Arab Board Urology Clinical Exam flashcards

36 cards. Read the term and the definition here. The deck at the top of this page is optional.

Cockcroft-Gault formula

Estimates creatinine clearance as (140 − age) × weight in kg divided by 72 × serum creatinine, multiplied by 0.85 for women. Used for drug dosing.

Ureteral stone lodgment sites

Three anatomic narrowings: ureteropelvic junction, crossing of the iliac vessels, and ureterovesical junction. Stones most often lodge at these points.

Detrusor muscle innervation

Parasympathetic S2–S4 fibers via pelvic splanchnic nerves cause detrusor contraction; sympathetic T10–L2 fibers relax the detrusor through beta-3 receptors.

PSA and 5-alpha-reductase inhibitors

Finasteride and dutasteride reduce serum PSA by approximately 50% after six months of therapy; PSA should be doubled for interpretation during treatment.

Clear cell renal cell carcinoma

The most common renal cancer subtype, about 75%, linked to VHL inactivation; it is highly vascular and responsive to VEGF-targeted tyrosine kinase inhibitors.

Non-muscle-invasive bladder cancer

Tumors confined to mucosa or lamina propria (Ta, T1, CIS). T1 and CIS carry high progression risk and are treated with intravesical BCG.

ISUP grade group 5

Corresponds to Gleason score 9 or 10 (e.g., 4+5, 5+4, 5+5) and represents the highest grade group and worst prognosis in prostate cancer.

Cryptorchidism tumor risk

Undescended testes carry a 4–10 fold increased risk of germ cell tumors; orchiopexy before puberty reduces but does not eliminate this risk.

Struvite stone formation

Magnesium ammonium phosphate stones form in urine infected by urease-producing organisms such as Proteus; complete stone clearance plus infection eradication is required.

Medical expulsive therapy

Alpha-blockers such as tamsulosin improve spontaneous passage of distal ureteral stones 5–10 mm by relaxing ureteral smooth muscle.

PCNL indications

Percutaneous nephrolithotomy is first-line for renal stones larger than 2 cm and for staghorn calculi, offering higher clearance than shockwave lithotripsy.

Uric acid stone dissolution

Urinary alkalinization to pH 6.5–7.0 dissolves uric acid stones; allopurinol is added when hyperuricemia or hyperuricosuria is documented.

Midurethral sling

A synthetic mesh tape placed under the midurethra to treat stress urinary incontinence; it is a common surgical option after failed pelvic floor training.

Vesicovaginal fistula presentation

Continuous urinary leakage after pelvic surgery, most often hysterectomy. Diagnosis is confirmed by dye test or cystoscopy.

Urethral diverticulum

Outpouching of the urethra presenting with postvoid dribbling, dyspareunia, and a suburethral mass; MRI is the imaging test of choice.

Detrusor sphincter dyssynergia

Involuntary sphincter contraction during detrusor contraction, seen in suprasacral spinal cord lesions; causes high bladder pressures and threatens the upper tracts.

BOOI calculation

The bladder outlet obstruction index equals detrusor pressure at maximum flow minus twice the maximum flow rate; values above 40 indicate obstruction.

Sacral neuromodulation indication

Refractory urgency-frequency, urge incontinence, or non-obstructive urinary retention after failed conservative therapy; a trial lead is placed before implantation.

Buccal mucosal graft

Preferred graft for urethroplasty because of thick epithelium, thin lamina propria, and rich vascularity; used for long or penile urethral strictures.

Pelvic fracture urethral injury

Posterior urethral disruption after pelvic fracture; managed with suprapubic catheter and delayed urethroplasty, with early realignment as an alternative.

Martius flap

A labial fat flap used for tissue interposition during repair of vesicovaginal or rectovaginal fistulas to improve healing and reduce recurrence.

Ischemic priapism

Low-flow priapism with dark hypoxic blood on aspiration, lasting over four hours; treated with aspiration, irrigation, and intracavernosal phenylephrine.

Peyronie disease

Acquired penile plaque causing curvature, pain, and shortening; stable disease with bothersome curvature may be treated surgically with plication or grafting.

Varicocele and infertility

The most common correctable cause of male infertility; repair is considered for palpable varicocele with abnormal semen parameters.

Azoospermia with high FSH

Elevated FSH with small testes suggests primary testicular failure; normal FSH and low ejaculate volume suggest obstruction such as CBAVD.

Posterior urethral valves

Congenital obstructing membranes in the posterior urethra causing bilateral hydronephrosis and a thick-walled bladder; treated with catheter drainage and valve ablation.

Vesicoureteral reflux grading

International grades I–V based on contrast extent on voiding cystourethrogram; grades I–III often resolve spontaneously, while IV–V may need surgery.

Testicular torsion window

A surgical emergency; testicular salvage is highest when detorsion is performed within six hours of symptom onset.

Positive T-cell crossmatch

A positive complement-dependent cytotoxicity T-cell crossmatch is a contraindication to kidney transplantation because it predicts hyperacute rejection.

BK virus nephropathy

Rising creatinine with decoy cells in urine or positive BK PCR after transplantation; treatment is reduction of immunosuppression.

Radiocephalic fistula

The preferred first arteriovenous access for hemodialysis, created between the radial artery and cephalic vein at the wrist (Brescia-Cimino fistula).

Retrograde urethrogram

Imaging test performed before catheterization when urethral injury is suspected, such as blood at the meatus or a high-riding prostate.

Intraperitoneal bladder rupture

Requires surgical repair; extraperitoneal rupture can be managed with catheter drainage alone. Diagnosis is made by CT cystography.

Fournier gangrene

Necrotizing fasciitis of the perineum and genitalia; treatment is urgent surgical debridement with broad-spectrum antibiotics and supportive care.

PI-RADS categories

A five-point scale on multiparametric MRI: PI-RADS 1–2 indicates clinically significant cancer is unlikely; PI-RADS 4–5 indicates it is likely.

CT urography indication

Used for evaluation of painless hematuria and suspected upper tract urothelial carcinoma; combines unenhanced, nephrographic, and excretory phases.