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Clinical Prep > E-med- Urology > Flashcards

E-med- Urology Flashcards

1
Q

Most common type of kidney stone

A

Calcium stone

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2
Q

Kidney stone

A

Inc urinary frequency
Dark urine
N/v
Colicky pain, radiating from flank to groin

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3
Q

Who to use US in when suspecting Kidney stone

A

Pregnant
Children
Previous hx of stones

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4
Q

What test to order for kidney stone in normal population (not prego or kid)

A

Non contrast CT

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5
Q

Kidney stone tx if stone is <5 mm (pencil eraser size)

A

Nothing

will often pass on its own

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6
Q

At what size will kidney stone probably NOT pass on its own?

A

Greater than 8 mm

Tx:
Lithotripsy "shock wave"
PCNL- nephrolithotomy- 1 cm incision
Ureteroscopy
Open surgery (limited)
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7
Q

Abnormal amount (too much) urine in the bladder =

A

> 100-150 mL

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8
Q

Tx of Urinary Retention- catheter

if blood clots:

A

then do Continuous Bladder Irrigation

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9
Q

Pt has urinary retention and the rest of these sx….

Delirium
Dilated pupils
Tachycardia
Hyperthermia

A

He prob took an Anticholinergic

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10
Q

With Acute Simple Cystitis, UA is often not needed.. i.e.. in

A

Non pregnant healthy females 18-45 yo

can have Clinical dx

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11
Q

When do you need to have UA to support simple bladder infection diagnosis

A 
Back pain- looks sick
immunocomp
hx of multi course abx
hx abx resistance
hx multi drug allergies
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12
Q

Make sure these are on your ddx when diagnosing acute simple cystitis

A

Gonorrhea
Chlamydia

including: urethritis, cervicitis, PID

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13
Q

Labs of Acute Simple cystisis

A 
Leukocyte esterase (pyuria)
Nitrite (gram neg bacteria)
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14
Q

Tx for simple cystitis

A

Macrobid x 5d
Fosfomycin 3g single dose
Keflex x7d
Bactrim (but not if high E.Coli resistance)

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15
Q

WBC casts on Urinalysis

A

Pyelonephritis

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16
Q

Pyelonephritis “Kidney infection”

A

FluoroQ

Cipro 500 BID x7d
Levoflox 750 qd x 5d

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17
Q

Acute Prostatitis

A

Acute bacterial infection of the prostate

younger than 35: G/C
older than 35: E.Coli

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18
Q

Sx of Prostatitis

A

general- fever, chills, muscle aches

LBP, pain in RECTUM or PERINEUM

Urinary retention, Dysuria

19
Q

What will you find on exam with Prostatitis

A

Tender abdomen and Perineal area

Tender, boggy prostate

20
Q

What NOT to do with prostate exam in setting of Prostatitis

A

MASSAGE the prostate

21
Q

Tx for Prostatitis

A

Bed rest, stool softener, hydrate

FluoroQ if older than 35

  • Cipro
  • Levo

Azithro and Rocephin if younger than 35 (tx for G/C)

22
Q

SIRS criteria!!! 2 or more is positive test

A 
Temp >100.4 or <96.8
WBC >12,000 or <4,000
(or >10% bands)
Tachy >90 bpm
Tachypnea >20
23
Q

ED Hematuria, if gross or >3 RBC on UA

A

If abnormal vitals, abnormal labs, or pain…. FURTHER workup

Further imaging or Catheter

24
Q

How long to treat Prostatitis (acute bacterial)

A

6 WEEKS

very long

25
Q

Tx of Prostatitis in older men

A

Bactrim or

Cipro

26
Q

Testicular torsion de-torsed by 6 hours

A

80-100% salvage rate

27
Q

High riding testicle

Loss of cremasteric reflex

A

Testicular Torsion

28
Q

Epididymitis

A

Retrograde spread of infected URINE down the Vas Deferens

29
Q

Relieved w testicular elevation

A

Epididymitis -yes

Testicular torsion- no

30
Q

Is Cremasteric reflex intact with Epididymitis?

A

Yes

with torsion, cremasteric reflex is not intact

31
Q

Tx for Epididymitis

A 
Bedrest
Scrotal elevation w rest
Abx
Pain med
Stool softener
32
Q

Tx for Epididy that is most likely caused by G/C

A

Rocephin IM +

Doxy x10 days

33
Q

Tx for Epididy caused by G/C

A

Rocephin and Doxy

34
Q

Tx for Epididy in MSM

A

Rocephin + Levofloxacin (stronger) x10d

35
Q

If Epididy is only caused by Enteric organism

A

Levofloxacin

36
Q

Epididymitis

A

Relieved w elevation

Cremasteric reflex intact

37
Q

Paraphimosis

A

Foreskin becomes retracted behind glans of penis and cannot be placed over glans

38
Q

Tx of Paraphimosis

A

Push on glans- pull on foreskin
Sugar Lidocaine warp
Dorsal slit in foreskin

39
Q

Priapism

A

Erection >4 hours

40
Q

Priapism tx

A

Phenylephrine injected into corpora cavernosa

41
Q

Fourniers gangrene

A

Staph
Strep
E Coli
Clostridium

42
Q

Simple UTI

A

Tx w Macrobid

43
Q

Any time you suspect Epididymitis, what MUST you perform?

A

Ultrasound!!!

Have to r/o Testicular Torsion

Clinical Prep (41 decks)

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