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Renal Week 3 2017/18 > 2: Urological emergencies > Flashcards

2: Urological emergencies Flashcards

(51 cards)

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1
Q

What is the most common urological emergency presenting to A&E?

A

Acute urine retention

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2
Q

What are the symptoms of acute urine retention?

A

No urine output

Increasing bladder pain - midline, suprapubic

Abdominal mass

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3
Q

What commonly causes acute urine retention in men?

A

Benign prostatic hyperplasia

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4
Q

Apart from BPH, what are some other causes of acute urine retention?

A

Prostate infection

Prostate infarction

Excessive fluid intake - think alcohol

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5
Q

Acute urine retention is either ___ or ___.

A

spontaneous , precipitated

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6
Q

What are some events which can precipitate acute urine retention?

A

Surgery

Catheterisation

Anaesthesia

Sympathomimemetic / anticholinergic medication

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7
Q

How is acute urine retention treated?

A

Catheter

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8
Q

What can be prescribed along with a catheter to treat acute urine retention?

A

Alpha blocker

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9
Q

What are some consequences following treated acute urine retention?

A

Post-obstructive diuresis (risk of dehydration)

Haematuria

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10
Q

What is a common renal cause of loin pain?

A

Renal calculus causing ureteric colic

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11
Q

How is the pain of ureteric colic managed?

A

NSAID - diclofenac, inhibits prostaglandins which mediate ureteric pain

Opiate analgesia if NSAIDs not effective

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12
Q

What drug can be prescribed to encourage the passing of small renal calculi?

A

Alpha blocker

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13
Q

If a renal calculus is large, how is it likely to be treated?

A

Surgery

ureteric stent, stone removal

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14
Q

What imaging method is gold standard for finding renal stones?

A

CT scan +/- contrast

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15
Q

What signs and symptoms would encourage you to intervene to remove a renal stone?

A

Unrelieved pain

Fever and other signs of infection and sepsis

N&V

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16
Q

Haematuria is a common presentation - what investigation is used to find the cause?

A

CT urogram

Cystoscopy

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17
Q

What special type of catheter is used to treat frank haematuria?

A

3-way irrigated catheter

helps to break up clots

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18
Q

What is a presentation caused by twisting of the spermatic cord?

A

Testicular torsion

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19
Q

What usually causes testicular torison?

Which group is it common in?

A

Spontaneous

Adolescent boys

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20
Q

Where is pain felt in testicular torsion?

A

Scrotum

may radiate to lower abdomen

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21
Q

How is suspected testicular torison investigated?

22
Q

How is testicular torsion treated?

Study These Flashcards
A

Surgically, within 4-6 hours of onset

23
Q

What must be done if the testis is black on exploration?

24
Q

What sign is produced by torsion of the appendix testis?

Study These Flashcards
A

Blue dot sign

25
What **infectious** disease presents like **testicular torsion**? How do you tell the difference?
**Epididimytis** Signs of infection, history of infectio,n, **pyuria** cremasteric reflex PRESENT
26
How is suspected **epididimytis** investigated?
**Urine culture** **Chlamydia PCR**
27
How is epididimytis treated?
**If confirmed to be an STI:** oral doxycycline **If confirmed to be a UTI**: oral oxfloxacin or ciprofloxacin
28
What is a common cause of scrotal tenderness and pruritus in children which self-resolves?
**Idiopathic scrotal oedema**
29
What is **painful swelling** of the foreskin called?
**Paraphimosis**
30
How is **paraphimosis** (painful swelling of the foreskin) treated?
**Attempt to reduce swelling to move foreskin back over glans:** iced glove, punctures, compression, dorsal slit
31
What is **priapism**?
**Prolonged erection** (\> 4hrs) painful not associated with arousal
32
I mean how likely is it that priapism will come up in exams
33
How is **priapism** investigated?
**Blood sample from corpus cavernosum** **USS**
34
How is **priapism** treated?
**Aspirate and irrigate with saline** **Alpha agonist** **Surgical shunt**
35
What is **Fournier's gangrene**?
**Necrotising fasciitis** of **male genitalia**
36
How is **Fournier's gangrene** treated?
**Surgical debridement** **Antibiotics**
37
What is the mortality rate of Fournier's gangrene?
**20%**
38
What organism commonly causes pyelonephritis?
***E. coli***
39
emphysematous pyelonephritis emergency form of "" with assoc gas
40
How is **emphyematous pyelonephritis** treated?
**Nephrectomy**
41
What is a **perinephric abscess**? How is it investigated? How is it treated?
**Collection of pus in kidney, mass, symptoms of infection** CT scan Antibiotics and drainage
42
**Renal trauma** is ___ depending on its severity.
**graded**
43
How does renal trauma tend to present?
**Haematuria** or obvious on examination
44
How is **renal trauma** investigated?
**CT with contrast**
45
How is 98% of renal trauma managed?
**Non-operatively** otherwise surgery
46
Which type of fracture can cause bladder trauma?
**Pelvic fracture**
47
What are the symptoms of bladder trauma?
**Suprapubic pain** **Urine retention** **Haematuria**
48
How is **bladder** **trauma** investigated?
**CT cystography**
49
What is a sign of bladder trauma on CT cystography with contrast?
**Flame shape**
50
How is **bladder trauma** treated?
**Catheterise** **Antibiotics** **Repeat** **CT cystography in 2 weeks**
51
**Urethral trauma** often presents with a distinctive \_\_\_-shaped haematoma in the perineum. How is it managed?
**butterfly haematoma** **suprapubic catheter** then **reconstruction**

Renal Week 3 2017/18 (12 decks)

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