Renal Procedures

Question 1

UA indications

Answer 1

Routine screen
Assess systemic disorders
Metabolic
Endocrine
Evaluate renal or urinary tract disease
Prenatal  evaluation

Question 2

situations where voided sample is not adequate

Answer 2

Vaginitis
Menses
Extremes in age (Adults and Children)
Morbid obesity 400-500lbs, M and F

Question 3

Specific gravity

Answer 3

comparison to pure water

if it is high, then that means there is more solids (and less water)

Question 4

leukocyte esterase

Answer 4

enzyme found on WBCs
indicates UTI
best PV when negative (and nitrites negative)

Question 5

Nitrites

Answer 5

indicates UTI
bacteria converts Nitrates Into Nitrites
best PV when negative (and LE negative)

Question 6

crystals

Answer 6

caused by supersaturation (most often d/ Calcium Oxylate

no clinical significant

Question 7

catheter indications

Answer 7

Acute urinary retention
Obtain uncontaminated sample
Diagnostic studies (Urodynamics, cystourethrogram)
Monitor urine output – ICU, postoperatively
Measure residual volume
Surgery on adjacent structures
Urinary tract surgery

Question 8

Catheter c/i

Answer 8

Known urinary tract obstruction (stricture)
Reconstructive surgery of urethra or bladder neck
Combative or uncooperative patient
Pelvic trauma – suspect urethra injury
Acute infection of the prostrate and/or urethra (relative)

Question 9

Catheter complications

Answer 9

infection
HU
urethra stricture

Question 10

suprapubic cath

Answer 10

Bladder neck stricture, contracture or obstruction
Inability to pass urethral catheter
Urethral trauma
Recent urethra or bladder neck surgery
Inability to tolerate or unwilling to self cath
Presence of urethral or prostate infection
Severe phimosis
Collect urine sample - analyze, culture
Relief of urinary retention

more often in males

Question 11

suprapubic cath c/i

Answer 11

Uncooperative patient
Blood dyscrasia or anti coagulation treatment
Infection or cellulitis of the suprapubic area

Question 12

suprapubic cath complications

Answer 12

Peri vesicular bleeding
Gross hematuria
Infection – skin, subcutaneous, intra abdominal, bladder
Intestinal perforation

Question 13

cystoscopy indications

Answer 13

Urinary incontinence
Known or suspected malignancy  
Recurrent UTI’s
Pelvic pain symptoms
Pelvic trauma
Intraoperative  assessment of bladder or urethral trauma

Question 14

cystoscopy c/i

Answer 14

UTI, pyelonephritis ( can cause sepsis)

Question 15

IVP

Answer 15

xray of kidneys
To detect problems in these areas including kidney stones, cancer, enlarged prostate
Size of stones and tumors are difficult to measure

Question 16

Extracorporeal Lithotripsy

Answer 16

procedure used to shatter simple stones in the kidney or upper urinary tract. Makes passing stone easier

Question 17

Intracorporeal lithotripsy

Answer 17

Laser is introduced through the cystoscand stones are broken into small pieces that will pass
higher complications, use after extracoporeal

Question 18

circumcisions c/i

Answer 18

Hypospadius or epispadius**
Atypical genitalia***
Undetermined phenotype (ambiguous genitalia)
Less than 12 hours postpartum
Illness
Prematurity (Relative)
Familial bleeding disorder  
Maternal thrombocytopenia

Question 19

risks of circumcision

Answer 19

Risks/complications
Bleeding**
Infection**
Trauma to glans or urethra
Poor cosmetic result 
Paraphimosis
Degloving of the penile shaft
Meatal stenosis - rare

Question 20

adult circumcision indications

Answer 20

Indications
Phimosis
Paraphimosis
Penile hygiene  
Recurrent balantitis
neoplasia 
cosmetic reasons are rare

Question 21

adult circumcision contraindications

Answer 21

Acute inflammation
Infection
Psychiatric disorder
Bleeding dyscrasia

Question 22

vasectomy c/i

Answer 22

Infection
Coagulation disorder
Inability to palpate or elevate vas deferens
Stress – divorce, financial
Inappropriate reasons for wanting procedure
Concern about ability to perform sexually after the procedure