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

Flashcards in 2: Urological emergencies Deck (51)
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1

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

Acute urine retention

2

What are the symptoms of acute urine retention?

No urine output

Increasing bladder pain - midline, suprapubic

Abdominal mass

3

What commonly causes acute urine retention in men?

Benign prostatic hyperplasia

4

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

Prostate infection

Prostate infarction

Excessive fluid intake - think alcohol

5

Acute urine retention is either ___ or ___.

spontaneous precipitated

6

What are some events which can precipitate acute urine retention?

Surgery

Catheterisation

Anaesthesia

Sympathomimemetic / anticholinergic medication

7

How is acute urine retention treated?

Catheter

8

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

Alpha blocker

9

What are some consequences following treated acute urine retention?

Post-obstructive diuresis (risk of dehydration)

Haematuria

10

What is a common renal cause of loin pain?

Renal calculus causing ureteric colic

11

How is the pain of ureteric colic managed?

NSAID - diclofenac, inhibits prostaglandins which mediate ureteric pain

Opiate analgesia if NSAIDs not effective

12

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

Alpha blocker

13

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

Surgery

ureteric stent, stone removal

14

What imaging method is gold standard for finding renal stones?

CT scan +/- contrast

15

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

Unrelieved pain

Fever and other signs of infection and sepsis

N&V

16

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

CT urogram

Cystoscopy

17

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

3-way irrigated catheter

helps to break up clots

18

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

Testicular torsion

19

What usually causes testicular torison?

Which group is it common in?

Spontaneous

Adolescent boys

20

Where is pain felt in testicular torsion?

Scrotum

may radiate to lower abdomen

21

How is suspected testicular torison investigated?

Doppler USS

22

How is testicular torsion treated?

Surgically, within 4-6 hours of onset

23

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

Remove it

24

What sign is produced by torsion of the appendix testis?

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