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Flashcards in Urological emergencies Deck (39)
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1

Hematuria in these situations is usually characterized by circular erythrocytes and absence of proteinuria and casts.

surgical/urological nonglomerular causes

2

A patient in the ER received a urine culture/cytology, renal US and flexible cystoscopy. What was his most likely presenting symptom?

hematuria

3

Most common urologic emergency and a cause of the acute abdomen. Characterized by sudden onset of severe flank pain with N/V due to passage of renal stone

ureteric or renal colic

4

Imaging that can identify other non-stone causes of flank pain, is quick, and doesn't require contrast

helical CT

5

What is the management of ureteric stones smaller than 5mm?

opiates and hydration

6

What are the definitive treatment options for a ureteric stone that is either associated w/fever, unresponsive to analgesics, impairing renal fxn, or has caused obstruction > 4wks?

ESWL or percutaneous nephrolithotomy

7

Painful inability to void, with relief of pain following drainage of the bladder by catheterization due to either increased urethral resistance, low bladder pressure, or interruption of the innervations of the bladder

acute urinary retention

8

Initial management options for acute urinary retention

urethral catheterization or suprapubic catheter

9

Patient presents with distended bladder that isn't painful, urinary dribbling, overflow incontinence, and a palpable lower suprapubic mass

chronic urinary retention

10

What is chronic urinary retention associated with?

reduced renal function or upper tract dilatation

11

What happens if the bladder of a patient with chronic urinary retention is drained to quickly?

sudden decompression causing hematuria

12

Most common cause of an acute scrotum

epididymitis

13

How soon does irreversible ischemic injury to the testicular parenchyma begin with intravaginal testicular torsion?

4 hrs

14

How can you differentiate between testicular torsion and epididymitis?

absent cremasteric reflex in testicular torsion

15

During surgical exploration of testicular torsion what should be done to preserve both affected and unaffected testes?

affected testis places in dartos pouch (suture fixation) and unaffected testis fixed to prevent subsequent torsion

16

Patient presents with dysuria, fever, epidiymal tenderness or massively swollen hemiscrotum with abscence of landmarks. cremasteric reflex present

epididymo-orchitis

17

Should be avoided with epididymo-orchitis

urethral instrumentation

18

Type of priapism due to hematological disease, malignant infiltration of the corpora cavernosa with malignant disease, or drugs.
Painful and most common type.

ischemic (veno-occlusive, low flow)

19

Type of priapism to perineal trauma, which creates an arteriovenous fistula. Painless

non-ischemic (arterial, high flow)

20

What is it important to warn all patients with priapism of?

possibility of impotence

21

Done to evaluate renal injuries if patient is transferred immediately to the operating theatre without having had a CT scan and a retroperitoneal hematoma is found

IVU

22

Imaging study of choice for renal injury. Accurate, rapid, and images other intra-abdominal structures

Contrast-enhanced CT

23

How is a traumatic kidney injury managed that doesn't have persistent bleeeding, an expanding hematoma, or pulsitile perirenal hematoma?

conservative (IV fluids and abx) follow-up ultrasound/CT

24

the peritoneum overlying the bladder, has been breached along with the wall of the bladder, allowing urine to escape into the peritoneal cavity.

intraperitoneal perforation

25

the peritoneum is intact
and urine escapes into the space around the bladder, but not into
the peritoneal cavity

extraperitoneal perforation

26

Classic triad of symptoms and signs that are suggestive of a bladder rupture

suprapubic pain and tenderness, difficulty or inability in passing urine, and hematuria

27

Why are bladder perforations repaired openly?

unlikely to heal spontaneously, large defects, leakage causes peritonitis, and associated other organ injury

28

The majority a result of a straddle injury in boys or men. Can also be due to direct injuries to the penis, penile fracture, injuries by GSW, inflation of balloon catheter

anterior urethral injuries

29

Patient presents with blood at end of penis, difficulty passing urine, frank hematuria, and penile swelling. What should you use to establish the diagnosis?

retrograde urethrography

30

Management of a contusion anterior urethral injury

small-gauge urethral catheter for one week