Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

renal > urological emergencies > Flashcards

urological emergencies Flashcards

1
Q

what is acute urinary retention a complication of

A

BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is acute urinary retention

A

inability to urinate with increasing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what can cause precipitated acute urinary retention

A
  • non prostate related surgery
  • catheterization or urethral instrumentation
  • anaesthesia
  • meds with sympathomimetic or anticholinergic effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

treatment for acute urinary retention

A

if painful with <1litre residue and normal serum electrolytes then trial without catheter
-alphablockers before TWOC improves chances of success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

who usually gets post-obstructive diuresis

A

patients with chronic bladder outflow obstruction in association with uraemia, oedema, CCF, hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what could acute loin pain be

A

urinary tract or AAA for example

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what causes the loin pain in ureteric colic

A

prostaglandins released by ureter in response to obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment for acute loin pain

A

NSAID +/- opiate

-alpha blocker for small stones that are expected to pass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

indications to treat a ureteric colic urgently

A
  • pain unrelieved
  • pyrexia
  • persistent nausea/vomiting
  • renal impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

urgent treatment of ureteric colic involves what?

A
  • ureteric stent or stone fragmentation/removal if no infection
  • percutaneous nephrostomy for infected hydronephrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment of clot retention causing frank haematuria

A

3 way irrigating haematuria catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

investigation for frank haematuria

A
  • CT urogram/USS

- cytoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what things could cause acute scrotum

A
  • torsion of spermatic cord
  • torsion of appendix testis
  • epididymitis
  • inguinal hernia
  • hydrocele
  • trauma
  • derm lesions
  • inflammatory vasculitis
  • tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

symptoms of spermatic cord torsion

A
  • sudden onset pain
  • nausea/vomiting
  • lower abdo pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is found on examination in spermatic cord torsion

A
  • testis high in scrotum
  • transverse lie
  • absence of cremasteric reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

if the testis are necrotic what do you do

A

remove them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

presentation of torsion of appendage (penis)

A
  • localised tenderness at upper pole

- blue dot sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what can cause epididymitis

A
  • UTI
  • urethritis
  • catheterisation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is found on examination in epididymitis

A
  • cremasteric reflex present
  • pyuria
  • swelling and increased blood flow on doppler
  • send for urine culture and and chlamydia PCR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

treatment for epididymitis

A

analgesia and scrotal support and bed rest

-ofloxacin 400mg/day for 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is paraphimosis

A

painful swelling of the foreskin distal to a phimotic ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when does paraphimosis usually happen

A

after foreskin retracted for catheterization or cytoscopy and staff forget to put foreskin back in natural position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

treatment for paraphimosis

A

iced glove
granulated sugar for 1-2 hours
multiple punctures in oedematous skin

24
Q

what is priapism

A

prolonged unwanted erection (>4hrs)

not associated with s3xual arousal

25
Q

causes of priapism

A
  • intracorporeal injection for ED
  • trauma
  • haematologic dyscriasis
  • neurological condition
  • idiopathic
26
Q

what are the two types of priapism

A

ischaemic and non-ischaemic

27
Q

what is ischaemic priapism

A

Vascular stasis in penis and decreased venous outflow, a true compartment syndrome.
Corpora cavernosa are rigid and tender, penis often painful

28
Q

what is non-ischaemic priapism

A

traumatic disruption of penile vasculature results in unregulated blood entry and filling of corpora

29
Q

diagnosis of priapism

A

aspirate blood from corpus cavernosum

  • dark blood means low flow ischaemic
  • normal blood means non-ischaemic

colour duplex USS

  • minimal flow in ischaemic
  • normal to high flow in non-ischaemic
30
Q

treatment of ischaemic priapism

A

aspiration +/- irrigation with saline
injection of alpha agonist
surgical shunt

31
Q

treatment for non-ischaemic priapism

A

observe

selective arterial embolisation

32
Q

fournier’s gangrene

A

form of necrotizing fasciitis occurring around the male genitalia

33
Q

pre disposing factors for fournier’s gangrene

A
  • diabetes
  • local trauma
  • periurethral extravastion
  • perianal infection
34
Q

presentation of fournier’s gangrene

A
  • starts as cellulitis
  • swelling and crepitus of scrotum, dark purple areas
  • marked toxicity
35
Q

investigation for fournier’s gangrene

A

plain x-ray or USS may confirm gas in tissues

36
Q

treatment for fournier’s gangrene

A

antibiotics and surgical debridement

37
Q

what is emphysematous pyelonephritis

A

An acute necrotizing parenchymal and perirenal infection caused by gas-forming uropathogens, usually E coli

38
Q

what is emphysematous pyelonephritis usually associated with

A

diabetes and ureteric obstruction

39
Q

symptoms of emphysematous pyelonephritis

A

fever
vomiting
flank pain

40
Q

what usually causes a perinephric abscess

A

rupture of an acute cortical abscess into the perinephric space or from haematogenous seeding from sites of infection

41
Q

diagnosis of perinephric abscess

A
  • high WCC
  • high serum creatinine
  • pyuria
  • CT
42
Q

treatment fo perinephric abscess

A

antibiotics and percutaneous or surgical drainage

43
Q

class 1 renal trauma

A
44
Q

class II renal trauma

A
45
Q

class III renal trauma

A
46
Q

class IV renal trauma

A
47
Q

class V renal trauma

A
48
Q

different classes of renal trauma

A
49
Q

indications for imaging in terms of haematuria

A
  • Frank haematuria in adult
  • Frank or occult haematuria in child
  • Occult haematuria + (systolic <90mmHg at any point)
  • Penetrating injury with any degree of haematuria
50
Q

presentation of a bladder injury

A
  • suprapubic tenderness
  • lower abdo bruising
  • guarding/rigidity
  • diminished bowel sounds
51
Q

diagnosis of extraperitoneal injury

A

flame-shaped collection of contrast in pelvis

52
Q

what would urethral injury be like on examination

A
  • blood at meatus
  • inability to urinate
  • palpably full bladder
  • high riding prostate
  • butterfly perineal haematoma
53
Q

investigations for urethral injury

A

retrograde urethrogram

54
Q

treatment for urethral injury

A

suprapubic catheter

55
Q

presentation of a penile fracture

A
  • cracking or popping sound
  • pain
  • rapid detumescence
  • discolouration
  • swelling
56
Q

treatment for penile fracture

A

circumcision incision with degloving of penis to expose all 3 compartments

renal (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions