FEBU Part 1 flashcards

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

Peyronie surgical threshold

Surgery is considered in the stable phase after at least 3 months without progression, with curvature greater than 30 degrees or bothersome deformity, and in men with erectile dysfunction not responding to medication.

Left varicocele anatomy

The left internal spermatic vein drains into the left renal vein at a right angle, predisposing to venous dilatation; the right drains directly into the inferior vena cava.

PDE5 inhibitor contraindication

PDE5 inhibitors are contraindicated with any nitrate because both increase cyclic GMP and can cause severe, refractory hypotension; alpha-blocker combination requires caution and dose separation.

Seminoma tumor markers

Pure seminoma may raise beta-hCG and LDH but does not raise alpha-fetoprotein; an elevated AFP indicates nonseminomatous germ cell tumor or mixed histology.

Muscle-invasive bladder cancer

The standard curative approach is neoadjuvant cisplatin-based combination chemotherapy followed by radical cystectomy with pelvic lymph node dissection; bladder preservation is selected in fit patients.

Clear cell renal carcinoma

Most common renal cell carcinoma subtype, arising from proximal tubule; often associated with VHL gene inactivation, which drives HIF accumulation and angiogenesis, making VEGF-targeted therapy useful.

Prostate cancer grade groups

ISUP grade group 1 is Gleason 3+3, group 2 is 3+4, group 3 is 4+3, group 4 is 8, and group 5 is 9-10; higher groups predict worse prognosis.

Struvite stone management

Struvite stones form in infection by urease-producing organisms such as Proteus; complete surgical removal plus eradication of infection is required because residual fragments perpetuate stone growth.

Acute ureteral colic imaging

Non-contrast computed tomography of the kidneys, ureters, and bladder is the preferred diagnostic test in adults because it detects stones and alternative causes of flank pain.

Uric acid stone treatment

Uric acid stones are radiolucent and dissolve with urine alkalinization, commonly using potassium citrate to a urine pH of about 6.5 to 7.0, plus hydration and purine restriction.

Infected obstructed kidney

An obstructing stone with fever or sepsis requires urgent decompression by ureteral stent or percutaneous nephrostomy plus broad-spectrum antibiotics; definitive stone treatment is delayed until infection resolves.

Overactive bladder definition

Urinary urgency, usually with frequency and nocturia, with or without urgency incontinence, in the absence of urinary tract infection or other obvious pathology.

Stress urinary incontinence

Involuntary urine leakage on effort, exertion, sneezing, or coughing due to increased abdominal pressure; initial treatment is pelvic floor muscle training, with midurethral sling for selected cases.

Detrusor overactivity

Urodynamic finding of involuntary detrusor contractions during filling; it may cause urgency and incontinence and is common in spinal cord injury above the sacral level.

Undescended testis timing

If a testis has not descended by 6 months corrected age, referral is indicated; orchidopexy is generally performed between 6 and 18 months to reduce infertility and malignancy risk.

Posterior urethral valves

Congenital obstructing membranes in the male posterior urethra causing poor stream, bilateral hydronephrosis, and thickened bladder; initial management is bladder drainage followed by cystoscopic ablation.

Hypospadias repair timing

Hypospadias is a ventral urethral meatus with dorsal hood and possible chordee; circumcision should be avoided before repair, which is usually done between 6 and 18 months of age.

Retrograde urethrogram

Contrast injected into the distal urethra identifies anterior urethral injury or stricture; it must precede attempted catheterization when urethral trauma is suspected.

Intraperitoneal bladder rupture

Cystography shows contrast outlining bowel loops; treatment is surgical repair because urine in the peritoneal cavity can cause peritonitis and metabolic derangement.

Penile fracture repair

Blunt trauma during erection tears the tunica albuginea, causing a snap, detumescence, and hematoma; early surgical repair reduces long-term curvature and erectile dysfunction.

Fournier gangrene

Polymicrobial necrotizing fasciitis of the perineum and genitalia; treatment is immediate broad-spectrum antibiotics and urgent surgical debridement, with repeated debridements as needed.

Acute bacterial prostatitis

Fever, perineal pain, and dysuria with a tender prostate; avoid vigorous prostate massage, obtain urine culture, and treat with antibiotics that penetrate the prostate.

Sterile pyuria causes

Pyuria without bacterial growth on culture suggests tuberculosis, chlamydia, stones, malignancy, interstitial cystitis, or recent antibiotic use; further evaluation depends on risk factors.

Hyperkalemia emergency treatment

Give intravenous calcium gluconate to stabilize cardiac membranes, then insulin with glucose and a beta-2 agonist to shift potassium intracellularly; dialysis removes potassium in refractory or renal failure cases.

Transplant hyperacute rejection

Caused by preformed recipient antibodies against donor antigens and occurs within minutes; the kidney becomes cyanotic and nonfunctioning, and the graft must be removed.

Living kidney donor advantage

Living donor transplantation offers shorter waiting time, planned surgery, and generally better long-term graft survival than deceased donor transplantation, but donor evaluation must exclude kidney disease and hypertension.

Testicular torsion window

Spermatic cord twisting compromises blood flow; surgical exploration and detorsion with bilateral orchidopexy should occur urgently, ideally within 6 hours, without waiting for imaging if suspicion is high.

Ischemic priapism treatment

Erection lasting over 4 hours is an emergency; aspirate corpora cavernosa and inject phenylephrine, and consider surgical shunt if that fails to restore detumescence.

Paraphimosis reduction

The retracted foreskin forms a constricting band behind the glans; apply manual compression and reduce, and perform a dorsal slit if reduction fails.

Glomerular filtration rate

Normal GFR is about 125 mL/min; the kidneys receive 20-25% of cardiac output, and most filtered sodium and water is reabsorbed in the proximal tubule.

Prostate zonal anatomy

The peripheral zone is the main site of prostate cancer, the transition zone commonly causes benign prostatic hyperplasia, and the central zone surrounds the ejaculatory ducts.

Micturition innervation

Parasympathetic fibers from S2-S4 contract the detrusor, sympathetic fibers from T10-L2 relax it and contract the bladder neck, and pudendal somatic fibers control the external sphincter.