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Flashcards in Urological emergencies Deck (52):
1

What can cause acute urinary retention?

Prostate infection
Bladder overdilation

2

In who is acute urinary retention common?

Men with BPH

3

What are the two types of acute urinary retention?

Spontaneous
Precipitated

4

What can precipitate acute urinary retention?

Catheterisation
Instrumentation
Anaesthesia

5

What clinical signs can be seen in acute urinary retention?

Full, palpable bladder

6

How is acute urinary retention solved?

If less than 1 litre then try alpha blocker.
If not, then catheterise.

7

What drugs can be given for calculi?

NSAIDs and opiate for pain
Alpha blocker to pass small stones

8

At what point will stones that have not been passed require investigation?

After 1 month

9

What imaging modality is used to view calculi?

CT
No contrast!

10

What presentation of calculi needs urgent treatment?

Pyrexia
Persistent n&v
High grade obstruction

11

What are some options of treating kidney stones?

Extracorporeal shock wave lithotripsy
Ureteric stent

12

If haematuria presents, what imaging would you use?

CT urogram with contrast
Cystoscopy

13

What can haematuria be a sign of?

Trauma
Infection
Stones
Tumour
BPH

14

What investigation is done for the acute scrotum?

Doppler USS

15

What is the blue dot sign?

Torsion of testicular appendage

16

What may be seen on examination of spermatic cord torsion?

Testis high in scrotum
Transverse lie
Absence of cremasteric reflex

17

What is the cremasteric reflex?

When inner thigh is lightly stroked the the testis should ascend due to contraction of cremaster muscles

18

How can testicular appendage torsion and spermatic cord torsion be differentiated?

Cremaster reflex present in appendage torsion
Testis are mobile

19

How is testicular appendage torsion fixed?

Will resolve spontaneously

20

What are the symptoms of epididymitis?

Pyrexia
Hydrocoele

21

What causes epidiymitis?

Chlamydia
UTI

22

On examination what is seen with epididymitis?

Cremaster reflex present
Doppler shows swollen epididymis

23

What investigations should be done for epididymitis?

Urine culture
Chlamydia PCR

24

What is the treatment for epididymitis?

Analgesia
Rest
Ofloxacin

25

What is paraphimosis?

Swelling of foreskin distal to the phimotic ring

26

When does paraphimosis occur?

When foreskin retracted and not replaced

27

What is the treatment for paraphimosis?

Iced glove
Granulated sugar
Manual replacement of foreskin

28

What is priapism?

Prolonged erection (>4hrs), not associated with sexual arousal

29

What might cause a priapism?

trauma
intracorporeal injection
sickle cell

30

How can priapism be classified?

Ischaemic
Non-ischaemic

31

What is ischaemic priapism?

Vascular stasis in penis and decreased venous outflow

32

What is non-ischaemic priapism?

Due to trauma to penile vascularisation

33

What is the treatment for non-ischaemic priapism?

May resolve spontaneously

34

What is the treatment for ischaemic priapism?

Aspiration
Injection of alpha-agonist

35

What is Fournier's gangrene?

Necrotising fasciitis around male genitalia

36

What pre-disposes to Fournier's gangrene?

Diabetes
Trauma
Perianal infection

37

What does Fournier's gangrene look like?

Swollen, erythematous, tender, painful, systemic toxicity.

38

What investigations are needed for Fournier's gangrene?

Plain X ray to confirm gas in tissues

39

What is the treatment for Fournier's?

Abx
Surgical debridement

40

What is emphysematous pyelonephritis?

Necrotising infection of renal parenchyma by E Coli

41

In who does emphysematous pyelonephritis occur?

Diabetics

42

What symptoms may be present with emphysematous pyelonephritis?

Fever
Vomiting
Flank pain
Ureteric obstruction

43

What investigations are done for emphysematous pyelonephritis?

KUB shows gas
CT shows extent

44

What is the treatment for emphysematous pyelonephritis?

Nephrectomy

45

How many classifications of renal trauma are there?

5

46

If there is a laceration through the collecting system what classification of trauma is present?

4

47

If there is a laceration of less than 1cm what classification of renal trauma is present?

2

48

What symptoms point towards a bladder trauma?

Suprapubic pain
Inability to void
Guarding
Diminished bowel sounds

49

What investigation must be done if blood at external meatus?

Retrograde urethrogram

50

What is likely to happen with a pelvic fracture?

Bladder trauma
Urethral damage

51

What is a butterfly haematoma?

Blood spread to anus in a symmetrical pattern
Sign of urethral injury

52

What are the possible consequences of penile fracture?

ED
Permanent curvature
Pain during intercourse