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EM GU
Emergency Medicine Genitourinary tract / Renal
28
Medical
Post-Graduate
01/21/2009

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Cards

Term
Dialysis in ARF?
Definition
HyperK+
fluid overload
significant acidosis
toxins - EtOH
Uremic Sx (pericarditis, encephalopathy, bleeding complications)
BUN > 100 Mg/dL (relative indication) w/or creat >10
Term
UTI refer to urologists
Definition
All peds
Male-prostatitis
Multiple infxn over 3 yrs
Term
What is Prehn's sign?
Definition
elevation of painful testicle -> relieves pain is epididymitis; not reliable enough to r/o torsion
Term
DDx of urinary retention
Definition
BPH - #1 in males > 50 y/o
Strictures
Drugs: anticholinergics, antihistamines, antispasmodics, TCA, alpha-adrenergic stimulants, antipsychotics
Meatal stenosis
Bladder neck contracture
Bladder CA
Prostatic CA
Neurogenic or atonic bladder
Term
Dx study of choice in suspected renal stone
Definition
IV Pyelogram: gives structural & functional info and occasionally is therapeutic (dye load->ureter dilat->passage of stone)
U/S & Ct also useful if dye is C/I, both lucent & opaque stone visible in CT
Term
DDx urethral strictures in males
Definition
Trauma
Instrumentation
Infxn: GC, Chlamydia
Term
Complication of ARF
Definition
Increase: K+, Mg+, AG acidosis
Decreae: Ca2+
Term
Tx for Volume overload in oliguric pts:
Definition
Diuretics, nitrates, dyalisis
Term
MC life threatening infxn post transplant renal pt & its tx:
Definition
CMV; Tx: gancyclovir
Term
Causes of Priapism
Definition
Reversible causes: Sickle cell dz or trait, corporal injection for impotence, leukemic infiltration (leukemia)
Irreversible: Hx spinal cord injury, Med. desyrel, phenothiazides
Term
Penis fracture
Definition
Tunica albuginea acute tear (usually erected), swelling, bent, painful
*URO consult x surgery!
Term
Penis fx study
Definition
Retrograde urethrogram w/?* CHECK!
Term
Penis fx study
Definition
Retrograde urethrogram w/?* CHECK!
Term
DDx prerenal azotemia
Definition
Term
Abx to avoid in ARF
Definition
Tetracycline, nitrofurantoin, methenamine, nalidixic acid, bacitracin
Term
Characteristics of prerenal azotemia
Definition
• hypoperfused, normal kidneys •Specific gravity >1.020-1.030 •low urine Na (<20 mEq/L) •micro UA - norm w/occ. hyaline casts
Term
MC Fournier's pathogen
Definition
•Anaerobes - bacteroides fragili •Aerobe: E.Coli •Other: hemo strep, staph, clostridium
Term
Immediate tx for priapism
Definition
Terbutaline 0.25 - 5 mg SQ ✓Start Uro consult ✓If sicker, transfuse, hyperbaric O2
Term
Paraphimosis
Definition
Inability to pull foreskin back over glands - vascular compromise
Term
Phimosis
Definition
Inability to retract foreskin assoc. w/chronic infections scarring of foreskin ❑ Tx: circumcision
Term
Risk factors for Fournier's
Definition
DM chronic EtOH, chronic steroids, UC/Crohn's
Term
MC renal transplant reject
Definition
Acute rejection: 1-12 wks post surgery
Term
Si/Sx of acute renal transplant reject
Definition
Tenderness, ↓urine output, low grade fever, discomfort, hypertension, ↑wight, peripheral edema, ↑creat
Term
Tx for acute renal transplant reject
Definition
Cyclosporine + ↑↑↑steroids
Term
DDx of ATN
Definition
MC: ischemia (prolonged hyperperfusion), nephrotoxins (aminoglyc, heavy metals, contrast dye), pigments (Hgb, myoglob)
Term
DDx of pyuria
Definition
UTI, pyelo, perineal abscess, acute glomerulonephritis, vulvovaginitis, vag FB, gastroenteritis, dehydration, STD (especially chlamidia)
Term
Elytes disturbance assoc w/renal failure
Definition
•↑K, ↑PO4, ↑Mg •↓Ca
Term
Tx UTI for 10-14 days in:
Definition
Pregnancy, prolonged symptoms, subclinical pyelo, assoc. dz, if sterile pyuria=chlamydia
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