Showing posts with label Renal and Urologic. Show all posts
Showing posts with label Renal and Urologic. Show all posts

75 y/o male with history of benign prostatic hypertrophy, but otherwise healthy, presents with acute onset suprapubic pain and difficulty urinating. Foley catheter is placed and drains 900 cc of urine. Should renal failure or postobstructive diuresis be of concern?

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No.  Renal failure and postobstructive diuresis are of concern in chronic urinary obstruction which often presents with no or minimal abdomi...

What characteristics of the clinical evaulation and urinalysis suggest a glomerular (nephrological), as opposed to a nonglomerular (renal pelvis, ureter, bladder, etc), cause of hematuria?

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2+ or greater proteinuria  RBC casts presence of at least 80% dysmorphic RBCs elevated blood pressure If the clinical evaluation and urinaly...

What is the likelihood of normal erectile function after penile fracture?

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Those undergoing surgical repair within 8 hours of injury have an excellent prognosis with almost all having return of normal erectile funct...

What are the indications for surgical exploration after blunt scrotal trauma?

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testicular rupture large hematocele  traumatic torsion  testicular dislocation  Testicular salvage rates are 80-90% if treated within 72 hou...

In general, kidney stones larger than what size (mm) in diameter will not pass?

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10 mm Source Worcester, E. and Coe, F. "Calcium Kidney Stones" N Engl J Med. Sep 2010.

True or False? Urine ouput decreases as the degree of urinary traction obstruction increases.

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False. If there is a complete obstruction, there will be no urine output. However, with partial obstructions, urine output can remain norma...

What is considered a normal post void residual?

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Less than 50 to 100 ml. Source Nygaard, I.  "Idiopathic Urgency Urinary Incontinence"  N Engl J Med.  Nov 2010.

What percentage of males with ischemic priapism lasting 24 hours will become impotent?

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90% Time is sexual function. Source Serkan, D. and Mulhall, J. "Priapism" Up to Date. 2010 Jan 28.

Tolvaptan: a new (at least to me) treatment for hyponatremia

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Tolvaptan is an ADH receptor antagonist. It can be used as an alternative or possible addition to water restriction or sodium chloride admi...

What is one of the most sensitive physical exam findings for testicular torsion?

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Loss of cremasteric reflex. Several small studies have demonstrated close to 99% sensitivity. The reflex is normally elicited by stroking o...

Can you name 15 causes of urinary retention?

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Obstructive (1) prostatic enlargement (benign, cancer) (2) bladder stones, neoplasm (3) urethral stricture, stones, foreign bodies (4) uter...

Can a circumcised male still get a paraphimosis?

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Yes, particularly males who are - often unknowingly - incompletely circumcised. Paraphimosis is a urologic emergency where the foreskin is...

What is the treatment for renal infarction?

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Available treatments include surgery to establish collateral circulation, intra-arterial thrombolysis, catheter embolectomy and heparin ther...

Any recommendations on preventing recurrent kidney stones?

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Calcium stones, particularly calcium oxalate and less often calcium phosphate, are the most common type of kidney stone, making up 80% of ca...

When is hematuria more than a simple UTI?

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If it's a simple UTI there should be associated dysuria, frequency and in the urinalysis, pyuria and bacteria. If not, the differential...

What is the sensitivity of color doppler ultrasonography for detecting testicular torsion?

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Sensitivity is about 86% depending on the radiologist, equipment, time of day, resident vs attending reading, etc... This means that if you ...