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Y2 Renal > Urological Emergencies > Flashcards

Urological Emergencies Flashcards

1
Q

what is acute urinary retention?

A

the inability to urinate with increasing pain

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2
Q

what is acute urinary retention a possible complication of?

A

benign prostate hyperplasia

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3
Q

what are the two possible causes of acute urinary retention?

A

spontaneous

precipitated by an event

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4
Q

what is the management for acute urinary retention?

A

catheter insertion

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5
Q

what investigations are done for frank haematuria?

A

CT urogram

cystoscopy

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6
Q

when is testicular torsion most common?

A

puberty

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7
Q

how does testicular torsion present?

A

sudden onset pain
nausea
vomiting
pain referral to lower abdomen

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8
Q

what is seen on examination of testicular torsion?

A

testes high in the scrotum

absent cremasteric reflex

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9
Q

what investigation may be done for testicular torsion?

A

doppler USS

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10
Q

how can epididymitis present?

A

dysuria
pyrexia
history of UTI or catheter

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11
Q

what is seen on examination of epididymitis?

A

cremasteric reflex present

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12
Q

what investigations are done for epididymitis?

A

doppler

urine culture + chlamydia PCR

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13
Q

what is the management for epididymitis?

A

analgesia
scrotal support
ofloxacin for 14 days

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14
Q

how is idiopathic scrotal oedema managed?

A

self limiting

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15
Q

what causes idiopathic scrotal oedema?

A

unknown

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16
Q

what is paraphimosis?

A

painful swelling of the foreskin distal to a phimotic ring

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17
Q

what is a common cause of paraphimosis?

A

foreskin retracted for catheterisation etc. and not replaced in its natural position

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18
Q

what is priapism?

A

prolonged unwanted erection for over four hours

often painful

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19
Q

what are four possible causes of priapism?

A

trauma
haematological diseases
neurological conditions
idiopathic

20
Q

what are the two types of priapism?

A

ischaemic

non ischaemic

21
Q

what are other names for ischaemic priapism?

A

veno occlusive

low flow

22
Q

what is the pathophysiology behind ischaemic priapism?

A

vascular stasis and decreased venous outflow in the penis

23
Q

how does ischaemic priapism present?

A

corpus cavernosum rigid and tender

often painful

24
Q

what is the pathophysiology behind non ischaemic priapism?

A

traumatic disruption of vasculature causes unregulated blood entry

25
Q

what two investigations are done for priapism?

A

aspirate blood from the corpus cavernosum

doppler USS

26
Q

what is seen on aspiration in ischaemic priapism?

A

dark blood

low oxygen, high CO2

27
Q

what is seen on aspiration in non ischaemic priapism?

A

normal arterial blood

28
Q

what is seen on doppler in ischaemic priapism?

A

minimal/absent blood flow

29
Q

what is seen on doppler in non ischaemic priapism?

A

normal/high flow

30
Q

what is the management for ischaemic priapism?

A

aspiration
injections of alpha agonists
surgery - shunt

31
Q

what is the management for non ischaemic priapism?

A

observe - often resolves spontaneously

selective embolisation

32
Q

what is fournier’s gangrene?

A

a form of necrotising fasciitis occurring around the male genitalia

33
Q

what are four risk factors for fournier’s gangrene?

A

diabetes
trauma
periurethral extravasation
perianal infection

34
Q

what is seen on examination of fournier’s gangrene?

A

swelling
crepitus
dark purple areas

35
Q

what is the treatment for fournier’s gangrene?

A

antibiotics

surgical debridement

36
Q

what increases mortality in fournier’s gangrene?

A

diabetes

alcoholism

37
Q

what is emphysematous pyelonephritis?

A

acute necrotising perirenal infection

38
Q

what is the most common cause of emphysematous pyelonephritis?

A

e coli

39
Q

what are the main risk factors for emphysematous pyelonephritis?

A

diabetes

ureteric obstruction

40
Q

how does emphysematous pyelonephritis present?

A

fever
vomiting
flank pain

41
Q

what is the investigation of choice for emphysematous pyelonephritis?

A

CT

42
Q

how is emphysematous pyelonephritis managed?

A

ICU admission

nephrectomy if it doesnt settle

43
Q

what causes a perinephric abscess?

A

rupture of cortical abscess

haematogenous spread of infection

44
Q

what investigation should be done for a perinephric abscess?

A

CT scan

45
Q

how is a perinephric abscess managed?

A

antibiotics

drainage

46
Q

what investigation is done for renal trauma?

A

CT with contrast

47
Q

what is bladder injury commonly associated with?

A

pelvic fractures

Y2 Renal (29 decks)

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