Trauma, infection Flashcards
(33 cards)
Blunt renal trauma: imaging in children
> ___ RBC / HPF
50
Renal trauma: exploration
Incise over aorta, ___ to IMV
Medial
Renal trauma: exploration and end up nephrectomy
Blunt 7%
Penetrating 31%
Ontable one shot IVU
___ml / kg at __ mins
2ml/kg , taken 10min
Presentation of post-transplantation ureteric stricture
Early
Asymptomatic worsening of RFT
Ureteral defect coverable by various techniques: UU Ureteroneocystostomy Psoas hitch Boari flap Renal descensus
2 4 6 - 10 12 - 15 5 - 8cm
Boari flap:
Tip width
Base width
Flap length to base ratio
>= 3cm >= 4cm <= 3 : 1
Extraperitoneal bladder injury: indications for surgical repair
failed foley drainage
bone spike puncturing
bladder neck/rectum/vaginal injury
Double injury incidence = ?
Bladder + urethra
Urethra + penis
10%
AAST classification for urethral injury
Grade 1 to 5 contusion stretch injury (no extravasate) partial disruption (contrast inside bladder) complete (< 2cm) complete (> 2cm/ prostate/ vagina)
Goldman classification for urethral injury based on urethrography
Type 1 to 5 5 anterior 4 bladder neck 1 posterior stretch 2 posterior above UD 3 posterior involving UD
What are the ways to gain length during bulbo-prostatic anastomotic urethroplasty?
3 ways (in addition to mobilisation)
separation of crura
wedge pubectomy
rerouting of urethra
what is SIRS
2 or more
what is sepsis
what is septic shock
MAP >=65
Lactic acidosis >= 1.8 mmol/L
what is sepsis six?
.
what is qSOFA score?
quick sequential organ failure assessment score
SBP < 100
RR > 22
GCS < 15
what is procalcitonin?
T 1/2
peptide precursor
bacterial infection
T 1/2 : 1 day
what are the FDA categories for drug safety
ABCD X
what pili = ?
mediates bladder invasion
mediates pyelonephritis
Type 1
p pili
steps of Gram stain
crystal violet
iodine mordant (fixative)
alcohol wash
safranin (counterstain)
Significant bacteriuria cutoff
Asymptomatic
Symptomatic
MSU 10^5 ; CSU 10^2 (2 in women)
MSU 10^2
what is emphysematous pyelonephritis
acute necrotizing parenchymal , pararenal infection
gas forming organism
what gas inside emphysematous pyelonephritis?
O H CO2 N
Prognostic factors in emphysematous pyelonephritis
shock, GCS, plt, AKI