General Urology and Basic Sciences Applied to Urology
Core concepts
Candidates must integrate anatomy, physiology, pharmacology, and microbiology into clinical reasoning. High-yield areas include renal physiology (glomerular filtration, tubular handling of sodium, water, acid-base, and potassium), the renin-angiotensin-aldosterone axis, and how diuretics act at specific nephron segments. Understand bladder smooth-muscle physiology and autonomic control: parasympathetic (pelvic nerve, M3) drives detrusor contraction, sympathetic (hypogastric, beta-3) relaxes the detrusor and contracts the trigone via alpha-1. Know the pharmacology of alpha-blockers, antimuscarinics, beta-3 agonists, PDE5 inhibitors, and antibiotics with urologic penetration. Microbiology: typical uropathogens, biofilm on catheters and stones, and the difference between colonization and infection. Embryology explains many clinical puzzles (ureterocele, hypospadias, undescended testis, Mullerian remnants).
Traps
Questions often test the mechanism rather than the drug name, or ask which nerve injury explains a deficit after pelvic surgery. Distinguish pre-renal from intrinsic renal failure using urine indices. Watch for acid-base distractors: type 1 vs type 2 renal tubular acidosis and stone risk. Antibiotic prophylaxis timing (within 60 minutes of incision) is a classic single-best-answer.
Worked example / rule of thumb
A patient on a thiazide develops hypokalemia and hypercalcemia: thiazides increase distal calcium reabsorption and cause potassium wasting - expect both. Loop diuretics cause hypocalcemia and also potassium wasting. Rule of thumb: loop loses calcium, thiazide keeps calcium.