6 things NOT to miss Flashcards
1
Q
_____ w/ fever
- 3 associated findings
A
Obstructive stone
- infected urine UPSTREAM of obstruction
- unable to drain infection
- abscess
2
Q
2 Tx for obstructive stone w/ fever?
A
Requires drainage
- nephrostomy tube
- ureteral stent
IV abx
3
Q
Testicular Torsion
- MC age of presentation is __-___ yrs old, but can occur at any age
- Acute onset of _____
- ____ deformity
- Absent ______
A
- 12 - 18
- severe testicular pain
- bell clapper
- cremaster
4
Q
PE findings of Testicular Torsion
- _____ testicle
- ____ riding
- _____ lie
- Absent _____
- No pain w/ _____ (_____)
- Thick or ____ spermatic cord
- Epididymis _____
A
- tender and firm
- high
- horizontal
- cremaster
- elevation of testis (Phren’s sign)
- knotted
- NOT posterior to testis
5
Q
What other condition would be on Ddx when evaluating Testicular Torsion?
- What 3 studies would you order?
A
Epididymis
- Dopper US
- Nuclear scan
- Phren’s Sign
6
Q
Tx of testicular torsion?
A
- Detorsion (open the book)
- Surgical : Scrotal exploration, detorsion and orchidopexy (unilateral/bilateral)
7
Q
What is this?
- Necrotizing fasciitis of male genitalia and perineum
- Involves mainly subcutaneous tissues
- Infection advances rapidly, over ____
A
Fournier’s Gangrene
- minutes
8
Q
3 risk factors of Fournier’s Gangrene
A
- Diabetes
- Alcohol abuse
- Immunocompromsed states
9
Q
- Painful swelling and induration of penis, scrotum, or perineum
- Cellulitis
- ____
- Necrosis
- Ecchymosis
- _____
- ______
- ______
- ____ absent if immunocompromised
A
Fournier’s Gangrene
- Eschar
- Crepitus
- Cutaneous anesthesia
- foul odor
- fever
10
Q
Imaging of Fournier’s Gangrene will show gas in the ____ tissues
A
Subcutaneous Tissues
11
Q
Tx for Fournier’s Gangrene
- Abx to cover ___ and ____
- Surgical _____
- _____ dressings
- ____ therapy
- HBO (hyperbaric oxygen)
A
- aerobic & anaerobic
- debridement
- wet - dry
- whirlpool
12
Q
2 causes of Acute Urinary Retention
A
- BPH
- Anticholinergic medications
13
Q
Acute Urinary Retention
- Normal _____
- Bladder scan (____)
- ___ gel / lubrication
- What 2 catheters?
- ____ tube
A
- bladder capacity
- Ultrasound
- lidocaine
- foley & coude
- coude is curved
- Suprapubic
14
Q
Persistent penile erection that continues hours beyond or is unrelated to sexual stimulation and lasts greater than 4 hours duration
A
Priapism
15
Q
4 causes of Priapism
A
- Sickle cell trait & disease
- Trazodone
- Cocaine
-
ED treatments
- Papverine/Prostaglandin E1/Phentolamine
- PDE-5 inhibitors
(SECT)
