Ch 90 Upper Urinary Tract Obstruction And Trauma Flashcards
What is the most commonly injured urologic organ from external trauma?
Kidney
Most of these injuries can be managed:
- Operatively
- Non-operatively
Non-operatively
What are the absolute indications for immediate renal intervention?
Hemodynamic instability with no or transient response to resuscitation or pulsatile expanding retroperitoneal hematoma
TRUE or FALSE: Penetrating renal injuries have higher chances of renorrhaphy/nephrectomy
TRUE
Trauma to the _____ axillary line is more prone to damage important renal strictures such as the renal hilum and pedicle compared with the ____ axillary line, which commonly results in parenchymal injury.
Anterior axillary line > renal strictures from damage to renal hilum and pedicle
Posterior axillary line > parenchymal injury
TRUE or FALSE: Majority of patients with penetrating renal injuries have associated abdominal injuries.
True
TRUE or FALSE: The kidney is the most commonly injured urologic organ from external trauma.
TRUE
TRUE or FALSE: All penetrating renal injuries require surgical exploration.
FALSE
Repeat imaging is warranted is the following instances, except:
A. Peri-renal hematoma
B. Drop in hematocrit
C. Flank pain
D. Fever
A. Peri-renal hematoma
B. Drop in hematocrit
C. Flank pain
D. Fever
Which among the following is correct, based on the American Association for the Surgery of Trauma (AAST) renal injury grading scale?
A. Cortical laceration < 1cm with perirenal hematoma – Grade 2
B. Parenchymal laceration > 1cm with urinary extravasation – Grade 3
C. Cortical laceration < 1cm with subcapsular hematoma – Grade 1
D. Partial laceration of renal vein with hilar hematoma – Grade 5
A. Cortical laceration < 1cm with perirenal hematoma – Grade 2
B. Parenchymal laceration > 1cm with urinary extravasation – Grade 3
C. Cortical laceration < 1cm with subcapsular hematoma – Grade 1
D. Partial laceration of renal vein with hilar hematoma – Grade 5
How do you perform a 1-shot IVP?
Give 2 mL/kg if IV contrast and take an xray after 10 mins
TRUE or FALSE: The degree of hematuria usually correlates with the severity of the renal injury
FALSE
The following are characteristic of deceleration injuries to the kidney, except:
A. Renal vein injury with contained hematoma
B. UPJ disruption with surrounding urinoma
C. Parenchymal laceration with urinary extravasation
D. Renal artery thrombosis resulting in renal infarction
A. Renal vein injury with contained hematoma
B. UPJ disruption with surrounding urinoma
C. Parenchymal laceration with urinary extravasation
D. Renal artery thrombosis resulting in renal infarction
Select the two absolute indications for immediate renal intervention in suspected renal trauma:
1) Hemodynamic instability with no or transient responds to resuscitation
2) Pulsatile or expanding retroperitoneal hematoma
What is the main purpose of doing a one-shot IVP?
Asses the function of the contralateral kidney
