RENAL 5

Question 1

testicular torsion is what 
who 
symptoms 
ix
rx

Answer 1

twist of spermatic cord -> ischaemic -> necrosis

peak in 13-15yo

severe and sudden pain

cremesteric reflex negative

surgical exploration - fix both sides to prevent bell clapper deformity

Question 2

torsion of appendage presents how
signs if early
ix
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Answer 2

insidious or like torsion
localised tenderness at upper pole and blue dot sign
testes mobile and cremesteric reflex positive (normal)
resolves spontaneously

Question 3

priapism is what
causes
ix
rx

Answer 3

prolonged erection over 4h not related to sex and painful

trauma, infection, sickle cell, near, idiopathic

aspirate in iscgaemic: low flow and dark blood. colour doppler USS

ischaemic: aspirate and irrigate with saline. inject alpha blockers (phenylprine) every 5-10mins. surgical shunt
non-ishcaemic: observe - can resolve spontaneously

Question 4

epididymis symptoms
ix
rx

Answer 4

dysuria, pyrexia, history of UTI, catheter, urethritis
cremesteric reflex positive, doppler :swollen and increased blood flow, urine culture and chlamydia PCR
analgesia and scrotal support, oflaxicin 400mg OD for14 days

Question 5

epididymal cyst is the commonest cause for what
where is it 
assoc with what 
ix
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Answer 5

cause of scrotal swelling
separate from the body of testicle and posterior to testicle
assoc with PKD, C fibrosis, VHL syndrome
USS
supportive

Question 6

epididymo orchtiis causes
symp
rx

Answer 6

C, G esp in <35. amiodarone
unilateral pain and swelling
ceftriaxone 500mg IM in one dose
Doxyccline 100mg PO BD 10-14 days

Question 7

hydrocele is what 
primary causes 
secondary causes 
symp
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Answer 7

accumulation of fluid in tunica vaginlais
patent tunica vaginalis
epidiymorchitis, testicular torsion, testicular torsion
SNT, anterior and below testicle, can get above, transluminates
clinica dx. USS
infantile: repair transvaginal ligation of PPV
adults: conservative, underlying cause

Question 8

varicocele is what 
which side is more common 
symptoms 
ix
rx

Answer 8

abnormal engagement of testicualr veins 
L>R
bag of worms. sub fertility 
doppler
conservative. if pain - surgery

Question 9

partamorphis how does it happen

treatment

Answer 9

nor replacing forekin after catheter/cystoscopy

iced glove, granulated sugar for 1-2 hours, puncture holes in oedematous skin, manual compression, dorsal slit

Question 10

fourners gangrene what is it 
causes
symptoms early and then late 
ix
rx

Answer 10

necrotising fasciitis. 
DM, local trauma
cellulitis in early. swelling, crepitus, dark purple areas
plain XR/USS to confirm gas in tissue 
ABs and surgical debridement