Urological Emergencies in Adults Flashcards
What is the clinical feature of renal colic?
Sudden onset of severe pain in the loin, microscopic haematuria, Nausea and vomiting
What is a common Alpha-blocker?
Doxazosin
What are common opiates you can give?
Morphine or pethidine
What radiological test do you usually use to see Radio-opaque ureteric stones?
X-Ray (abdomen)
What does ultrasound help with the identification of?
Hydronephrosis
What is the function of a stent?
A stent helps with stopping peristalsis of the ureters and allows for easy passage of a ureteric stone
ESWL is usually indicated for stones in which part of the urinary tract?
Upper ureteric calculi
What are the 4 major indications for intervention in ureteric stones?
- Anuria
- Large stone that will not pass spontaneously
- UTI
- Renal Failure(increased serum creatinine)
How does anuria occur?
When pt. Have bilateral ureteric stones or had a nephrectomy
What are some of the surgical options for ureteric calculi?
- ESWL
- PCNL
- ureterolithotomy (open surgery)
- Double J Stent
- Percutaneous Nephrostomy
What is the definition of microscopic haematuria?
> 3 RBCs per High powered Field
Indications for immediate catherterisation?
- Presence of a UTI
- renal failure
- acute or chronic urinary retention
What does a French catheter mean?
It is the circumference of the catheter in millimeters
What size catheter do you place in females?
14-16 F
What are the causes of urinate retention in females?
Pregnancy
Fibroids
Urethral strictures
Urethral diverticuli
Causes of urinary retention in men
BPH
Prostate Cancer
What is an example of an anti-cholinergic?
Tricyclic Anti depressants
What is the definition of priapism
Prolonged election for more than 6 hours without sexual desire
What is another name for Tamsulosin? And what does it treat?
Flomax
It treats BPH
What is the complication you need to look out for in patients after chronic urinary retention?
Post Obstructive Diuresis/ Haematuria
What is post-obstructive Diuresis?
It is defined as polyuria after obstruction of the bladder
Urine output will be about 10L per day
What are the two types of Priapism?
Low Flow(veno-occlusive) High Flow(arterial)
How long does it take for cavernous smooth muscle to experience necrosis?
24-48 hrs
In low flow priapism-the____ are spared
Glans and the corpus spongiosum
What size butterfly needle is used in the treatment of Priapism?
19 Gauge butterfly needle
An example of Intracorporeal Injection is:
Alpha-blocker= phenylephrine
Which nerve is stimulated at the perineum and gives sensation to the spinal cord?
Pudendal Nerve
What causes the deep arteries to dilate in the corpus cavernosum?
Nitric Oxide
All sympathetic neurons arise from:
T1-L2
What are the complications of Low-Flow Priapism?
- Erectile Dysfunction
2. Infection (cavernositis)
Treatment of Paraphimosis
Penile Block
Circumcision in a month
Define Paraphimosis
It is a retracted foreskin that is irreducible as a result of lymphatic obstruction
What are the 4 clinical features of high flow Priapism?
- No pain
- Bright res blood upon aspiration
- History of spinal cord injury
Extremely painful Testicular pain causes:
Epidydimitis
Testicular Torsion
Scrotal fullness pain:
Varicocele
Hydrocele
Describe the Cremaster Reflex:
When you stroke the medial aspect of the thigh, the testicles retract
What is the definition of a hydrocele?
Collection of fluid between the visceral and parietal layers of the tunica vaginalis of the testis
