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Fdnts 3 Exam 1 > Things not to miss > Flashcards

Flashcards in Things not to miss Deck (21)
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1
Q

What are 6 things not miss?

A
Obstructive stone w/Fever
testicular torsion
Fournier's gangrene
acute urinary retention
Priapism
paraphimosis
2
Q

why is obstructive stone w/fever important not to miss?

A

infected urine upstream of obstruction

unable to drain infx

abscess

3
Q

Tx for obstructive stone w/fever?

A

requires drainage: nephrostomy tube, ureteral stent

IV abx

4
Q

testicular torsion is MCly seen in what age range?

A

12-18 y/o

5
Q

what is testicular torsion and what is the classic finding?

A

acute onset of severe testicular pain

Bell-clapper deformity

6
Q

PE for testicular torsion

A
Tender firm testicle
High riding
Horizontal lie	
Absent cremasteric reflex
No pain relief with elevation of testis 
Thick/knotted spermatic cord
Epididymis not posterior to testis
7
Q

Differential dx for testicular and how can you diagnose?

A

epididymitis:

doppler U/S, nuclear scan, prehn’s sign

8
Q

Tx for testicular torsion

A

detorsion: “open the book”
surgical: scrotal exploration, detorsion and orchidopexy (uni/bilateral)

9
Q

what is Fournier’s Gangrene?

A

Necrotizing fasciitis of male genitalia and perineum

Involves mainly subcutaneous tissues

Infx advances rapidly, over minutes

10
Q

RF’s for Fournier’s Gangrene

A

Diabetes
Alcohol abuse
Immunocompromised state

11
Q

Presentation of Fournier’s gangrene

A
Painful swelling and induration of the penis, scrotum, or perineum
Cellulitis
Eschar
Necrosis
Ecchymosis
Crepitus
Cutaneous anesthesia
Foul odor
Fever (absent in immuno)
12
Q

what will you see on imaging in Fournier’s gangrene?

A

Gas in subcutaneous tissues

13
Q

Tx for Fournier’s Gangrene

A
IV antibiotics to cover aerobic and anaerobic
Surgical debridement
Wet to dry dressings
Whirlpool therapy
HBO
14
Q

causes of acute urinary rentention

A

BPH

Anticholinergic meds

15
Q

Acute urinary retention: bladder capacity, imaging, tx?

A
Normal bladder capacity
Bladder scan (Ultrasound)
Lidocaine gel/ Lubrication
Foley catheter
Coude catheter
Suprapubic tube
16
Q

Priapism??

A

Persistent penile erection that continues hours beyond, or is unrelated to sexual stimulation and lasts greater than 4 hours duration

17
Q

Causes of priapism?

A
Sickle cell trait and disease
Trazodone
Cocaine
ED tx's (Papaverine/Prostaglandin E1/ Phentolamine &
PDE-5 Inhibitors)
18
Q

What are signs of sequelae in priapism

A

Ischemia/hypoxia
Progressive cavernosal fibrosis
Erectile dysfunction

19
Q

Tx for priapism

A

18 gauge needle into corpus cavernosum/ corpora cavernosa

Aspiration

Instillation of phenylephrine

If not successful, proceed to shunts

20
Q

what is paraphimosis?

A

Foreskin (prepuce) gets stuck proximal to corona and glans

21
Q

What do you do if a pt p/w paraphimosis?

A

Compress edema

May need a block

Index and long finger on either side. Thumbs on glans. Push and pull.