Emergencies Flashcards
what can acute urinary retention be a complication from
BPH (banging prostatic hyperplasia )
what is urinary retention
inability to urinate with increasing pain
what might cause a urinary retention
prostate infection, bladder over distension, excessive fluid intake, alcohol, prostatic infarction
what are causes of precipitated urinary retention
non-prostate related surgery, catheterisation/ urethral instrumentation, anaesthesia, medication
when would you insert a catheter for urinary retention
if there is more than 1 litre residue
if there is painful retention, and
trial without catheter and prescribe alpha blocker for voiding success
what would patients with post- obstructive diuresis present wit h
chronic bladder outflow obstruction with uraemia, oedema, CCF, hypertension
what is diuresis
excess urine production
what would you do if the urine output does not get better in diuresis obstruction
IV fluids and sodium replacement
what is a differential for acute loin pain outside of renal
AAA
what is the most commonest cause of acute loin pain
renal colic/ calculi
what is the treatment for renal colic/ stoens
NSAID and opiate (alpha blockers for small stones that are expected to pass)
when would you treat renal calculi urgently?
unrelieved pain, pyrexia, persistent nausea, high grade obstruction
what treatment would you do in renal calculi
stent or stone removal- nephroscope for infected hydronephrosis
what can cause frank haematuria
infection, stones, tumours, benign prostatic hyperplasia, polycystic kidneys, trauma, platelet deficiencies
how would you restive frank haematuria
use a three way catheter
what investigations would you do for frank haematuria
CT urogram and cystoscopy
what are causes of acute scrotum
torsion of spermatic cord, torsion of appendix testis, epididymitis, inguinal hernia, hydrocelele, trauma, dermatological lesions, tumour
what age group does torsion of spermatic cord happen to?
puberty age?
what symptoms do you have with spermatic cord torsion
sudden onset of pain, previous self limiting pain, maybe nausea and vomiting, referred pain to lower abdomen
what would you se in a patient with torsion of spermatic cord
testis high in scrotum, lie transverse, and absence of cremasteric reflex
what is the cremasteric reflex?
where touched on the inner thigh, the testis moves in an upwards direction
what is acute hydrocele
when fluid accumulates in the inner lining (tunica vaginalis) of the scrotum that contains the testes
how would you image testicular torsion?
doppler USS
