Flank pain Flashcards
Differentials for flank pain
Kidney - colic - pyelonephritis - cancer - abscess Spinal area - leaking AAA - fracture - met - disc prolapse Gynae - ectopic pregnancy - testicular torsion - ovarian torsion Muscular - spain
What GI related pathologies might be worried about in flank pain
Diverticulitis
Pancreatitis
Appendicitis
Difference in pain between stone in ureter vs kidney
Ureter- colicky
Kidney- constant
HPC questions for flank pain
Dehydration- stones Nausea and vomiting- stones, biliary colic, appendicitis Haematuria- stones, kidney LUTS- UTI Cloudy or smelly urine- infection Leg weakness- spinal pathology
What stones does recurrent cystitis predispose to
Struvite (MAP)
Why is PCKD relevant in flank pain history
Predisposes to pyelonephritis, stones
What is a strong popliteal pulse indicative of
Popliteal aneurysm
What do 50% of people with popliteal aneurysms have
AAA
What does an alkaline pH suggest
Presence of urease producing bacteria
What are some urease producing bacteria
Klebsiella
Pseudomonas
Proteus
What does presence of red cell casts as opposed to pure red cells suggest about aetiology
Casts come from kidney as implies stones are being forced through whereas pure cells implies lower than kidney
Blood investigations for renal colic
U&Es- kidney function
Ca, phosphate, urate- help with aetiology
What can make vision of an AAA on US difficult
Obesity
Unfasted
Air in transverse colon
What CT is used for UTC
Non contrast CT KUB
Why would you not use opiates in UTC
NSAIDS and paracetamol shown to have similar effects on pain in these patients
