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