Upper Tract Obstruction Flashcards

(29 cards)

1
Q

Intrinsic Causes of Upper Tract Obstruction at Pelvi-Ureteric Junction

A
PUJ Obstruction
Stone
Ureteric Tumour
Blood Clot
Fungal Ball
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2
Q

Intrinsic Causes of Upper Tract Obstruction at Ureter

A
Stone
Ureteric Tumour
Scar
Clot
Fungal Ball
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3
Q

Intrinsic Causes of Upper Tract Obstruction at Vesico-Ureteric Junction

A

Stone
Bladder Tumour
Prostate Cancer
Ureteric Tumour

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4
Q

Extrinsic Causes of Upper Tract Obstruction at Pelvi-Ureteric Junction

A
PUJ Obstruction
Lymph Nodes (Tumour)
Abdo Mass (tumour)
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5
Q

Extrinsic Causes of Upper Tract Obstruction at Ureter

A

Lymph Nodes (Tumour, Retroperitoneal Fibrosis)
Iatrogenic
Abdo/Pelvic Mass (Tumour)
Pregnant Uterus

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6
Q

Extrinsic Causes of Upper Tract Obstruction at Vesico-Ureteric junction

A

Cervical Tumour

Prostate Cancer

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7
Q

Symptoms and Signs of Upper Tract Obstruction

A

Pain
Frank Haematuria
Palpable Mass
Microscopic Haemturia

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8
Q

Management of Upper Tract Obstruction

A

Resusitation

Treat Cause

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9
Q

Emergency Treatment of Upper Tract Obstruction

A

Percutaneous Nephrostomy Insertion or Retrograde Insertion

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10
Q

How to Treat Stone in Obstruction

A

Ureteroscopy and Laser Lisotripsy

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11
Q

How to treat Ureteric Tumour in Obstruction

A

Radical Nephro-Ureterectomy

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12
Q

How to trat PUJ Obstrution in Obstruction

A

Laparoscopic Pyeloplasty

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13
Q

If urethra is impassible for cauterisation then use

A

16F SPC

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14
Q

Management Lower Tract Obstruction Emergency

A

Catherisation

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15
Q

Treating BPE in Obstruction

A

TURP

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16
Q

Treating Urethral Stricture in lower tract Obstruction

A

Optic Urethrotomy

17
Q

Treating Meatal Stenosis in Lower Tract obstruction

A

Meatal Dilation

18
Q

Treating Phimosis in Lower Tract obstruction

19
Q

Chronic Retention High Pressure presents as

A

Painless
Incontinent
Raised CR
Bilateral Hydro Nephrosis

20
Q

Chronic Retention Low Pressure presents as

A

Painless
Dry
Normal CR
Normal Kidneys

21
Q

Complications of Urinary Retention

A

Decompression Haematuria

Post Obstructive Diuresis

22
Q

What is decompression haematuria

A

shearing of small vessels

usually self limit

23
Q

what is post obstructive diuresis

A

greater than 200ml

can lead to life threat sodium and water depletion

24
Q

If upper tract is obstructed what will ultrasound show

A

Hydronephrosis and Hydroureter

25
What could Nuclear Isotope (Tech 99) scan determine
Split Renal Function (should be 50/50) | Used for Chronic Unilateral PUJ Obstruction
26
CT KUB Advantages
No risk of contrast nephrotoxicity Can be used in renal failure stones and obstruction in emergency
27
ct urogram contraindications
renal failure | gives out 15-20 radio
28
ct urogram advantages
can detect masses
29
gold standard for renal colic test
ct kub