ cell: seminoma and non-seminoma (90%)
diagnosis and management of seminoma
- 10% have elevated b-hcg, do NOT hav elevated AFP
ALL get orchiectomy and retroperitoneal XRT
diagnosis and management of non-seminoma testicular ca
- 90% have elevated AFP and B-HCG
ALL get orchiectomy and RP LN dissection
Stage 2 or greater: Chemo
what chemotherapy agents do you give in testicular ca?
cisplatin, bleomycin, VP-16
how do you proceed when you get stage I prostate ca after a TURP?
when do you give XRT and androgen ablation in prostate ca?
extracapsular invasion (T3+) or metastatic disease
#1 primary tumor of the kidney
when can you perform wedge resection of metastatic RCC?
isolated lung or colon mets
MC location of RCC mets?
#1 tumor of the kidney
mets from breast ca
when do you perform a partial nephrectomy in RCC?
in patients who would otherwise require HD after nephrectomy, tumor <4cm and Cr >2.5
what is von-hippel lindau syndrome?
multifocal and recurrent RCC, renal cysts, CNS tumor and pheochromocytomas
risk factors for transitional cell ca of bladder?
smoking, aniline dyes, cyclophosphamide
what is T2 transitional bladder cancer and how do you manage?
T2 invades into muscle wall, manage w cystectomy w ileal conduit, chemo (MVAC: methotrexate, vinblastine, adriamycin, cisplatin) and XRT
squamous cell ca of bladder is related to what?
what layer hypertrophies in BPH?
initial therapy of BPH?
alpha blockers: terazosin, doxazosin (relax smooth muscle)
5-alpha-reductase inhibitors: finasteride
inhibits conversion of testosterone to dihydrotestosterone, inhibits prostate hypertrophy