Urology and vascular basics Flashcards
Symptoms of renal stones
ureteric colic loin-groin pain sudden onset pain nausea and vomiting can't lie still occasionally get bladder obstruction
Examination findings for renal calculi
tachycardia no fevers unless infection--> emergency BP usually unaffected soft, non-tender abdomen renal angle tenderness
Bedside tests for renal calculi
urine dip- microscopic haematuria
ECG, BM, vitals
Bloods for renal calculi
FBC U&E LFT CRP Calcium amylase/lipase clotting VBG for lactate
Imaging for renal stones
CTKUB
AXR
Tx for renal stones
conservative- analgesia (PR diclofenac), fluids, anti-emetics, catheter if bladder obstruction
Medical- usually no abx, 5-10mm stones may be treated with medical expulsive meds e.g. alpha blockers
Surgical- extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy, uterorenoscopy and dormier basket removal
2 things to consider when you see haematuria
how much
is it frank blood
5 causes of haematuria
false blood- beetroot, rifampicin stone tumour clotting disorder infection BPH prostatitis infarct
Ix for haematuria
beside- urine dip, MC&S (microscopy, culture and sensitivity), BM, ECG, vitals
bloods- FBC, CRP, U&E, LFT, VBG
imaging- renal USS, flexible cystoscopy and biopsy, CT/MRI, renal angiography
Sx of bladder ca
painless haematuria
recurrent UTI
renal failure
Risk factors for bladder cancer
smoking amine exposure chronic cystitis schistosomiasis pelvic irradiation
3 types of bladder cancer
transitional cell carcinoma
adenocarcinoma
squamous cell carcinoma
Ix of bladder cancer
2 week referral
urine dip
USS
Flexible cystoscopy
Tx options for bladder cancer
depends on stage
superficial- diathermy via transurethral cystoscopy/ transurethral resection, intravesicular chemo with mitocin C or intervesicular immunotherapy
invasive- radical cystectomy, chemo/rad
Sx of renal cell carcinoma
loin pain, mass, painless haematuria