Urinary Tract Obstruction Flashcards Preview

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Flashcards in Urinary Tract Obstruction Deck (55)
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1

When may a unilateral urinary tract obstruction be clinically silent?

If the other kidney is functioning normally

2

What are some examples of when a urinary tract obstruction requires urgent treatment?

If the obstruction is bilateral, or there is obstruction with infection

3

How does an acute upper urinary tract obstruction typically present?

Loin to groin pain

4

Symptoms of loin pain, renal failure, superimposed infection and polyuria suggest what type of urinary tract obstruction?

Chronic upper urinary tract obstruction

5

Why does chronic upper urinary tract obstruction cause polyuria?

There is a reduced concentrating ability of the kidney

6

How does an acute lower urinary tract obstruction typically present?

Acute urinary retention

7

Overflow incontinence can be a feature of which type of urinary tract obstruction?

Chronic lower urinary tract obstruction

8

If a patient presents with any signs/symptoms of urinary tract obstruction, what two bedside tests must always be done?

Bloods for U&Es, urine for MC&S

9

What is the first line imaging modality of choice for someone with a suspected urinary tract obstruction?

Ultrasound

10

When should a CT scan be arranged for someone with urinary tract obstruction?

If there is hydronephrosis or hydroureter on ultrasound scans

11

What are the two main treatment options for an upper urinary tract obstruction?

Nephrostomy or ureteric stent

12

What medication can be used to help reduce the pain associated with a ureteric stent?

Alpha blockers

13

How is a lower urinary tract obstruction treated?

Insert a catheter and treat the underlying cause if possible

14

What are the two main causes of urinary retention?

Obstruction, or reduced detrusor muscle power

15

What are the two main causes of acute urinary retention?

Prostatic enlargement and urethral strictures

16

What group of medications are a recognised cause of acute urinary retention?

Anti-cholinergic medications

17

If a patient is in acute urinary retention and fails to void, how should they be treated?

Catheterisation and an alpha blocker (e.g. tamsulosin)

18

How are patients who are in acute urinary retention as a result of clot retention treated?

3-way catheter and bladder washout

19

Why should patient's U&Es always be monitored closely after catheterisation for acute urinary retention?

Risk of post-obstructive diuresis and salt-losing nephropathy

20

Why may chronic urinary retention lead to renal failure?

Bilateral obstructive nephropathy

21

Treating the underlying cause is the best way to manage chronic urinary retention. What else can be used to help control the condition, regardless of the underlying cause?

Intermittent self catheterisation

22

In patients with chronic urinary retention, an episode of acute urinary retention may only be recognised when what symptom develops?

Overflow incontinence

23

After placing a catheter in someone with acute-on-chronic urinary retention, what may happen with regards to their renal function?

There may be a significant rise in creatinine, but this usually returns to baseline after a few days

24

If you suspect obstructive uropathy, what imaging investigation should always be requested?

Renal ultrasound

25

What can be done to try and avoid post-obstructive diuresis in patients who have been catheterised as a result of urinary retention?

Give resuscitation fluids, and then match input with output

26

What can be done to try and avoid salt-losing nephropathy in patients who have been catheterised as a result of urinary retention?

Give isotonic (1.26%) sodium bicarbonate solution and withhold any nephrotoxic drugs

27

What type of disorder is idiopathic retroperitoneal fibrosis?

Autoimmune

28

What type of urinary tract obstruction is caused by retroperitoneal fibrosis?

Progressive, bilateral urinary tract obstruction

29

What type of malignancy is a recognised secondary cause of retroperitoneal fibrosis?

Lymphoma

30

Who does retroperitoneal fibrosis typically present in?

Middle aged males