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Clin Med II - Exam 4 > Ross - About the Flow > Flashcards

Ross - About the Flow Flashcards

1
Q

characteristics of renal colic

A

abrupt flank pain

CVA tenderness

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2
Q

renal colic begins in the __

and radiates to the __

A

lateral abd

genitals

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3
Q

symptoms NOT characteristic of renal colic (3)

A

rebound

guarding

abd tenderness

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4
Q

rf for renal colic (6)

A

obesity

DM

gout

immobilization

fam hx

IBD

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5
Q

tx for 1st instance of renal colic

A

imaging → non contrast CT

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6
Q

pt’s w. guarding or rebound tenderness likely don’t have renal cause, but still may need imaging… if this is the case, who may need imaging

A

fever

signs of obstructing stone

elderly (>65 yo)

omg is she serious with this study guide

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7
Q

CT has replaced __ as preferred diagnostic test for renal pain, but does not show

A

US

delayed filling

dilation of collecting system

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8
Q

US is not sensitive to diagnose

A

renal calculi

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9
Q

imaging of choice for renal calculi

A

IVP?

I think? this is very confusing on the study guide

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10
Q

2 types of renal stone

A

calcium

struvite

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11
Q

calcium stones include

A

oxalate

phosphate

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12
Q

less common type of renal stones

A

uric acid

cysteine

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13
Q

mc location ob obstructed stone

A

uterovesicular junction → pelvic brim uteropelvic junction

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14
Q

where does the ureter cross the iliac vessels

A

uterovesicular junction

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15
Q

what do you think when you see a CT w. stranding of perinephric fat, hydronephrosis, and nephromegaly

A

signs of obstruction

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16
Q

what imaging should be used to look for blood, crystals, and signs of infxn

A

UA

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17
Q

bacteria in obstructed collecting system causes (3)

A

abscess

renal destruction

sepsis

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18
Q

what pt’s need urology consult

A

high grade obstructions

large stones

infected stones

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19
Q

basic tx for renal stones

A

analgesia

antiemetic

IV hydration

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20
Q

what analgesics are 1st line for renal stones

A

IV lidocaine

nsaids

narcotics

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21
Q

indications for admit/urology consult for renal stones (5)

A

complicated stones:

high obstructions

stones > 8 mm

intractable pain

e.o UTI

transplanted/solitary kidney

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22
Q

indication for medical expulsion therapy for stones

A

< 10 mm

no risk of infxn

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23
Q

stones > __ are unlikely to pass on their own and need consult

A

8 mm

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24
Q

condition involving retraction of foreskin and entrapment of the glands

A

paraphimosis and entrapment

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25
Q

complications of paraphimosis/entrapment

A

edema

gangrene

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26
Q

tx for paraphimosis/entrapment

A

reduce

incise if can’t reduce physically (GU will do this)

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27
Q

phimosis is mc and less complicated in __

A

nenoates

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28
Q

sign of complicated phimosis in neonate

A

urine outflow obstruction

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29
Q

phimosis in neonate may require

A

dorsal slit in foreskin

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30
Q

2 types of priaprism

A

high flow

low flow

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31
Q

mc type of priaprism

A

low flow

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32
Q

3 meds that can cause priaprism

A

neuroleptics

hydralazine

CCB

33
Q

if you see a young or pre pubescent pt w. priaprism, consider

A

sickle cell dz

34
Q

tx for priaprism

A
  1. try non invasive first
  2. if this doesn’t work → need to be drained
35
Q

how do you drain (3 steps) a priaprism

A
  1. injxn of epi or phenylephrine into corpus cavernosa
  2. aspiration of blood thru a 18 g needle
  3. if no relief → urology consult
36
Q

what size needle to drain priaprism

A

18 g

i feel like she would ask this

37
Q

direct blunt GU trauma are associated w. tears in the (2)

A

tunica albuginea

corpus cavernosa

38
Q

if GU trauma involves a urethral tear, you need to order

A

retrograde urethrogram → inject dye into urethra

39
Q

maldevelopment of normal fixation of testes that occurs btw enveloping tunica vaginalis and posterior scrotal wall

A

testicular torsion

40
Q

when you see “bell clapper” deformity, think

A

testicular torsion

41
Q

mc pt population for testicular torsion (2)

A

neonate

preadolescence

42
Q

testicular torsion is mc associated w. __ method of injury

A

trauma

stenuous effort

43
Q

PE findings of testicular torsion

A

firm tender testes aligned on horizontal axis

absent cremasteric reflex

44
Q

tx for testicular torsion

A

can try manual detorsion

all need urology consult

45
Q

should you wait for US results to consult urology if you suspect testicular torsion

A

no!

46
Q

__% of pt’s have bell clapper deformity on both sides

A

40

47
Q

sx of epididymal torsion

A

less pain than tt

point tenderness

48
Q

what does a blue dot sign make you think

A

ischemic necrotic appendix

49
Q

polymicrobial GU infxn w. similar pathology to necrotizing fasciitis

A

fournier gangrene

50
Q

2 mc pathogens in fournier gangrene

A

e. coli

bacterioides (anaerobe)

51
Q

rf for fournier gangrene (2)

A

DM

etoh

52
Q

lab to order if you suspect fournier’s gangrene

A

lactate

53
Q

what do you think when you see, bullae in scrotum or groin, intense pain, fever

A

fournier gangrene

54
Q

imaging for fournier gangrene

A

CT w. contrast of abd and pelvis

55
Q

fournier gangrene infection is located

A

w.in fascial planes

56
Q

tx steps for fournier gangrene

A
  1. emergent surgical consult
  2. CT
57
Q

epididymitis/epididymo-orchitis mc affects __ yo

and is usually associated w. __

A

35

STI

58
Q

consider treating pt < 35 w. epididymitis for (2)

A

chlamydia

ghonorrhea

59
Q

if pt >35 presents w. epididymitis, consider what 3 pathogens

A

e. coli

klebsiella

pseudomonas

60
Q

for teenagers w. epididymitis, consider __

A

infected reflux

61
Q

pt’s > 65 w. epididymitis, consider

A

urinary outlet obstruction → enlarged prostate

STI

62
Q

tx for epididymitis in pt > 65 yo

A

US

GU referral

63
Q

cause of epididymitis in young unvaccinated adult

A

mumps

64
Q

sx of epididymitis related to mumps

A

salivary gland enlargement

65
Q

urethritis is mc caused by

A

STI → gonococcal or non-gonococcal

66
Q

sx of urethritis

A

penile d.c

+/- WBC on UA

look for herpetic lesions

67
Q

tx for prostatitis is determined by

A

acute vs chronic

68
Q

possible sx of prostatitis

A

perineal and/or lower back pain

fever

69
Q

tests to order for prostatitis

A

UA

culture

70
Q

AVOID __ in prostatitis dx

A

catheter

prostate massage

71
Q

pharm for prostatitis

A

fluoroquinolones or cephalosporins > 28 days

72
Q

sx of chronic prostatitis (3)

A

back pain

scrotal pain

painful ejaculation

73
Q

what is NOT a common sx of chronic prostatitis

A

fever

74
Q

sx of prostatitis can be present for __ or more months

A

3

75
Q

do symptoms need to be continuous for dx of chronic prostatitis

A

no → can be recurrent

76
Q

length of duration of tx for chronic prostatitis

A

2-3 mo

non emergent urology referral

77
Q

UTI + fever in neonate is mc

A

pyelonephritis

78
Q

for urine collection in neonate, you can try __

but will probably need __

A

bag specimen

catheterize

Clin Med II - Exam 4 (20 decks)

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