case 4 overv Flashcards
**AAA/
classic presentation
hx of smoking +
triad =
severe abd pain; +
a pulsatile abd mass; +
hyPO tension.
unexplained hypotension/consider
intra-abdominal hemorrhage
GI tract=>hematemesis; melena; or hematochezia or
splenic rupture;
GU: rupture of an ectopic pregnancy)
intraperitoneal=AAA rupture;
or sepsis
AAA/tx
OR directly
AAA/ medical management
Smoking cessation+
BP control: ASA+ statins
Nephrolithiasis/
classic presentation
T=rapid onset of=hint: the stone is suddently blocked
Q:excruciating back and flank pain;
R:radiate to the abdomen (front) or groin (down).
S:REALLY BAD pain ;pts writhe and move about constantly (unlike peritonitis) to get comfortable. hint: u move ur body to try and help the stone to get unstuck
Ass. w.: NV
dysuria; or urinary frequency+
hematuria (80%).
Nephrolithiasis/risk factors
recurrence: 50%
gender: male=2-3x female
Fhx: +
Nephrolithiasis
/etiology/ types of stones
Calcium oxalate stones 75%/
Uric acid stones (++ purine in food or anti gout tx)5–10%
Struvite stones 5-15% (from infection; ex:proteus)
nephrolithiasis/
pathophys
form when [] of salts (ie; calcium; oxalate; or uric acid) bec supersaturated in the urine =>precipitation +crystallization
nephrolithiasis/
complications:3
Ureteral obstruction
Pyelonephritis
Sepsis
nephrolithiasis/dx imaging
In non pregnant pt:Non contrast renal CT
in pregnant pt: USound
nephrolithiasis/
dx test in
urine
blood
other
urine= UA + UCx +
blood= basic serum chem; +several meas. of serum calcium/
any retrieved stones ? UCx; pH; and chem analysis
**nephrolithiasis/
rx helping stone passage
Stone passage=> Nifedipine and tamsulosin
