GU Study Guide

Question 1

Does neprholithiasis produce rebound tenderness

Answer 1

No

Question 2

Elderly patients older than 65 with nephrolithiasis need what imaging

Answer 2

CT non contrast

Question 3

Signs of obstruction on CT?

Answer 3

Stranding of perinephric fat, hydronephrosis, nephromegaly.

Question 4

Basic treatment of nephro?

Answer 4

Analgesia - IV lidocaine, NSAIDs, narcotics, anti emetics, IV hydration

Question 5

Consider admission or urology consultation for stones that are?

Answer 5

High obstructions, stones greater than 8 mm, intractable pain, evidence of UTI, transplanted or solitary kidney. - Complicated stones.

Question 6

Foreskin pulled back and entrapping of the glans is called?

Answer 6

Paraphimosis.

Question 7

What foreskin abnormality is common in neonates and make require a dorsal slit?

Answer 7

Phimosis.

Question 8

Paraphimosis can result in?

Answer 8

Edema, gangrene. Must be reduced forward. If not able to reduce with pressure then need incise (call GU)

Question 9

What are the two states of Priapism?

Answer 9

High flow and low flow state

Question 10

What meds can lead to priapism?

Answer 10

Neuroleptics, hydralazine, calcium channel blockers

Question 11

What is the first noninvasive treatment for priapism

Answer 11

Terbutaline or psuedophedrine PO. If this does not work then needs to be drained.

Question 12

Terbutaline and pseudophedrine did not work for priapism. What is the next step?

Answer 12

Injection of epinephrine or phenylephrine into corpus cavernous, then aspiration of blood through 18 gauge needle. No relief from this - GU emergency and call urology

Question 13

Tears in the tunica albuginea or corpus cavernosa need what diagnostic test to rule out urethral tear?

Answer 13

Retrograde urethrogram (inject dye into the urethra and take X-rays to see where it goes.

Question 14

Tears in the tunica albuginea and or corpus cavernous are associated with direct blunt trauma. What are they often associated with?

Answer 14

Urethral tears

Question 15

What is a maldevelopment of the normal fixation that occurs between the enveloping tunica vaginalis and the posterior scrotal wall. This allows the epididymys to hang freely

Answer 15

Bell clapper deformity.

Question 16

Patient presents with a firm, tender, and teste that is alinged in a horizontal axis and no cremasteric reflex, what is it?

Answer 16

Testicular torsion

Question 17

If you have a high suspicion of TT you should a) perform an ultrasound b) call uro c) nothing

Answer 17

Call uro first - dont wait for ultrasound

Question 18

Torsion of the epididymal appendix is less painful and presents with?

Answer 18

Point tenderness and blue dot sign.

Question 19

You see a bullae on the scrotum and intense pain and fever. First step is to?

Answer 19

CT with contrast or lactate level.

Contact surgery early before CT if you have high suspicion.

Question 20

Patient younger than 35 comes in with epididymitis. This is probably from?

Answer 20

STI - consider obtaning a culture and treating those with STI for chlamydia and gonorrhea.

Older than 35 - E. coli, klebsiella and pseudomonas.

Question 21

Urithritis cause?

Answer 21

Typically STI

UA may be positive for wbc - look for herpitic lesions

Question 22

Patient presents with perineal, low back pain, and a fever. DX? work up? tX?

Answer 22

prostatitis

Obtain a UA and culture to acess organism. Do not catheterize or perform prostate massage

Treat with fluroquinolones or cephalosproins for more than 28 days.

Question 23

UTI in a neonate causes fever. This is probably resulting from?

Answer 23

Pyelonephritis - get a clean sample - probably cath.