week 9 - GU

Question 1

describe the kidneys

Answer 1

• 2 bean shaped bodies situated behind the peritoneum
• asymmetrical; left slightly longer and narrower than right, right slightly lower than left
• lie in oblique plane
• normally extend from T12 to L3

Question 2

describe the ureters

Answer 2

• 2 tubes 10” to 12” long
• retroperitoneal
• extend from renal pelvis
• enter bladder at ureteral orifice
• use peristalsis

Question 3

describe the bladder

Answer 3

• musculo-membranous sac situated immediately posterior and superior to SP of pelvis
• serve as urine reservoir

Question 4

describe the urethra

Answer 4

• carries urine from bladder to exterior of body
• about 1.5” long in females and
• 7” to 8” long in males
• sphincter at neck of bladder

Question 5

preliminary film for micturating cystourethrography

Answer 5

bladder view for adult

Question 6

after care of micturating cystourethrography

Answer 6

possibility of dysuria; analgesic may be prescribed to adults

Question 7

pre procedural care for PCN/PCNL

Answer 7

• fasting for 4 hours
• empty bladder just before exam

Question 8

prelim film for PCN/PCNL

Answer 8

supine AP of the renal area or KUB

Question 9

complications of PCN/PCNL

Answer 9

• perirenal and intrarenal hemorrhage
• hematuria
• pneumothorax
• infection
• arteriovenous fistula
• puncture of adjacent organs

Question 10

after care of PCN/PCNL

Answer 10

• vacuum bottle connected to drainage catheter
• CXR to exclude pneumothorax or haemo-pneumothorax
• bed rest for 12hrs
• BP and temp half-hourly for 6hrs
• urine cultures - ?infection

Question 11

prelim films for a retrograde pyeloureterography

Answer 11

if done in X-ray dot: KUB

Question 12

complications of retrograde pyeloureterography

Answer 12

• introduction of infection
• mucosal damage to the ureter
• perforation of the ureter or renal pelvis by the catheter

Question 13

after care for retrograde pyeloureterography

Answer 13

• post anesthetic observation
• prophylactic antibiotics may be used
• inform the patient about the possibility of hematuria

Question 14

pre preparation for HSG

Answer 14

• patient to abstain from intercourse between appt booking and at time of exam unless reliable method of contraception is used
• exam usually booked between 4th and 10th days in a regular 28-day cycle

Question 15

preliminary film for HSG

Answer 15

coned AP view of pelvic cavity on request

Question 16

complications of HSG

Answer 16

• bleeding from trauma to the uterus or cervix
• intravasation of CM
• infection

Question 17

after care of HSG

Answer 17

• patient may have bleeding per vagina for 1-2 days and pain may persist for up to 2 weeks

Question 18

after care for T-tube

Answer 18

• drain out CM remaining in the biliary system
• check no kinking of tubes
• secure tubing by tapes

Question 19

patient preparation for PTBD

Answer 19

• NPO 4 hours before procedure
• premed include analgesia
• antibiotics before and for at least 3 days following
• iv fluid to avoid dehydration

Question 20

preliminary film for PTBD

Answer 20

supine AP of the right side of abdomen

Question 21

PTBD possible complications

Answer 21

• bleeding
• biliary and generalised sepsis
• bile leak with bile peritonitis or biloma

Question 22

after care of PTBD

Answer 22

• flush the externally draining catheter with normal saline and exchange at 3 monthly intervals
• antibiotics for at least 3 days

Question 23

Patient preparation for ERCP

Answer 23

• NPO 6 hours prior to procedure
• stop certain medications such as aspirin before procedure
• antibiotic cover

Question 24

preliminary films for ERCP

Answer 24

• if done in endoscopy room: none
• otherwise, AP and RPO of upper abdomen

Question 25

possible ERCP complications

Answer 25

Acute pancreatitis
Perforation
Cholangitis

Question 26

possible complications for micturating cystourethrography

Answer 26

• pyelonephritis and renal scarring
• recurrent fever