Pestana- 12. Urology Flashcards
What do you expect in a young man with severe, sudden testicular pain with swollen, high riding testicle?
testicular torsion
What is the treatment for testicular torsion?
immediate surgery to untwist testis + orchiopexy
What condition is suspected in sexually active males with severe, sudden testicular pain + fever + pyuria and testicle in hormal position?
acute epididymitis
How do you treat acute epididymitis?
antibiotics and ultrasound (so you do not miss torsion)
What is included in a urological workup?
IVP?
CT (look for renal tumors)
sonogram (look for dilation)
What is the only way to look at bladder mucosa?
cystoscopy
What do you expect in old man with chills, fever, dysuria, frequency, diffuse low back pain and exquisitely tender prostate on rectal exam?
acute bacterial prostatitis
What do you need to remember with acute bacterial prostatitis?
ONLY DO 1 PROSTATE EXAM! continued massage can lead to septic shock
What is the most common reason that a new-born boy does not urinate on his day of birth?
posterior urethral valve
How do you manage posterior urethral valve?
catheterization
What is the diagnostic test for posterior urethral valves?
voiding cystourethrogram
What side of the penis is hypospadias opening?
ventral side
Can you circumcise a child with hypospadias?
NO (need all of that skin for plastic reconstruction)
What do you not need to miss in a child with a UTI?
vesicureteral reflux
How do you fix vesicureteral reflux?
long-term abx until child grows out of the problem
What do you expect in a little girl who pees appropriately but is wet with urine all the time?
low implantation of the ureter
What should you expect if you see an adolescent who binge drinks for the first time then develops colicky flank pain?
Ureteropelvic junction obstruction (normal UOP until you have large diuresis)
What is the workup of hematuria?
CT and cystoscopy
What metabolic abnormality is seen with RCC?
hypercalcemia
How do you diagnose testicular cancer?
radical orchiectomy
When do old men with BPH typically develop acute urinary retention?
after a cold (using antihistamines and drinking tons of fluids)
How long do you need to cath a patient with acute urinary retention?
3 days (at least)
What is the first line treatment for BPH?
alpha-blockers (tamsulosin)
What is the treatment for very large BPH glands?
5-alpha-reductase inhibitors
What is the final surgical option for BPH?
TURP
How small must a kidney stone be to have a good chance of passing spontaneously (70%)?
= 3mm
What is the most common tool for breaking up large kidney stones?
extracorporeal shock-wave lithotripsy
What is the most comon cause of pneumaturia?
diverticulitis
