Urological Emergencies in Adults

Question 1

What is the clinical feature of renal colic?

Answer 1

Sudden onset of severe pain in the loin, microscopic haematuria, Nausea and vomiting

Question 2

What is a common Alpha-blocker?

Answer 2

Doxazosin

Question 3

What are common opiates you can give?

Answer 3

Morphine or pethidine

Question 4

What radiological test do you usually use to see Radio-opaque ureteric stones?

Answer 4

X-Ray (abdomen)

Question 5

What does ultrasound help with the identification of?

Answer 5

Hydronephrosis

Question 6

What is the function of a stent?

Answer 6

A stent helps with stopping peristalsis of the ureters and allows for easy passage of a ureteric stone

Question 7

ESWL is usually indicated for stones in which part of the urinary tract?

Answer 7

Upper ureteric calculi

Question 8

What are the 4 major indications for intervention in ureteric stones?

Answer 8

• Anuria
• Large stone that will not pass spontaneously
• UTI
• Renal Failure(increased serum creatinine)

Question 9

How does anuria occur?

Answer 9

When pt. Have bilateral ureteric stones or had a nephrectomy

Question 10

What are some of the surgical options for ureteric calculi?

Answer 10

• ESWL
• PCNL
• ureterolithotomy (open surgery)
• Double J Stent
• Percutaneous Nephrostomy

Question 11

What is the definition of microscopic haematuria?

Answer 11

> 3 RBCs per High powered Field

Question 12

Indications for immediate catherterisation?

Answer 12

• Presence of a UTI
• renal failure
• acute or chronic urinary retention

Question 13

What does a French catheter mean?

Answer 13

It is the circumference of the catheter in millimeters

Question 14

What size catheter do you place in females?

Answer 14

14-16 F

Question 15

What are the causes of urinate retention in females?

Answer 15

Pregnancy
Fibroids
Urethral strictures
Urethral diverticuli

Question 16

Causes of urinary retention in men

Answer 16

BPH

Prostate Cancer

Question 17

What is an example of an anti-cholinergic?

Answer 17

Tricyclic Anti depressants

Question 18

What is the definition of priapism

Answer 18

Prolonged election for more than 6 hours without sexual desire

Question 19

What is another name for Tamsulosin? And what does it treat?

Answer 19

Flomax

It treats BPH

Question 20

What is the complication you need to look out for in patients after chronic urinary retention?

Answer 20

Post Obstructive Diuresis/ Haematuria

Question 21

What is post-obstructive Diuresis?

Answer 21

It is defined as polyuria after obstruction of the bladder

Urine output will be about 10L per day

Question 22

What are the two types of Priapism?

Answer 22

Low Flow(veno-occlusive) 
High Flow(arterial)

Question 23

How long does it take for cavernous smooth muscle to experience necrosis?

Answer 23

24-48 hrs

Question 24

In low flow priapism-the____ are spared

Answer 24

Glans and the corpus spongiosum

Question 25

What size butterfly needle is used in the treatment of Priapism?

Answer 25

19 Gauge butterfly needle

Question 26

An example of Intracorporeal Injection is:

Answer 26

Alpha-blocker= phenylephrine

Question 27

Which nerve is stimulated at the perineum and gives sensation to the spinal cord?

Answer 27

Pudendal Nerve

Question 28

What causes the deep arteries to dilate in the corpus cavernosum?

Answer 28

Nitric Oxide

Question 29

All sympathetic neurons arise from:

Answer 29

T1-L2

Question 30

What are the complications of Low-Flow Priapism?

Answer 30

1. Erectile Dysfunction | 2. Infection (cavernositis)

Question 31

Treatment of Paraphimosis

Answer 31

Penile Block | Circumcision in a month

Question 32

Define Paraphimosis

Answer 32

It is a retracted foreskin that is irreducible as a result of lymphatic obstruction

Question 33

What are the 4 clinical features of high flow Priapism?

Answer 33

1. No pain 2. Bright res blood upon aspiration 3. History of spinal cord injury

Question 34

Extremely painful Testicular pain causes:

Answer 34

Epidydimitis | Testicular Torsion

Question 35

Scrotal fullness pain:

Answer 35

Varicocele | Hydrocele

Question 36

Describe the Cremaster Reflex:

Answer 36

When you stroke the medial aspect of the thigh, the testicles retract

Question 37

What is the definition of a hydrocele?

Answer 37

Collection of fluid between the visceral and parietal layers of the tunica vaginalis of the testis