Urinary Tract Obstruction

Question 1

symptoms of upper urinary tract obstruction

Answer 1

dull, sharp or colicky flank pain (intermittent or persistant)
nausea and vomiting
anuria (if bilateral)
haematuria

Question 2

signs of upper urinary tract obstruction

Answer 2

palpable mass, microscopic haematuria, complication signs

Question 3

complications of upper urinary tract obstruction

Answer 3

infection, sepsis and renal failure

Question 4

sites of obstruction in upper tract

Answer 4

pelvic ureter junction
ureter
vesico-ureter junction

Question 5

sites of obstruction in lower tract

Answer 5

bladder neck
prostate
urethra
urethral meatus
foreskin

Question 6

what type of tumour would occur in the upper tract to cause obstruction

Answer 6

a transitional cell carcinoma

Question 7

what is the most common renal cancer

Answer 7

clear cell carcinoma

Question 8

causes of obstruction in all parts of upper tract

Answer 8

stone and tumour

Question 9

causes of obstruction only in PUJ and ureter

Answer 9

blood clot and fungal ball

Question 10

things that might cause obstruction from outside the upper tract

Answer 10

lymph nodes
abdominal mass
prostate tumour

Question 11

investigations for upper tract obstruction

Answer 11

dipstick
renal ultrasound
urea and creatinine
WBC 
non-contrast CT (pyelogram)
PSA

Question 12

risk factors for urinary tract obstruction

Answer 12

BPH
constipation
urolithiasis
spinal cord injury
malignancy
meatal stenosis

Question 13

emergency treatment of upper obstruction

Answer 13

percutaenous nephrostomy insertion
OR
retrograde stent insertion

Question 14

what is a percutaneous nephrostomy insertion

Answer 14

a small flexible tube inserted into kidney to drain urine. can also be to remove kidney stones

Question 15

effect of retrograde stent on ureter

Answer 15

dilates it because ureter doesn’t like plastic

Question 16

where does a retrograde stent go

Answer 16

in the ureter

Question 17

presentation of lower tract obstruction

Answer 17

LUTS
acute/chronic urinary retention
recurrent UTIs
frank haematuria
bladder stones
renal failure

Question 18

sign in urine of lower or upper tract obstruction

Answer 18

haematuria (frank or microscopic)

Question 19

what kind of urinary retention does lower tract obstruction present with

Answer 19

acute or chronic

Question 20

effect of urinary retention on abdomen

Answer 20

abdomen bulges at bladder

Question 21

emergency treatment of lower tract obstruction

Answer 21

urethral or suprapubic catheterisation

Question 22

imaging in lower tract obstruction

Answer 22

bladder scan, renal tract ultrasound

Question 23

decompression haematuria

Answer 23

small vessels shear in presssure change