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Phase 2: Surgery > Urology > Flashcards

Flashcards in Urology Deck (15):
1

Urological Emergencies

Stones/loin pain
Retention
Testicular pain
Urological trauma

2

Causes of loin pain

Urological
- pyelonephritis/UTI
- ureteric/renal colic

Non-Urological
- Msk
- Gynae
- Vascular (dissecting iliac aneurysm)
- Gen surgery

3

Causes of ureteric colic

Ureteric calculi
Clot colic
PUJ obstruction

4

Typical history of ureteric colic

Sudden onset
Severe, colicky pain, can't get comfortable
Radiates to IF, testicle, penis, labia
Unilateral
PMH/FMH stones
N&V
Rigors / Fever (!! Warning !!)

5

Investigations of ureteric colic

Bloods (FBC, U and Es, cultures, clotting screen, calcium, urate)

Urine dip

CT KUB

6

Examination findings with ureteric colic

May be rolling around
May have tachycardia (!! If hypotension or fever !!)
Flank/IF tenderness
Non visible haematuria

7

Mx ureteric colic

Analgesia (NSAIDS)
Rehydrate
Anti-emetic

6mm+ need intervention

8

When to interfere with ureteric colic?

6mm+ and proximal
Infection
Renal impairment
Intractable pain two weeks
One kidney
Occupation
Conservative management failed

9

What are the interventions for ureteric colic

Ureteroscopy and laser trips
ESWL (extracorporeal shockwave lithotripsy)
JJ stent

10

INFECTION AND KIDNEY STONE

!!! Call for help, may have pyonephrosis

11

Pyonephrosis management

GET HELP (ITU/senior)... SEPSIS
Resuscitation (fluids, o2, antibiotics IV gentamicin or co-amoxiclav & tazosin)
ABG (lactate, SBE)
DRAIN (either external (percutaneous) or internal) then send home
Readmit electively to remove stone

12

What is urinary retention and who gets it

INABILITY TO PASS URINE
More common in males

13

Causes of urinary retention

BPH/malignant prostate enlargement
Constipation
UTI
Excess fluid/overdistension
Neuro (cauda equina, MS)
Urethral stricture/ phimosis
Surgery
Drugs

14

Acute VS Chronic Urinary Retention

Acute - painful and relieved by drainage, no upper tract insult, RV <1000ml

Chronic- less pain/no pain, may have abdo distension, larger clothes, RV >1000ml, may have upper tract insult (obstructive uropathy)

15

Factors necessary for a cancer screening programme

- early intervention beneficial
- disease course well understood
- cost effective
- publicly acceptable test
- accurate test
- disease must be an important health problem