Arab Board Urology Final Written flashcards

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

Most common renal cell carcinoma subtype

Clear cell renal cell carcinoma accounts for 75-80% of renal cell carcinomas and is associated with inactivation of the VHL tumor suppressor gene on chromosome 3p.

Gleason grade group 5

Gleason score 9-10 (grade group 5) is the highest grade group in prostate cancer, indicating poorly differentiated tumor with single cells or cords and worst prognosis.

BCG for bladder cancer

Intravesical bacillus Calmette-Guérin is first-line adjuvant therapy for high-risk non-muscle-invasive bladder cancer (T1, CIS, high-grade Ta) to reduce recurrence and progression.

Testicular tumor markers

Alpha-fetoprotein is elevated in yolk sac tumors and some embryonal carcinomas; beta-hCG is elevated in choriocarcinoma and 10-20% of seminomas; LDH correlates with tumor burden.

Adrenal incidentaloma size criterion

Adrenal incidentalomas larger than 4 cm or with heterogeneous appearance on imaging have increased risk of malignancy and generally warrant surgical resection.

First-line imaging for renal colic

Non-contrast computed tomography of the abdomen and pelvis is the imaging modality of choice for suspected acute renal colic, with sensitivity and specificity exceeding 95%.

Struvite stone treatment

Struvite (infection) stones require complete stone removal and eradication of urea-splitting bacteria (e.g., Proteus) to prevent recurrence; often need percutaneous nephrolithotomy.

Medical expulsive therapy

Alpha-1 adrenergic blockers such as tamsulosin relax distal ureteral smooth muscle and improve spontaneous passage of distal ureteral stones 5-10 mm.

Uric acid stone management

Uric acid stones are radiolucent and dissolve with urinary alkalinization using potassium citrate to achieve urine pH 6.5-7.0; allopurinol is used if hyperuricemia is present.

PDE5 inhibitor contraindication

Phosphodiesterase type 5 inhibitors are absolutely contraindicated in patients taking any nitrate medication because of the risk of severe, potentially fatal hypotension.

Azoospermia FSH interpretation

Elevated follicle-stimulating hormone with small testes suggests non-obstructive azoospermia (primary testicular failure), whereas normal FSH and testicular volume suggest obstructive azoospermia.

Varicocele laterality

Varicoceles occur on the left side in 85-90% of cases because the left internal spermatic vein drains into the left renal vein at a right angle, increasing hydrostatic pressure.

Ischemic priapism management

Ischemic (low-flow) priapism lasting more than 4 hours is an emergency treated by corporal aspiration, saline irrigation, and intracavernosal phenylephrine injections.

Stress urinary incontinence first-line

Pelvic floor muscle training is first-line conservative therapy for stress urinary incontinence; midurethral sling surgery is offered after failed conservative management.

Detrusor overactivity on urodynamics

Detrusor overactivity is defined by involuntary detrusor contractions during the filling phase of cystometry, often causing urgency and urge incontinence.

POP-Q stage 3

Pelvic Organ Prolapse Quantification stage 3 indicates the leading edge of prolapse extends more than 1 cm beyond the hymen but not completely everted.

Hypospadias circumcision contraindication

Circumcision should be avoided in infants with hypospadias because the foreskin may be needed for urethral reconstruction; severe cases require referral before any surgery.

Orchidopexy timing

Orchidopexy for undescended testis should be performed by 12-18 months of age to reduce the risk of infertility and testicular malignancy.

Posterior urethral valves presentation

Posterior urethral valves are the most common cause of lower urinary tract obstruction in boys, presenting with prenatal hydronephrosis, thick-walled bladder, and poor urinary stream.

Vesicoureteral reflux grades

Vesicoureteral reflux is graded I-V on voiding cystourethrography; grades I-III often resolve spontaneously, while grades IV-V may require antibiotic prophylaxis or surgery.

BK virus nephropathy

BK virus nephropathy after renal transplantation presents with rising creatinine and decoy cells in urine; treatment is reduction of immunosuppression to preserve graft function.

Transplant ureteral stenosis

Ureteral stenosis is a common urologic complication after renal transplantation, usually at the ureterovesical anastomosis, treated with balloon dilation and stenting or surgical revision.

Post-transplant immunosuppression

Maintenance immunosuppression after renal transplant typically includes a calcineurin inhibitor (tacrolimus), an antimetabolite (mycophenolate), and corticosteroids.

Posterior urethral injury sign

Posterior urethral injury from pelvic fracture presents with blood at the meatus, perineal hematoma, and a high-riding prostate; retrograde urethrography is diagnostic and catheterization is avoided.

Buccal mucosa graft urethroplasty

Buccal mucosa graft is the gold standard for long anterior urethral strictures (>2 cm) and recurrent strictures, offering high success rates compared with repeated urethrotomy.

Penile fracture management

Penile fracture is a rupture of the tunica albuginea during erection, presenting with a cracking sound, detumescence, and hematoma; emergent surgical repair reduces complications.

Genitourinary tuberculosis diagnosis

Genitourinary tuberculosis should be suspected with sterile pyuria and hematuria; diagnosis requires three early-morning urine samples for acid-fast bacilli culture.

Fournier's gangrene treatment

Fournier's gangrene is a necrotizing fasciitis of the perineum requiring emergency surgical debridement and broad-spectrum antibiotics covering gram-positive, gram-negative, and anaerobic organisms.

Acute bacterial prostatitis treatment

Acute bacterial prostatitis presents with fever, dysuria, and a tender prostate; treatment is a fluoroquinolone for 4-6 weeks, with hospitalization and intravenous antibiotics if severe.

Bladder parasympathetic innervation

Parasympathetic fibers from S2-S4 travel via the pelvic splanchnic nerves to cause detrusor muscle contraction during voiding.

Renal autoregulation mechanism

Renal blood flow is autoregulated by the myogenic response of afferent arterioles and tubuloglomerular feedback from the macula densa, maintaining constant flow over a range of pressures.

Testicular torsion time window

Testicular torsion requires surgical exploration within 6 hours of onset to maximize testicular salvage; delayed presentation increases risk of orchiectomy.