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Fusion prostatic biopsyMohammad IhmeidanThis document discusses multiparametric MRI and its use in guiding prostate biopsies. It provides information on anatomic, diffusion-weighted, and dynamic contrast-enhanced MRI and how they help visualize prostate tumors with high sensitivity and specificity. It then describes different approaches to targeted prostate biopsies using MRI information, including cognitive fusion, software-based fusion, and in-bore fusion biopsies. It discusses limitations and advantages of each method and concludes that while targeted biopsies improve cancer detection, mapping biopsies supplemented with targeted biopsies remain the standard for identifying clinically significant tumors.
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Anatomy physiology and embryology of urinary tract
Anatomy physiology and embryology of urinary tractMohammad IhmeidanThe kidneys filter waste from the bloodstream and regulate water, electrolyte, and acid-base balance. They remove urea and other waste through urine while producing hormones like erythropoietin and renin. The kidneys contain nephrons which filter blood in the glomerulus and reabsorb nutrients in the tubules. Urine is transported by the ureters to the bladder, then exits through the urethra. The urinary system develops from intermediate mesoderm through pronephros, mesonephros, and metanephros stages, with the metanephros becoming the adult kidneys.
Fusion prostatic biopsy
Fusion prostatic biopsyMohammad IhmeidanThis document discusses multiparametric MRI and its use in guiding prostate biopsies. It provides information on anatomic, diffusion-weighted, and dynamic contrast-enhanced MRI and how they help visualize prostate tumors with high sensitivity and specificity. It then describes different approaches to targeted prostate biopsies using MRI information, including cognitive fusion, software-based fusion, and in-bore fusion biopsies. It discusses limitations and advantages of each method and concludes that while targeted biopsies improve cancer detection, mapping biopsies supplemented with targeted biopsies remain the standard for identifying clinically significant tumors.
Renal cell carcinoma
Renal cell carcinomaMohammad IhmeidanRenal cell carcinoma accounts for approximately 3% of adult solid malignancies in the US, with over 51,000 new cases and 12,900 deaths annually. It arises from renal tubular epithelium and includes several subtypes associated with different genetic mutations and prognoses. Surgery is the main treatment for localized disease, while advanced or metastatic renal cell carcinoma has a poor prognosis despite newer targeted therapies and immunotherapies that have improved outcomes.
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Male reproductive system - Anatomy
Male reproductive system - AnatomyMohammad IhmeidanThe major components of the male reproductive system are the testes, epididymis, ductus deferens, and ejaculatory duct on each side. The scrotum contains the testes and is divided into two compartments. The testes develop in the abdomen and descend into the scrotum before birth. Within the testes are seminiferous tubules that produce sperm. The epididymis is a coiled duct that courses along the testes where sperm mature. Blood flows into the testes via the testicular artery and drains via the testicular veins. The penis contains three cylinders of erectile tissue and transmits semen and urine.
Testicular tumors 
Testicular tumors Mohammad IhmeidanThis document provides information about testicular tumors including presentation, risk factors, classification, staging, and treatment. It begins with an introduction stating that testicular cancer is the most common malignancy in males aged 15-35. It then discusses signs and symptoms, risk factors such as cryptorchidism and family history, tumor markers, patterns of spread, staging classifications, and treatment options based on stage for both seminomas and non-seminomas. Treatment may involve surgery, radiation therapy, chemotherapy, lymph node dissection, and surveillance depending on tumor type and stage. Prognosis has improved significantly over time with overall 5-year survival rates now over 95% due to advances in diagnosis and treatment.
Vesico ureteral reflux 
Vesico ureteral reflux Mohammad IhmeidanThis document summarizes key points about vesicoureteral reflux (VUR):
- VUR is retrograde flow of urine from the bladder to the upper urinary tract and is more common in females under 5 years old. It can be primary due to UVJ deficiency or secondary to bladder issues.
- VUR is graded I-V based on VCUG findings. Low grade (I-III) often resolves spontaneously while high grade (IV-V) is less likely to without intervention. Treatment involves watchful waiting with antibiotics or surgical correction.
- Surgical correction aims to lengthen the UVJ tunnel to satisfy a 5:1 ratio using various techniques. Endoscopic injection
Wilms tumors
Wilms tumorsMohammad IhmeidanWilms tumor, also known as nephroblastoma, is the most common renal tumor of childhood. It has an annual incidence of 7.6 cases per million children under 15 years old. Treatment involves surgery to remove the tumor along with chemotherapy and sometimes radiation therapy in a multimodal approach. The goal is to remove the tumor bulk surgically while using chemotherapy to eliminate any micrometastases in order to cure the cancer. Protocols vary depending on factors like age, tumor stage and histology, but generally include either surgery followed by chemotherapy or neoadjuvant chemotherapy before surgery, with excellent long-term survival rates with modern therapies.
Bladder injuries
Bladder injuriesMohammad IhmeidanBladder injuries can occur from trauma or medical procedures and range from extraperitoneal to intraperitoneal. Extraperitoneal injuries make up 70% of cases and are often associated with pelvic fractures, while intraperitoneal injuries expose the bladder more directly. Clinical signs include hematuria, pelvic pain, and inability to catheterize. Diagnosis involves cystography to detect contrast leakage. Treatment depends on the severity and location of the injury, with uncomplicated extraperitoneal injuries often managed conservatively with catheter drainage and complicated or intraperitoneal injuries typically requiring surgical repair.
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Urethral traumaMohammad IhmeidanThis document discusses urethral trauma, including classification, etiology, clinical manifestations, investigations, and principles of management. It separates discussions of posterior and anterior urethral injuries. For posterior injuries, immediate suprapubic cystostomy is standard, while delayed reconstruction is typically done via open posterior urethroplasty after 3 months. Anterior injuries may be treated with catheter diversion or primary realignment, while anastomotic urethroplasty is preferred for obliterated bulbar urethras after several weeks.
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The cystoscope and accessoriesMohammad IhmeidanThe rigid cystoscope and its accessories are described. Key components include the cystoscope sheath, bridges, obturators, and telescopes. The cystoscope sheath comes in different sizes measured in French and is used to intoduce the rigid cystoscope into the bladder. Bridges connect the sheath to the telescope and may have one or two accessory channels. Obturators are specific to each sheath size and make the tip smooth for insertion. Telescopes have different viewing angles and are classified by this. The document outlines the parts and uses of these rigid cystoscope components.
Physicochemistry of renal stones
Physicochemistry of renal stonesMohammad IhmeidanUrinary stones are the third most common problem of the urinary tract. Stone formation is a complex process that depends on the interaction of urinary concentration of ions, pH, flow rate, and inhibitors. Crystallization, crystal growth, aggregation, and adherence to the epithelium are required steps. Urine must be supersaturated for stones to form, but supersaturation alone is insufficient due to urinary inhibitors like citrate, magnesium, and glycoproteins. Common calcium stones may originate from subepithelial plaques that serve as anchors for stone growth.
Postobstructive diuresis
Postobstructive diuresisMohammad IhmeidanPost-obstructive diuresis occurs after relief of a urinary tract obstruction, where large amounts of salt, water, and urea are excreted in the urine. It is caused by accumulation of fluids and solutes during obstruction and impairment of tubular reabsorption capabilities. Risk factors include edema and azotemia. The pathophysiology involves derangements in urinary concentrating ability due to disrupted aquaporin channels and sodium transport, as well as insensitivity to ADH. Treatment focuses on complete relief of obstruction, fluid replacement, electrolyte correction, and monitoring.
Renal physiology 
Renal physiology Mohammad IhmeidanThe kidney has several important functions including regulating blood pressure, fluid balance, and blood pH. The basic structural and functional unit of the kidney is the nephron, which filters blood to form urine. Each nephron contains a glomerulus for blood filtration and tubules (proximal tubule, loop of Henle, distal tubule, collecting duct) for reabsorption and secretion. Filtration occurs due to blood pressure gradients, with most filtrate reabsorbed along the nephron. The kidneys also produce hormones like renin, prostaglandins, and erythropoietin to help regulate blood pressure, red blood cell production, and other processes.
Peri-operative Anaphylaxis 
Peri-operative Anaphylaxis Mohammad IhmeidanAnaphylaxis is a severe, life-threatening allergic reaction caused by the sudden release of mast cell and basophil mediators. It can be triggered by IgE-mediated or non-IgE mediated mechanisms. Common triggers include medications like antibiotics and contrast dyes, as well as stings, foods and latex. Symptoms affect multiple organ systems like the skin, respiratory and cardiovascular systems. Treatment involves stopping the trigger, supportive care, and medications like epinephrine, antihistamines and corticosteroids. Patients require monitoring for 24 hours due to risk of recurrence or delayed reactions.
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ABSITE Review: Practice Questions, Second Edition 2nd edition by FIser, Mohammad IhmeidanThe document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise has also been shown to increase gray matter volume in the brain and reduce risks for conditions like Alzheimer's disease and dementia.
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