Renal Colic, Bladder + Renal cancer Flashcards
Investigations for ?renal colic
CTKUB - malesFemales - USS first then CT
Management for renal colic
Diclofenac IM + metoclopramide
Stone will pass spontaneously - urgent urology assessment within 7 days
Extracorporeal shock wave lithotripsy if stone removal indicated
Alpha adrenergic blocker to pass stone
Emergency = stent
How do renal stones cause colic?
Obstruction causes increase in tension, stimulating prostaglandin productionCauses vasodilation + diuresis which increases pressure more Smooth muscles spasms = colicky pain
3 main sites of obstruction for kidney stones
Vesico-ureteric junction Mid ureter where is crosses iliac vessels Pelvic ureteric junction
RF for kidney stones
Dehydration High urine pH MaleFHx Obesity Diet - high in protein
Presentation of kidney stones
Sudden onset severe unilateral abdo pain, originating in flank + radiating to groin Lasts mins-hours, occurring in spasmsN+V + haematuria Typically restless Dysuria, frequency + straining
Presentation of bladder cancer
Painless haematuria
Investigations for bladder cancer
Cystoscopy
Urine cytology
CT for staging
Management of bladder cancer
Transurethral resection of bladder tumor
Intravesical chemo
RT
Long term surveillance needed
Radical cystectomy if disease is invasive
S+S of renal cell carcinoma (RCC)
Mass, pain, haematuria, paraneoplastic syndromes, presence of mets
Usually found incidentally
Investigations for ?RCC
CT abdo or US
Management of renal tumors
Imaging cannot detect benign vs malignant so all should be resected
Indications for admission with renal colic
Intractable pain Fever Kidney with ureteral obstruction Bilateral obstructing stones Intractable vomiting Compromised renal function
