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Junior Posting > Urological Emergencies > Flashcards

Urological Emergencies Flashcards

1
Q

Acute urinary retention

(Gradual or Sudden?) ____________

A

Sudden inability to micturate

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2
Q

Acute urinary retention is always painful

T/F

A

F

Invariably but not always painful

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3
Q

Painless Acute urinary retention are associated with ?

A

CNS pathology

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4
Q

Epidemiology of AUR

___% of all men in their 7th decade

___% of all men in their 8th decade

A

10

33

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5
Q

Chronic urinary retention is invariably (painful or painless?)

A

Painless

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6
Q

Acute on chronic retention can occur in ____,_____,______, etc

A

BPH
CA-P
strictures

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7
Q

Clinical evaluation of CUR patient

DRE is unreliable in ________

A

Full bladder

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8
Q

Problems of urethral catheterization

•risk of urethral _______, which can lead to _____ and _____
•increased risk of _______
•increased patient discomfort

A

Trauma; bleeding; strictures

UTIs

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9
Q

Management of urinary retention

_______ catheterization
__________ catheterization

A

Urethral

Suprapubic

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10
Q

Suprapubic catheterization

Can be :
-) _________ cystostomy
-) __________ cystostomy

A

Cystofix

Open

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11
Q

Suprapubic catheterization is the only reasonable option in ______ structures and acute _________

A

Tight; prostatitis

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12
Q

Problems of Suprapubic catheterization

  • requires ____________
    -potential risk of ———— in untrained hands
A

Higher level of training

Bowel injury

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13
Q

Advantages of Suprapubic catheterization

-)reduced risk of _____
-)improved ____________
-)no risk of __________ or _______
-)_____________ can be tried

A

UTI

patient comfort

urethral damage or stricture

trial of micturition

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14
Q

Complications After Relieve of Acute on Chronic Retention

Post obstructive diuresis
-output is >_____mls/hr for ____hours
-______ damage and impaired nephron’s ability to __________
-hypovolaemia, reduced electrolytes

A

200; 2

tubular; concentrate urine

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15
Q

Post obstructive diuresis

Risk factors

Increased _______, _________ , ______ kidney, post void volume > ______ .

Admit and offer IVF to correct fluid and electroyte imbalance.

A

Blood pressure

renal failure; solitary

IL

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16
Q

After relieve of acute on chronic retention, Most pts will exhibit diuress

T/F

A

F

Most pts will not exhibit diuress

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17
Q

Age Specific Haematuria

_______- 25 yrs
________- 30
_______-35
_______-45
_________- 50

A

Schistosomia

Trauma

UTI

Calculi

Tumors

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18
Q

CLINICAL FEATURES of hematuria

Pain - Painless haematuria highly suggestive of ____________.
Pain - _________,_______

A

malignant disease

Inflammation, stones

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19
Q

Hematuria :Duration

  • Short hx - _______ ,________

-Long (months / years) - _______,________,___________ etc.

A

Tumor , acute infections

TB, Calculi, hydronephrosis

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20
Q

Most cases of gross haematuria are self limiting.

T/F

A

T

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21
Q

Treatment of hematuria

  • Can patient empty bladder? - If not - _________ with __________
    and flush to ________

If there’s Continued clot formation or significant haematuria, use a _________ catheter and start continuous ________.

A

catheterize

haematuric catheter

evacuate clot.

3 way Foley ; irrigation

22
Q

Massive Haematuria - Haematuria
severe enough to threaten the patients with the risk of severe __________

A

hypovolaemia

23
Q

Intractable Haematuria -______,_______ haematuria, which fails to respond to ___________ treatment.

Invariably from ________,_______, or _____

_________- main culprit

A

Severe, persistent

conservative

kidney or bladder or prostatic urethra

Bladder

24
Q

Haematuria most times self limiting.

T/F

A

T

25
Q

First episode of haematuria gives best chance of early diagnosis and cure of malignant disease.

T/F

A

T

26
Q

Degree of haematuria correlates with severity of underlying problem in early cases.

A

F

It does not

27
Q

_________ + ________ + ___________ = RCC.

A

Haematuria

Loin mass

loin pain

28
Q

Painless haematuria - _________ disease
until proved otherwise.

A

Malignant

29
Q

All patients (with few exceptions) having hematuria should have an

______ or _____ + ____________.

A

IVU

USS

cystoscopy

30
Q

In Bladder injuries - _________ is mandatory.

A

catheterisation

31
Q

If urethral injury suspected - Avoid
urethral catheterization because it can convert _________ into a —————

A

partial rupture

complete one.

32
Q

In a normal Capacity bladder,
Sensation of Pain occurs when the volume exceeds
a. 150mls d. 400mls
b. 200mls C. 300mls e. 500mls

A

E

33
Q

The drugs known to precipitate Acute Urinary Retention (AUR) include:

b. ___________
c. _________
d. _____________
e. ________

A

Diuretics

Prazosin

Alfuzosin

Probanthilin

34
Q

Causes of Acute Urinary Retention (AUR) in women include:

a. ________
c. ______________ uterus
e. Psychogenic

A

Cystitis

Retroverted gravid

35
Q

Likely causes of AUR include
a. Benign Prostatic hyperplasia (BPH)
b. Urethral stricture disease
c. Prostatic carcinoma
d. Bilateral ureteric stones
e. Tumors involving the bladder fundus.

A

A
B
C

36
Q

Acute Urinary Retention can be defined as:
(a)Inability to pass urine despite the urge to void
b)Inability to pass urine despite the presence of a
full bladder.
c) Anuria
(d)Oliguria
(e)All of the above

A

B

37
Q

The following drugs are known to precipitate AUR
a. Morphin
b. Probanthilin
c. Diuretics
d. Prazosin
e. Alfuzosin

A

B
C
D
E

38
Q

Causes of AUR in women include
a. Cystitis
b. Urethral Stricture
c. Retroverted gravid uterus
d. Carbuncle
e. Psychogenic

A

A
B
C

39
Q

AUR IS
(a)Commonly associated with CUR
(b) Always painful
(c) Usually of short duration of onset
(d)Almost invariably associated with a palpable bladder
(e)The commonest urologic disorder presenting to the emergency room.

A

C

40
Q

Urethral stricture
• _______ age group
• Previous history of ______,______, or _______ – few weeks or ____ yrs before presentation

• Previous LUTS may be absent.

• Poor stream (improved or not improved?) by straining

• Post STI- ________ urethra and (short or long?)
• Post catheterisation strictures rising
•______/______ tests are mandatory

• Treatment is __________

A

Any

trauma,STI,instrumentation; 20

Improved

anterior; long

RUCG\MCUG

urethroplasty

41
Q

TRAUMA
• Now a major cause of AUR
• Usually occurs in ____________
• AUR usually associated with ______ at external meatus
• AUR more common with _________ urethral trauma
• Pelvic fracture- ________ urethra
•saddle- ________ urethra

A

young male adults

blood ; posterior

posterior; anterior

42
Q

•_________ attempt(s) at passage of a well lubricated urethral catheter permitted

A

A single

43
Q

______________________ (SPC) is the safest

A

Suprapubic cystosomy

44
Q

IMPORTANT MESSAGES

Avoid ______________

Always use an ____________________ gel.

A

suprapubic tap

anaesthetic lubricating

45
Q

______________ is scientifically a better option than urethral catherization for an indwelling catheter

A

Suprapubic cystostomy

46
Q

Always observe patient for at least ____________ after relieve of obstruction

A

few hours

47
Q

IMPORTANT MESSAGES

____________ Antibiotics – Controversial

Replacement of Indwelling Catheter- ________-__________

Clean intermittent Catheterization.

A

Prophylactic

2-4 weeks-3months.

48
Q

Commonest causes Of hematuria in Lagos – ______,______,______,_______,________

________ - rare

Tumors can arise at any age

A

Trauma, Tumors, BPH,Stones, SCD

Infection

49
Q

Painless haematuria highly suggestive of ______________

Painful hematuria– ________,_________

A

malignant disease.

Inflammation, stones

50
Q

Short history of hematuria- ______,_______

Long (months / years) history of hematuria – _______,________, hydronephrosis etc.

A

Tumor, acute infections

TB, Calculi

51
Q

Haematuria in Renal trauma
• Can be absent in ______ of vascular pedicle
• When persistent and life threatening is an indication for _______ and _____

• .conservativeTx involves absolute _______ until urine is completely clear
• _________ injury is an indication for surgery
• .most injuries are _______ and _______

A

avulsion

CT and surgery

bed rest; Penetrating

blunt and minor

52
Q

Prostatic origin of hematuria

• ______ commonest
• May be severe
• Will respond to __________
• Do __________ in non responsive cases
• Cystoscopic clot evacuation with Elliks evacuator
• Place for emergency _________ and _______________

A

Bph

bladder irrigation

Diathermy fulguration

prostatectomy

5 alpha reductase inhibitor

Junior Posting (35 decks)

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