Duke PA Genito-Urinary Emergencies
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| Definition of acute renal failure | Rapidly deteriorating kidney function (accumulation of nitrogenous waste)
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| Urine output less than 0.5-1cc/kg/hr (400cc/day in adults) | oliguria
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| Most common cause of acute renal failure | Hypovolemia
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| No urine output | Anuria
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| Prerenal cause of ARF | Hypovolemia, ineffective circulating volumes (sepsis, anaphylaxis, third spacing), decreased cardiac output (chf, mi)
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| What can cause dehydration | Vomiting and diarrhea, diuretics, skin losses (burns)
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| Renal origins of ARF | Tubulointerstitial, glomerular, vascular
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| Postrenal origins of ARF | Ureteral or bladder obstruction, urethral obstruction
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| Causes of ureteral or bladder obstruction | Kidney stones, blood clots, malignancies, prostatic hypertrophy
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| Urethral obstructions | Strictures, phimosis, meatal stenosis
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| What lab are you looking at to determine ARF | Creatinine >1.4
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| Treatment for prerenal ARF | Volume replacement, maximize cardiac output
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| Treatment for renal ARF | Low dose dopamine, mannitol in early rhabdomyolysis, dialysis
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| Treatment for postrenal ARF | Relieve obstruction (foley, ureteral stent, nephrostomy)
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| Signs and symptoms of UTI | Dysuria, frequency, urgency, hematuria, urethral discharge, pain (suprapubic, rectal, costovertebral)
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| Most common UTI pathogen | E-coli
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| Safe UTI treatments during pregnancy | Nitrofurantoin
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| Duration of treatment for uncomplicated UTI’s | 3 days
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| Duration of treatment of pyelonephritis, pregnant patients with UTIs, complicated/frequent UTIs/prior treatment failure | 7-14 days
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| Treatment for GC | Ceftriaxone (Rocephin) IM
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| Treatment for Chlamydia | Azithromycin or doxycycline
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| Treatment for trichomonas | Metronidazole (Flagyl)
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| Presentation of acute prostatitis | Fever, malaise, back or rectal pain, rectal exam reveals swollen/firm/painful prostate
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| Source of acute prostatitis in males<35 yo | GC, chlamydia
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| Source of acute prostatitis in males>35 | E-coli, klebsiella, Enterobacter, proteus
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| Treatments for acute prostatitis | Quinolone, Bactrim
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| Presentation of urolithiasis | Flank pain (abrupt onset, severe, colicky, may radiate to scrotum), N/V, previous episodes, CVA tenderness, LQ pain
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| What are some deadly diseases that can mimic presentation for kidney stones | AAA, appendicitis, tuboovarian abscess, ectopic pregnancy
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| Any female of childbearing age with abdominal pain gets a work up for what | Pregnancy
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| Modality of choice for evaluation of urolithiasis in pregnant females | Ultrasound
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| Presentation of testicular torsion | Young men, pain with abrupt onset (after exertion, or during sleep), severe low abdominal/inguinal canal/scrotum, N/V, horizontal lie of testicle, absence of cremasteric reflex
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| Testicular torsion must be detorsed within __ for salvage | 4-6
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| Blue dot sign on translumination of testes is pathognomonic for what | Testicular appendage torsion
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| What is Prehn’s sign and what is it a sign of | Pain relief with elevation of testicle, epididymo-orchitis
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| Treatment for priapism | Subcutaneous terbutaline/phenylephrine, Surgery
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| Inability to retract the foreskin due to fibrous constriction or scar | Phimosis
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| Inability to reduce retracted foreskin over the glans | paraphimosis
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