GU-Surgery Flashcards
Gross hematuria in the absence of RBC casts indicates
non-glomerular disease
red urine, smoker, flushed face, no RBC casts, hypertension and headache
Renal cell carcinoma
Polycythemia and hypertension with RCC indicates
paraneoplastic syndrome
1st line of tx for pt with urinary stones in the middle or distal ureter >10mm
ureterorenoscopy with stone removal
1st line of tx for pt with urinary stones <10mm
Observation for spontaneous pass
The most common cause of Urinary track obstruction in male newborns?
posterior urethral valves
Urosepsis, palpable bladder, history of oligohydramniosis, in a male newborn. Dx? Tx?
- Posterior urethral valve
- Ablation of urethral valve
1st line of treatment for BPH?
alpha-blockers (Terazosin, Tamsulosin, doxazosin)
Adjunctive treatment for BPH
5 alpha reductase inhibitors (Finasteride therapy)
name 4 features of kidney dysfunction
- Fatigue
- anemia
- Uremia
- elevated creatinine
Pt in long-term use of NSAID and aspirin-caffeine causes analgesic nephropathy due to
inhibition of prostacyclin production - shrunken kidneys with irregular contours and capillary calcifications
Initial hematuria, cleared by the end of the stream is
hematuria from urethral origin (or prostate)
The tx of choice for castration-resistance prostate cancer with localized skeletal metastasis
External beam radiotherapy (EBRT)
Indicated to rapidly decompress the renal collecting system to prevent permanent kidney injury from urinary tract obstruction
percutaneous nephrostomy
indicated for emphysematous pyelonephritis and acute renal failure or septic shock
nephrectomy
treatment for muscle-invasive bladder cancer without positive lymph nodes or distal metastasis
Radical cystectomy
treatment for low grade non-muscle-invasive bladder cancer
Transurethral resection of tumor with intravesical chemotherapy (TURBT)
Predisposing factors to acute urinary retention (AUR)(3)
BPH
Constipation
amitriptyline intake
Acute kidney injury (AKI) that is post renal can be ruled out by
ultrasonography
Best test to diagnose posterior urethral valves (PUV)
Voiding cystourethrogram
respiratory distress, potter facies, limb anomalies, and oligohydramnios before birth is
potter sequence
best step in a hemodynamically stable pt with suspected renal trauma
CT imaging with contrast
Best imaging test for evaluating urethral injuries
Retrograde urethrogram
US in young pt shows a solitary, round, sharply demarcated, hypo echoic lesion in there renal parenchyma with a strong posterior wall echo. Dx? NSIM?
- Simple renal cyst
- No treatment, reassurance
HTN difficult to control
hypokalemia
Cr>30% after ACE inhibitor
Renal artery stenosis
Flank pain following ingestion of diuresis-inducing beverages
Ureteropelvic junction obstruction (mild form in adult, sever in childhood)
Previous UTI, slow abx therapy response, poor urine flow, flank or suprapubic mass, high Cr. U/S hydronephrosis, ureteric dilation or renal scarring in child 2-24months. Dx? Testing?
Vericoureteral reflux, Voiding cystourethrography
19F, renal bruit and hypertension, Dx? NSIM?
Fibromuscular dysplasia causing renal artery stenosis ,
ACE inhibitor & Percutaneous transluminal angioplasty with out stent placement
Treatment for renal artery stenosis due to atherosclerotic disease
Precutaneous transluminal angioplasty with stent placement
increased rate of pyelonephritis and retrograde flow of urine in vesicoureteral reflux risk to
renal scarring
Lower abd pain, palpable lower abd mass due to distention of urinary bladder, hx of BPH, post-op
Bladder outlet obstruction
headache, lightheadedness, tinnitus in young women with high bp and concurrent cervical and abd bruits, DX? Lab value
Fibromuscular dysplasia, elevated renin level
the definitive treatment of hyperkalemia in Chronic renal failure patient
Hemodialysis
The most common cause of bladder outflow obstruction and acute urinary retention
BPH
abd mass felt in a child <2 yo irregular abd mass that often crosses the midline and associated with constitutional symptoms
Neuroblastoma
Older than 2 yo non-tender abd mass that does not cross midline, smooth surface, mostly incidental finding, but may present with abd pain & hypertension
Wilms’ tumor
Preferred test to diagnose bladder rupture
Retrograde cystography
Gross hematuria with pelvic fracture in trauma indicates
Traumatic bladder rupture
Hematuria with pain and hematoma over the flank in trauma indicates. Dx? testing?
Renal injury, Intravenous pyelography
First line of surgical procedure for stress incontinence after conservative therapy (pelvic floor muscle exercises/kegel)?
Urethral sling
Gold standard surgical procedure for strep incontinence after conservative therapy who also have pelvic organ prolapse
Urethropexy
Pt with urolithiasis a low urine pH is characteristic for
calcium oxalate, uric acid, or cystine stones
Pt with nephrolithiasis, foley catheter got UTI, UA with alkaline urine pH. organism?
Proteus mirabilis
Pt with foley catheter got UTI, normal urine pH, no nephrolithiasis, Organism?
E-Coli
What should be performed in all febrile children with confirmed UTI between 2-24months ? Reason?
Renal and bladder ultrasound (RBUS), because it can detect anatomical abnormalities & vesicoureteral reflux
What procedure can not be performed with active UTI
Voiding cystourethrography (VCUG)
Pt >35yo or with risk factor for urothelial malignancy should undergo ______ to evaluate the lower urinary tract and ______ to evaluate the upper urinary tract
Cystoscopy
CT Urography
Pt with blunt abd trauma with microscopic hematuria, stable. NSIM?
observation and follow up
