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Nurse Practitioner:
doi: 10.1097/01.NPR.0000350570.46106.ba
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Evaluation and management of genitourinary emergencies

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INSTRUCTIONS Evaluation and management of genitourinary emergencies

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* Registration deadline is May 31, 2011.

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Evaluation and management of genitourinary emergencies

General Purpose: To provide the NP with an overview of the diagnosis, evaluation, and management of selected GU emergencies. Learning Objectives: After reading the preceding article and taking the following test, you should be able to: 1. Describe the etiologies and presentations of selected GU emergencies. 2. Discuss the diagnostic findings and management of selected GU emergencies.

1. AUR in men is mainly characterized by bladder distension and

a. gross hematuria.

b. unilateral flank pain.

c. dysuria.

d. lower abdominal pain.

2. Progressive symptoms associated with BPH include hesitancy, nocturia, dribbling, and

a. flank pain.

b. decreased urinary stream.

c. hematuria.

d. scrotal swelling.

3. Each of the following is used to group common etiologies of AUR in men except

a. those due to increased resistance (obstruction).

b. neuromuscular/neurogenic causes.

c. bladder overdistention.

d. infectious conditions.

4. Spinal cord trauma, multiple sclerosis, or Parkinson's disease can cause

a. priapism.

b. AUR.

c. testicular torsion.

d. FG.

5. A digital rectal examination that reveals a smooth, enlarged prostate usually indicates

a. prostate cancer.

b. phimosis.

c. BPH.

d. priapism.

6. Initial diagnostic tests for women with AUR may include all of the following except

a. colposcopy.

b. pelvic ultrasound.

c. urine culture.

d. urine dipstick.

7. Priapism is characterized by a prolonged erection that

a. usually lasts between 1 and 4 hours.

b. involves rigidity of the corpus spongiosum and glans.

c. is seen most often in teenage boys.

d. is unrelated to sexual stimulation or arousal.

8. Patients with sickle cell disease and low-flow priapism may require

a. immediate I.V. fluids and oxygen.

b. immediate hyperbaric oxygen.

c. urgent laceration of the penile artery.

d. urgent embolization of the penile vein.

9. High-flow priapism is

a. more of an emergency than low-flow priapism.

b. referred to as the ischemic type.

c. associated with a higher rate of permanent complications than low-flow priapism.

d. caused by a partial obstruction of oxygenated blood.

10. Physical exam of high-flow priapism reveals

a. a very rigid and painful erection.

b. a nontender, semirigid penis.

c. a very rigid and swollen penis.

d. a tender red penis and swollen scrotum.

11. Obstructing renal calculi can lead to all of the following except

a. pyelonephritis.

b. impaired renal function.

c. nephrosclerosis.

d. septic shock.

12. Symptoms indicative of urosepsis and septic shock include fever,

a. hypotension, and tachycardia.

b. hypertension, and diaphoresis.

c. bradycardia, and tachypnea.

d. hypertension, and confusion.

13. Immediate management of the patient with an obstructing renal stone includes

a. bladder catheterization and administration of I.V. fluids.

b. pain management and oxygen administration.

c. bladder decompression with a straight catheter and administration of an alpha blocker.

d. urology consult for decompression of the renal collecting system and treatment of sepsis.

14. The “blue dot” sign is

a. visible through the skin at the perirectal area.

b. considered a surgical emergency.

c. indicative of torsion of a testicular appendage.

d. indicative of testicular torsion.

15. In contrast to epididymitis, a diagnostic finding for testicular torsion is

a. pain relief with scrotal elevation above the symphysis pubis.

b. a negative Prehn sign.

c. a positive cremasteric reflex.

d. testicular retraction in response to stroking the inner thigh.

16. Which statement about management of testicular torsion is correct?

a. A Doppler ultrasound should be performed prior to referral to the urologist.

b. It should be treated within a 12- to 24-hour period.

c. The affected testicle is always treated with an orchiectomy.

d. Bilateral orchiopexy with fixation is the preferred treatment.

17. The key physical exam finding in the patient with FG is

a. crepitus.

b. fluctuance.

c. malodorous affected tissue.

d. visible evidence of perineal trauma.

18. Immediate management of FG includes hemodynamic stabilization, I.V. fluid resuscitation, and

a. a course of oral penicillin.

b. ice application to the affected site.

c. subcutaneous terbutaline injection.

d. immediate urology consult for surgical debridement.

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