Emergencies and Hernias

Question 1

Most common urologic emergency

Answer 1

Renal colic

Usually due to passage of stone

Question 2

Renal colic presentation

Answer 2

Sudden onset colicky flank pain
Can migrate from flank to groin
Nausea and vomiting

Question 3

Imaging for stones

Answer 3

KUB
IVP
Helical CT (standard)

Question 4

Stone mgmt

Answer 4

Hydration, analgesia, most stones <5mm pass

Question 5

Mgmt of acute urinary retention

Answer 5

Catheterization

Tx underlying dz

Question 6

Difference btw acute and chronic urinary retention

Answer 6

Acute is painful

Chronic is not

Question 7

Acute scrotum causes

Answer 7

Torsion of spermatic chord (most serious)
Torsion of epididymus
Epididymitis (most common)

Question 8

When does ischemic injury start in a twisted testicle?

Answer 8

4 hrs

Question 9

Best test for torsion

Answer 9

Color doppler US

Question 10

Priapism types

Answer 10

Ischemic: painful (veinous obstruction)
Nonischemic: Not painful (arterial obs)

Question 11

Imaging for kidney injury

Answer 11

Contrast CT

Question 12

Bladder perf triad

Answer 12

Suprapubic pain and tenderness
Difficulty passing urine
Hematuria

Question 13

Anterior urethral injuries

Answer 13

Rare
Straddle injury in men
GSW, trauma, cath

Question 14

Ant. urethral dx

Answer 14

Retrograde urethrography

Question 15

Ant urethral tx

Answer 15

Contusion: small cath for a week
Partial rupture: suprapubic cath
Penetrating trauma: surgery

Question 16

Posterior urethral injuries are usually caused by?

Answer 16

Pelvic fractures

Some also have ass’d bladder rupture

Question 17

Posterior urethral injury mgmt

Answer 17

Stent or surgery Most groin hernias are?

Question 18

Most groin hernias are?

Answer 18

Inguinal

Question 19

Femoral hernias are more common in?

Answer 19

Elderly women

Question 20

40% of femoral hernias become?

Answer 20

Strangulated