urological procedure

Question 1

appearance of urine in UA and what it means

Answer 1

pink - blood
orange - meds
blue/green - drugs of ingested dyes, Pseudomonas
brown/black - myoglobin, bilirubin, rhubarb, meds

Question 2

what 2 evaluation will be pos on UA if patient has UTI?

Answer 2

leukocyte esterase and nitrates

Question 3

findings on microscopic evaluation and what it means

Answer 3

WBC - infection
RBC - kidney disease, decreased coagulation, cancer
epithelial cells - contamination, cancer
casts - kidney disease
crystals - kidney stones
bacteria or yeast - infection

Question 4

RBC casts in UA indicative of?

Answer 4

1. glomerulonephritis

2. severe tubular damage

Question 5

WBC casts in UA indicative of?

Answer 5

acute pyelonephritis

Question 6

crystals in UA are formed by

Answer 6

1. augmentation of concentration
2. decreased supersaturation capacity
3. crystals with a promoter effect

Question 7

uric acid in UA indicates

Answer 7

poor dilution volume at an acidic pH

Question 8

calcium oxalate in UA indicates

Answer 8

no significant clinical meaning

Question 9

bacteria in UA indicates? what’s the most common bacteria found?

Answer 9

1. UTI

2. E. coli

Question 10

Bence-Jones proteins in UA indicates

Answer 10

multiple myeloma

Question 11

indications for catheter

Answer 11

1. acute urinary retention
2. obtain uncontaminated sample
3. diagnostic studies (urodynamics, cystourethrogram)
4. monitor urine output - ICU, postop
5. measure residual volume
6. surgery on adjacent structures
7. urinary tract surgery

Question 12

contraindications for catheter

Answer 12

1. known urinary tract obstruction (stricture)
2. reconstructive surgery of urethra or bladder neck
3. combative or uncooperative patient
4. pelvic trauma - suspect urethra injury
5. acute infection of the prostate and/or urethra (relative)

Question 13

complications of catheter

Answer 13

1. infection
2. hematuria
3. urethral stricture

Question 14

long term use of catheter

Answer 14

1. chronic retention
2. neurogenic bladder with retention (unable to self cath)
3. incontinent with complicated skin breakdown or infection
4. comfort measure for terminally ill

Question 15

suprapubic catheterization indications

Answer 15

1. bladder neck stricture, contracture or obstruction
2. inability to pass urethral catheter
3. urethral trauma
4. recent urethra or bladder neck surgery
5. inability to tolerate or unwilling to self cath
6. presence of urethral or prostate infection
7. severe phimosis
8. collect urine sample
9. relief of urinary retention

Question 16

suprapubic cathetrization contraindications

Answer 16

1. uncooperative patient
2. blood dyscrasia or anti-coagulation treatment
3. infection or cellulitis of the suprapubic area

Question 17

suprapubic catherization complications

Answer 17

1. peri-vesicular bleeding
2. gross hematuria
3. infection - skin, subQ, intra-abdominal, bladder
4. intestinal perforation

Question 18

what is bladder scan used for?

Answer 18

non-invasive measurements of the bladder volume and post void residual volume

Question 19

what is flow cystometry used for?

Answer 19

evuluation of urinary incontinence, an overactive bladder, and urinary retention

Question 20

cystoscopy indications

Answer 20

1. urinary incontinence
2. known or suspected malignancy
3. recurrent UTIs
4. pelvic pain symptoms
5. pelvic trauma
6. intraop assessment of bladder or urethral trauma

Question 21

cystoscopy contraindications

Answer 21

1. relative - UTI or pyelonephritis (can cause sepsis so patient is treated with antibiotics before procedure)

Question 22

what is intravenous pyelogram and what is it used for?

Answer 22

1. X-ray of the kidneys, ureters, bladder

2. to detect problems in these areas including kidney stones, cancer, enlarged prostate

Question 23

what is an extracorporeal lithotripsy?

Answer 23

procedure used to shatter simple stones in the kidney or upper urinary tract

Question 24

what is an intracorporeal lithotripsy?

Answer 24

laser is introduced through the cystoscope into the ureter and stones are broken into small pieces that will pass

Question 25

infant circumcision indications

Answer 25

1. parental desired 2. may decrease UTIs and STIs 3, may decrease penile cancer rate

Question 26

infant circumcision contraindications

Answer 26

1. hypospadius or epispadius 2. atypical genitalia 3. undetermined phenotype (ambiguous genitalis) 4. less than 12hrs postpartum 5. illness 6. prematurity (relative) 7. familial bleeding disorder 8. maternal thrombocytopenia

Question 27

infant circumcision risks/complications

Answer 27

1. bleeding 2. infection 3. trauma to glans or urethra 4. poor cosmetic result 5. paraphimosis 6. degloving of the pneil shaft 7. meatal stenosis - rare

Question 28

adult circumcision indications

Answer 28

1. phimosis 2. paraphimosis 3. penile hygience 4. recurrent balantitis 5. neoplastic foreskin 6. excessive foresking redundancy 7. frenular tears 8. patient or spouse preference

Question 29

adult circumcision contraindications

Answer 29

1. acute inflammation 2. infection 3. psychiatric disorder 4. bleeding dyscrasia

Question 30

adult circumcision complications

Answer 30

1. bleeding 2. hematoma 3. infection 4. pain with erection 5. stricture or scarring 6. wound disruption usually due to erection

Question 31

vasectomy indications

Answer 31

1. undesired fertility

Question 32

vasectomy contraindications

Answer 32

1. infection 2. coagulation disorder 3. inability to palpate or elevate vas deferens 4. stress - divorce, financial 5. inappropriate reasons for wanting procedure 6. concern about ability to perform sexually after the procedure