GU Trauma

Question 1

Trauma imaging

Renal :

Ureteral :

Bladder :

Urethral :

Testicular:

Answer 1

CTU

CTU

Cystogram

RUG/Cysto

Ultrasound

Question 2

Indications for CTU

1. ____ hematuria
2. Micro hematuria with ____

Answer 2

1. gross hematuria

2. microhematuria + hypotension

Question 3

Must get f/up imaging for grade ____ renal lacerations

Answer 3

4-5

Question 4

Non-expanding subcapsular hematoma without parenchymal laceration

Grade ___ kidney injury

Answer 4

1

Question 5

Non-expanding peri-renal hematoma

Grade ___ kidney injury

Answer 5

2

Question 6

<1cm in depth kidney laceration w/o urine extravasation

Grade ___ kidney injury

Answer 6

2

Question 7

> 1 cm in depth kidney laceration w/p urinary extravasation

Grade ___ kidney injury

Answer 7

3

Question 8

Parenchymal laceration through cortex & collecting system

Grade ___ kidney injury

Answer 8

4

Question 9

Injury of renal artery or vein with contained hemorrhage

Grade ___ kidney injury

Answer 9

4

Question 10

Completely shattered kidney

Grade ___ kidney injury

Answer 10

5

Question 11

Complete avulsion of renal hilum with devascularized kidney

Grade ___ kidney injury

Answer 11

5

Question 12

Treat of XGP kidney on boards

Answer 12

nephrectomy

Question 13

In unstable patients, manage ureteral injuries with ____

Answer 13

drainage (PCN vs stent)

Question 14

Management of traumatic ureteral contusions

Answer 14

Stenting vs resection + primary repair

Question 15

Management of ureteral injury above iliac vessels

Answer 15

primary repair (U-U)

Question 16

Management of ureteral injury below iliac vessels

Answer 16

reimplant

Question 17

Imaging for pt with gross hematuria + pelvic fracture

Answer 17

Retrograde cystogram (XR or CT)

use 300-400cc

Question 18

Indications to operatively repair an extraperitoneal bladder injury

Answer 18

Bladder neck injury
Foreign body
+vaginal injury
Failure of bladder drainage

Question 19

Diagnostic exam for blood at meatus after pelvic trauma

Answer 19

RUG

Question 20

Immediate management of complete pelvic fracture urethral injury with no contrast reaching bladder on RUG

Answer 20

SPT

Question 21

Immediate management of partial pelvic fracture urethral injury with some contrast reaching bladder on RUG

Answer 21

Primary realignment vs SPT

Question 22

Penetrating trauma to scrotum - management?

Answer 22

Scrotal exploration

Question 23

Ecchymosis of penis with snapping sound followed by detumescence - diagnosis?

Answer 23

penile fracture

Question 24

Imaging for penile fracture if exam is equivocal

Answer 24

penile u/s

Question 25

Penile fracture is due to a defect in _____

Answer 25

tunica albuginea

Question 26

Always evaluate the ____ during penile fracture surgery

Answer 26

urethra **9-20% of fractures have concomitant urethral injury**

Question 27

Care for amputated penis

Answer 27

Wrap in saline soaked gauze, put in plastic bag, and place on ice