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Renal > Emergencies > Flashcards

Emergencies Flashcards

1
Q

what can acute urinary retention be a complication from

A

BPH (banging prostatic hyperplasia )

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2
Q

what is urinary retention

A

inability to urinate with increasing pain

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3
Q

what might cause a urinary retention

A

prostate infection, bladder over distension, excessive fluid intake, alcohol, prostatic infarction

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4
Q

what are causes of precipitated urinary retention

A

non-prostate related surgery, catheterisation/ urethral instrumentation, anaesthesia, medication

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5
Q

when would you insert a catheter for urinary retention

A

if there is more than 1 litre residue

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6
Q

if there is painful retention, and

A

trial without catheter and prescribe alpha blocker for voiding success

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7
Q

what would patients with post- obstructive diuresis present wit h

A

chronic bladder outflow obstruction with uraemia, oedema, CCF, hypertension

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8
Q

what is diuresis

A

excess urine production

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9
Q

what would you do if the urine output does not get better in diuresis obstruction

A

IV fluids and sodium replacement

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10
Q

what is a differential for acute loin pain outside of renal

A

AAA

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11
Q

what is the most commonest cause of acute loin pain

A

renal colic/ calculi

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12
Q

what is the treatment for renal colic/ stoens

A

NSAID and opiate (alpha blockers for small stones that are expected to pass)

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13
Q

when would you treat renal calculi urgently?

A

unrelieved pain, pyrexia, persistent nausea, high grade obstruction

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14
Q

what treatment would you do in renal calculi

A

stent or stone removal- nephroscope for infected hydronephrosis

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15
Q

what can cause frank haematuria

A

infection, stones, tumours, benign prostatic hyperplasia, polycystic kidneys, trauma, platelet deficiencies

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16
Q

how would you restive frank haematuria

A

use a three way catheter

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17
Q

what investigations would you do for frank haematuria

A

CT urogram and cystoscopy

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18
Q

what are causes of acute scrotum

A

torsion of spermatic cord, torsion of appendix testis, epididymitis, inguinal hernia, hydrocelele, trauma, dermatological lesions, tumour

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19
Q

what age group does torsion of spermatic cord happen to?

A

puberty age?

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20
Q

what symptoms do you have with spermatic cord torsion

A

sudden onset of pain, previous self limiting pain, maybe nausea and vomiting, referred pain to lower abdomen

21
Q

what would you se in a patient with torsion of spermatic cord

A

testis high in scrotum, lie transverse, and absence of cremasteric reflex

22
Q

what is the cremasteric reflex?

A

where touched on the inner thigh, the testis moves in an upwards direction

23
Q

what is acute hydrocele

A

when fluid accumulates in the inner lining (tunica vaginalis) of the scrotum that contains the testes

24
Q

how would you image testicular torsion?

A

doppler USS

25
Q

how would you treat testicular torsion?

A

surgically fix testis, remove testis if necrotic, MUST fix contralateral side also

26
Q

what would you see in torsion of appendages

A

blue dot sign, cremasteric reflex is present

27
Q

what history with a patient who presents with epididymitis have?

A

UTI, urethritis, catheterisation/ instrumentation

28
Q

what is the common presenting complaint with epididymitis

A

dysuria/ pyrexia

29
Q

what investigations would you do if you suspected epididymitis

A

doppler- swollen/ increased blood flow

urine for culture and chlamydia PCR

30
Q

how would you treat epididymitis

A

analgesia and scrotal support, bed rest. Ofloxacin 400mg for 14 days

31
Q

what is paraphimosis

A

painful swelling of the foreskin distal to a phimotic ring

32
Q

when would paraphimosis often occur

A

when foreskin has been retracted for catheterisation or cystoscopy and member forget stop out it back into normal position

33
Q

what is the treatment for paraphimosis

A

iced glove, granulated sugar for 1-2 hours

34
Q

what is priapism

A

prolonged erection which is painful and not associated with sexual arousal

35
Q

what is the treatment of ischaemic priapism

A

aspiration and irrigation with saline. Injection of alpha agonist, surgical shunt, if more than 72 hours, think about a penile prosthesis

36
Q

what are non ischaemic treatment of priapism

A

may resolve spontaneously, selective arterial embolisation with non-permeant materials

37
Q

what is Fourniers gangrene

A

a form of necrotising fasciitis occurring around the male genitilia

38
Q

where does fourniers gangrene most commonly arise

A

skin, urethra, rectal region

39
Q

what can predispose someone to mourners gangrene

A

diabete, trauma, perianal infection

40
Q

what investigations would you do for fourniers gangrene

A

Xray or USS may confirm gas in tissue

41
Q

how would you treat fourniers gangrene

A

antibiotics, surgical debridement

42
Q

what type of patient does emphysematous pyelonephritis commonly occur in

A

diabetes

43
Q

what surgical procedure is done in emphysematous pyelonephritis

A

nephrectomy

44
Q

what is bladder injury commonly associated with

A

pelvic fracture

45
Q

what wold make you suspicious of a bladder injury?

A

fracture of suprapubic paint nd inability to void

46
Q

what would you use to image a bladder injury?

A

CT cystography

47
Q

how would you treat a bladder injury

A

large bore catheter, antibiotics, repeat cystogram in 14 days

48
Q

can you get a penile fracture?

A

yes lol

Renal (18 decks)

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