Urology and vascular basics Flashcards
Symptoms of renal stones
ureteric colic loin-groin pain sudden onset pain nausea and vomiting can't lie still occasionally get bladder obstruction
Examination findings for renal calculi
tachycardia no fevers unless infection--> emergency BP usually unaffected soft, non-tender abdomen renal angle tenderness
Bedside tests for renal calculi
urine dip- microscopic haematuria
ECG, BM, vitals
Bloods for renal calculi
FBC U&E LFT CRP Calcium amylase/lipase clotting VBG for lactate
Imaging for renal stones
CTKUB
AXR
Tx for renal stones
conservative- analgesia (PR diclofenac), fluids, anti-emetics, catheter if bladder obstruction
Medical- usually no abx, 5-10mm stones may be treated with medical expulsive meds e.g. alpha blockers
Surgical- extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy, uterorenoscopy and dormier basket removal
2 things to consider when you see haematuria
how much
is it frank blood
5 causes of haematuria
false blood- beetroot, rifampicin stone tumour clotting disorder infection BPH prostatitis infarct
Ix for haematuria
beside- urine dip, MC&S (microscopy, culture and sensitivity), BM, ECG, vitals
bloods- FBC, CRP, U&E, LFT, VBG
imaging- renal USS, flexible cystoscopy and biopsy, CT/MRI, renal angiography
Sx of bladder ca
painless haematuria
recurrent UTI
renal failure
Risk factors for bladder cancer
smoking amine exposure chronic cystitis schistosomiasis pelvic irradiation
3 types of bladder cancer
transitional cell carcinoma
adenocarcinoma
squamous cell carcinoma
Ix of bladder cancer
2 week referral
urine dip
USS
Flexible cystoscopy
Tx options for bladder cancer
depends on stage
superficial- diathermy via transurethral cystoscopy/ transurethral resection, intravesicular chemo with mitocin C or intervesicular immunotherapy
invasive- radical cystectomy, chemo/rad
Sx of renal cell carcinoma
loin pain, mass, painless haematuria
Risk factors for renal cell carcinoma
smoking
obesity
end stage renal disease
hypertension
Ix for renal cell carcinoma
bloods- FBC, U&E, ALP, Calcium
imaging- CT, MRI, CXR for mets
Tx for renal cell carcinoma
radical nephrectomy
medical for those with advanced disease of who won’t survive surgery
Sx of testicular torsion
sudden onset severe pain
nausea and vomiting
lower abdo pain
examination findings in testicular torison
inflam of 1 testis- hot, swollen, tender
testis rides high and transversely
lack cremasteric reflex
ddx for testicular torsion
epidymo-orchiditis
strangulated hernia
appendicitis
Tx for testicular torsion
emergency surgery
NBM
routine bloods- FBC, CRP, U&E, G&s, clotting
acute px of AAA
sudden onset abdo/back/loin pain
examination of acute AAA
hypoT
tachyC
peripherally shutdown/shocked- hypovolemic
