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TRAUMA by DP > Genitourinary Trauma > Flashcards

Genitourinary Trauma Flashcards

1
Q

imaging “gold standard” for the stable patient with suspected renal injury

A

IV contrast-enhanced CT scan of the abdomen and pelvis

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2
Q

True or false

The FAST examination is useful for identifying free intraperitoneal fluid, but does not specifically evaluate renal injury and does not identify renal vascular injury

A

True

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3
Q

What imaging to use?

Multisystem trauma or suspected renal parenchymal or vascular injury

A

Multisystem trauma or suspected renal parenchymal or vascular injury

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4
Q

What imaging to use?

Any visceral injury resulting in free intraperitoneal fluid

A

FAST

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5
Q

What imaging to use?

Renal artery injury

A

Renal angiography

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6
Q

What imaging to use?

Ureteral injury

A

Abdominal-pelvic IV contrast CT scan

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7
Q

What imaging to use?

Bladder injury

A

Retrograde cystogram

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8
Q

What imaging to use?

Urethral injury

A

Retrograde urethrogram

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9
Q

What imaging to use?

Scrotal/testicular injury

A

Color Doppler US

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10
Q

True or false

In Ureteral injury, delayed films are needed to identify extravasation

Obtain IV pyelogram or retrograde pyelogram if still suspicious with negative CT

A

True

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11
Q

In Urethral injury, Retrograde urethrogram if performed prior to abdominal- pelvic contrast CT scan, can interfere with diagnosis

A

True

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12
Q

True or false

Scrotal/testicular injury

Contrast-enhanced US or MRI if suspicion is high and initial US is negative

A

True

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13
Q

Renal Injury Scale

Hematuria with normal anatomic studies (contusion) or subcapsular, non-expanding hematoma; no laceration

A

Grade I

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14
Q

Renal Injury Scale

Perirenal, nonexpanding hematoma or <1 cm renal cortex laceration with no urinary extravasation

A

Grade II

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15
Q

Renal Injury Scale

> 1 cm renal cortex laceration with no collecting system involvement or urinary extravasation

A

Grade III

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16
Q

Renal Injury Scale

Laceration through cortex and medulla and into collecting system or segmental renal artery or vein injury with hematoma

A

Grade IV

17
Q

Renal Injury Scale

Shattered kidney or vascular injury to renal pedicle or avulsed kidney

A

Grade V

18
Q

True or false

Delayed bleeding can occur up to a month after injury and is most commonly due to an arteriovenous fistula that has developed after a deep parenchymal laceration

A

True

19
Q

Disposition:
Grade I injury:
Those with a renal contusion (microscopic hematuria with normal imaging)

A

Discharge

20
Q

Disposition:

subcapsular hematoma

A

admitted for a short observation stay followed by a hematocrit and clinical reevaluation

21
Q

Disposition:

gross hematuria

A

need admission and require bed rest until the gross hematuria clears

22
Q

Disposition:

grade II or higher injury

A

Admit to trauma surgeon, general surgeon, or urologist

23
Q

Interpret

A

Normal retrograde urethrogram

24
Q

Interpret

A

Extravasation of contrast in retrograde urethrogram

25
Q

Posterior urethral injury is suggested by the triad of

A

urinary RETENTION
BLOOD at the meatus
HIGH-RIDING prostate

26
Q

How to perform retrograde urethrogram

A

Gently injecting 20 to 30 mL of contrast into the urethra and obtaining a radiograph

Extravasation identifies the existence and location of the urethral tear

In partial anterior urethral lacerations : contrast extravasation at the site of injury and contrast material outlining the urethra proximal to the site of injury

In complete anterior urethral lacerations : contrast extravasation at the site of injury WITHOUT contrast proximal to the site of injury.

Extravasation of contrast along fascial planes of the perineum is another indication of urethral disruption.

27
Q

Identify

A

Eggplant deformity

28
Q

Penile fracture mechanism of injury

A

Penile fracture, with or without urethral injury, occurs when the corpus cavernosum ruptures after being forcibly bent, usually during sexual intercourse.

A cracking sound may be heard, followed by penile pain, rapid swelling, discoloration, and visible deformity (“eggplant deformity”)

29
Q

Zipper injury to the penis is caused when the penile skin is trapped in the trouser zipper.

What is management?

A

MINERAL OIL and LIDOCAINE infiltration are useful in freeing the penile skin from the zipper.

Otherwise, wire-cutting or bone-cutting pliers are used to divide the median bar (or diamond) of the zipper.

TRAUMA by DP (13 decks)

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