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Surgical placement > Urology and vascular basics > Flashcards

Urology and vascular basics Flashcards

1
Q

Symptoms of renal stones

A 
ureteric colic
loin-groin pain
sudden onset pain
nausea and vomiting
can't lie still 
occasionally get bladder obstruction
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2
Q

Examination findings for renal calculi

A 
tachycardia
no fevers unless infection--> emergency 
BP usually unaffected
soft, non-tender abdomen
renal angle tenderness
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3
Q

Bedside tests for renal calculi

A

urine dip- microscopic haematuria

ECG, BM, vitals

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4
Q

Bloods for renal calculi

A 
FBC
U&E
LFT
CRP
Calcium
amylase/lipase
clotting
VBG for lactate
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5
Q

Imaging for renal stones

A

CTKUB

AXR

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6
Q

Tx for renal stones

A

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

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7
Q

2 things to consider when you see haematuria

A

how much

is it frank blood

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8
Q

5 causes of haematuria

A 
false blood- beetroot, rifampicin
stone
tumour
clotting disorder
infection 
BPH
prostatitis
infarct
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9
Q

Ix for haematuria

A

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

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10
Q

Sx of bladder ca

A

painless haematuria
recurrent UTI
renal failure

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11
Q

Risk factors for bladder cancer

A 
smoking
amine exposure
chronic cystitis 
schistosomiasis 
pelvic irradiation
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12
Q

3 types of bladder cancer

A

transitional cell carcinoma
adenocarcinoma
squamous cell carcinoma

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13
Q

Ix of bladder cancer

A

2 week referral
urine dip
USS
Flexible cystoscopy

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14
Q

Tx options for bladder cancer

A

depends on stage
superficial- diathermy via transurethral cystoscopy/ transurethral resection, intravesicular chemo with mitocin C or intervesicular immunotherapy
invasive- radical cystectomy, chemo/rad

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15
Q

Sx of renal cell carcinoma

A

loin pain, mass, painless haematuria

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16
Q

Risk factors for renal cell carcinoma

A

smoking
obesity
end stage renal disease
hypertension

17
Q

Ix for renal cell carcinoma

A

bloods- FBC, U&E, ALP, Calcium

imaging- CT, MRI, CXR for mets

18
Q

Tx for renal cell carcinoma

A

radical nephrectomy

medical for those with advanced disease of who won’t survive surgery

19
Q

Sx of testicular torsion

A

sudden onset severe pain
nausea and vomiting
lower abdo pain

20
Q

examination findings in testicular torison

A

inflam of 1 testis- hot, swollen, tender
testis rides high and transversely
lack cremasteric reflex

21
Q

ddx for testicular torsion

A

epidymo-orchiditis
strangulated hernia
appendicitis

22
Q

Tx for testicular torsion

A

emergency surgery
NBM
routine bloods- FBC, CRP, U&E, G&s, clotting

23
Q

acute px of AAA

A

sudden onset abdo/back/loin pain

24
Q

examination of acute AAA

A

hypoT
tachyC
peripherally shutdown/shocked- hypovolemic

25
Q

DDx for AAA

A

perforated viscus
acute abdomen- pancreatitis, diverticulitis, appendicitis
renal colic

26
Q

management of ruptured AAA

A

ABCDE
CT aorta when haemodynamically stable
surgery if fit

27
Q

mx of asymptomatic AAA

A

surveillance until 5.5cm diameter
lifestyle interventions
antiHT, statins, anti-platelets
surgical mx

28
Q

define acute limb ischaemia

A

sudden onset reduction in limb perfusion which threatens the viability of the limb

29
Q

3 causes of acute limb ischaemia

A

embolisation
thrombosis in situ
trauma

30
Q

px of acute limb ischaemia

A

6 P’s

  • pale
  • pain
  • pulseless
  • paraesthesia
  • paralysis
  • perishingly cold
31
Q

ddx for acute limb ischaemia

A

DVT

spinal cord/peripheral nerve compression

32
Q

Ix for acute limb ischaemia

A

bedside- ECG to check for AF
bloods- lactate, G&S and routine
imaging- doppler US and CT angio

33
Q

Mx of acute limb ischaemia

A

conservative- O2, analgesia, fluids
medical- heparin, thrombolytics
surgical- embolectomy, bypass

34
Q

define chronic limb ischaemia

A

peripheral artery disease as a result of reduced blood supply to the limb

35
Q

2 causes of chronic limb ischaemia

A

atherosclerosis

vasculitis

36
Q

px of chronic limb ischaemia

A

intermittent claudification/rest pain/ gangrene

37
Q

ddx for chronic limb ischaemia

A

spinal stenosis

38
Q

Ix for chronic limb ischaemia

A

bedside- APBI, ECG, BM
bloods- routine and lipid profile
imaging- doppler US, CT/MRI angio

39
Q

Tx for chronic limb ischaemia

A

conservative- lifestyle interventions
medical- antiHT, statins, diabetic control, antiplatelet
surgical- angioplasty and bypass

Surgical placement (13 decks)

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