Urology
Renal colic, urinary retention, haematuria, testicular emergencies, UTI and prostate disease. Prostate cancer testing is a shared-decision topic in Australia.
High-yield points
Testicular torsion: sudden severe pain, high-riding testis, absent cremasteric reflex; surgical exploration within 6 hours, do not delay for ultrasound.
Renal colic: non-contrast CT KUB; NSAIDs for pain; stones under 5 mm usually pass.
Obstructed infected kidney (stone with fever) is an emergency needing drainage (stent or nephrostomy) plus antibiotics.
Painless visible haematuria in an adult: suspect urothelial cancer; CT urogram and cystoscopy.
Uncomplicated cystitis in women (eTG): trimethoprim for 3 days, or nitrofurantoin, or cefalexin; cefalexin in pregnancy.
Acute urinary retention: catheterise, review drugs (anticholinergics, opioids), look for constipation; BPH is common.
PSA testing: requires informed shared decision-making; men who choose it are offered testing every 2 years from 50 to 69.
Asymptomatic bacteriuria is not treated except in pregnancy and before urological procedures.
India vs Australia
Where the answer the AMC marks correct differs from what’s usually taught in Indian MBBS.
| Aspect | India (MBBS)What you learn in MBBS | Australia (AMC)What the exam marks as correct |
|---|---|---|
| PSA testing | Often ordered routinely in older men. | No screening program. Discuss benefits and harms (overdiagnosis, biopsy risks) before testing, and document the patient's decision. |
| Uncomplicated cystitis in women | Fluoroquinolones or nitrofurantoin; high ESBL rates. | eTG: trimethoprim 3 days, nitrofurantoin 5 days or cefalexin 5 days. Fluoroquinolones not first line. |
| Renal colic | Ultrasound and X-ray KUB. | Largely the same management; non-contrast CT KUB is standard, with medical expulsive therapy for small distal stones. |
PSA testing
India (MBBS)
Often ordered routinely in older men.
Australia (AMC): what the exam expects
No screening program. Discuss benefits and harms (overdiagnosis, biopsy risks) before testing, and document the patient's decision.
Uncomplicated cystitis in women
India (MBBS)
Fluoroquinolones or nitrofurantoin; high ESBL rates.
Australia (AMC): what the exam expects
eTG: trimethoprim 3 days, nitrofurantoin 5 days or cefalexin 5 days. Fluoroquinolones not first line.
Renal colic
India (MBBS)
Ultrasound and X-ray KUB.
Australia (AMC): what the exam expects
Largely the same management; non-contrast CT KUB is standard, with medical expulsive therapy for small distal stones.
The Australian context
There is no organised prostate cancer screening program in Australia. PSA testing is individual, and doctors are expected to explain the benefits and harms (overdiagnosis, biopsy complications) before ordering it. Asking a patient's permission and documenting the discussion is examinable.