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PCM III final exam > urological procedure > Flashcards

urological procedure Flashcards

1
Q

appearance of urine in UA and what it means

A

pink - blood
orange - meds
blue/green - drugs of ingested dyes, Pseudomonas
brown/black - myoglobin, bilirubin, rhubarb, meds

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2
Q

what 2 evaluation will be pos on UA if patient has UTI?

A

leukocyte esterase and nitrates

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3
Q

findings on microscopic evaluation and what it means

A 
WBC - infection
RBC - kidney disease, decreased coagulation, cancer
epithelial cells - contamination, cancer
casts - kidney disease
crystals - kidney stones
bacteria or yeast - infection
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4
Q

RBC casts in UA indicative of?

A
  1. glomerulonephritis

2. severe tubular damage

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5
Q

WBC casts in UA indicative of?

A

acute pyelonephritis

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6
Q

crystals in UA are formed by

A
  1. augmentation of concentration
  2. decreased supersaturation capacity
  3. crystals with a promoter effect
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7
Q

uric acid in UA indicates

A

poor dilution volume at an acidic pH

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8
Q

calcium oxalate in UA indicates

A

no significant clinical meaning

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9
Q

bacteria in UA indicates? what’s the most common bacteria found?

A
  1. UTI

2. E. coli

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10
Q

Bence-Jones proteins in UA indicates

A

multiple myeloma

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11
Q

indications for catheter

A
  1. acute urinary retention
  2. obtain uncontaminated sample
  3. diagnostic studies (urodynamics, cystourethrogram)
  4. monitor urine output - ICU, postop
  5. measure residual volume
  6. surgery on adjacent structures
  7. urinary tract surgery
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12
Q

contraindications for catheter

A
  1. known urinary tract obstruction (stricture)
  2. reconstructive surgery of urethra or bladder neck
  3. combative or uncooperative patient
  4. pelvic trauma - suspect urethra injury
  5. acute infection of the prostate and/or urethra (relative)
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13
Q

complications of catheter

A
  1. infection
  2. hematuria
  3. urethral stricture
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14
Q

long term use of catheter

A
  1. chronic retention
  2. neurogenic bladder with retention (unable to self cath)
  3. incontinent with complicated skin breakdown or infection
  4. comfort measure for terminally ill
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15
Q

suprapubic catheterization indications

A
  1. bladder neck stricture, contracture or obstruction
  2. inability to pass urethral catheter
  3. urethral trauma
  4. recent urethra or bladder neck surgery
  5. inability to tolerate or unwilling to self cath
  6. presence of urethral or prostate infection
  7. severe phimosis
  8. collect urine sample
  9. relief of urinary retention
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16
Q

suprapubic cathetrization contraindications

A
  1. uncooperative patient
  2. blood dyscrasia or anti-coagulation treatment
  3. infection or cellulitis of the suprapubic area
17
Q

suprapubic catherization complications

A
  1. peri-vesicular bleeding
  2. gross hematuria
  3. infection - skin, subQ, intra-abdominal, bladder
  4. intestinal perforation
18
Q

what is bladder scan used for?

A

non-invasive measurements of the bladder volume and post void residual volume

19
Q

what is flow cystometry used for?

A

evuluation of urinary incontinence, an overactive bladder, and urinary retention

20
Q

cystoscopy indications

A
  1. urinary incontinence
  2. known or suspected malignancy
  3. recurrent UTIs
  4. pelvic pain symptoms
  5. pelvic trauma
  6. intraop assessment of bladder or urethral trauma
21
Q

cystoscopy contraindications

A
  1. relative - UTI or pyelonephritis (can cause sepsis so patient is treated with antibiotics before procedure)
22
Q

what is intravenous pyelogram and what is it used for?

A
  1. X-ray of the kidneys, ureters, bladder

2. to detect problems in these areas including kidney stones, cancer, enlarged prostate

23
Q

what is an extracorporeal lithotripsy?

A

procedure used to shatter simple stones in the kidney or upper urinary tract

24
Q

what is an intracorporeal lithotripsy?

A

laser is introduced through the cystoscope into the ureter and stones are broken into small pieces that will pass

25
Q

infant circumcision indications

A
  1. parental desired
  2. may decrease UTIs and STIs
    3, may decrease penile cancer rate
26
Q

infant circumcision contraindications

A
  1. hypospadius or epispadius
  2. atypical genitalia
  3. undetermined phenotype (ambiguous genitalis)
  4. less than 12hrs postpartum
  5. illness
  6. prematurity (relative)
  7. familial bleeding disorder
  8. maternal thrombocytopenia
27
Q

infant circumcision risks/complications

A
  1. bleeding
  2. infection
  3. trauma to glans or urethra
  4. poor cosmetic result
  5. paraphimosis
  6. degloving of the pneil shaft
  7. meatal stenosis - rare
28
Q

adult circumcision indications

A
  1. phimosis
  2. paraphimosis
  3. penile hygience
  4. recurrent balantitis
  5. neoplastic foreskin
  6. excessive foresking redundancy
  7. frenular tears
  8. patient or spouse preference
29
Q

adult circumcision contraindications

A
  1. acute inflammation
  2. infection
  3. psychiatric disorder
  4. bleeding dyscrasia
30
Q

adult circumcision complications

A
  1. bleeding
  2. hematoma
  3. infection
  4. pain with erection
  5. stricture or scarring
  6. wound disruption usually due to erection
31
Q

vasectomy indications

A
  1. undesired fertility
32
Q

vasectomy contraindications

A
  1. infection
  2. coagulation disorder
  3. inability to palpate or elevate vas deferens
  4. stress - divorce, financial
  5. inappropriate reasons for wanting procedure
  6. concern about ability to perform sexually after the procedure

PCM III final exam (7 decks)

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