Conference: 10/26/2022

Prostatitis:

                   – E. coli in 80% of acute cases (chronic more common), others: STD pathogens

                   – Dx: DRE tender prostate, labs not always helpful

                                      – CT scan only if suspicion for prostate abscess

                   – Rx: 4 wk course of antibx with follow up with urology

Testicular Torsion:

                   – 2 types: Extra-vaginal torsion: neonates. Intravaginal torsion: adolescents

                   – Gold standard dx: surgery, scrotal Doppler US sensitivity about 86-92%

                   – Twist Score: helps determine high vs low risk for torsion

                   – Rx: Urology/OR, manual detorsion: open book 540-720 degrees

Chest Tube procedure sim:

                   – CT choices: 24F for viscous fluid and pigtail for uncomplicated PTX

                                      – Use own judgement

                   –  Can give 2g Ancef

                   – Go in about 10-12cm

GU Trauma: Dr. Huecker:

                   – 2019 model of clinical practice of emergency medicine

                   – Renal injury: Some injuries have no hematuria

                                      – gross hematuria, elderly, penetrating trauma

                                      – Injury classification >4 laceration into collection system go to surgery typically

                   – Ureter Injury: Iatrogenic 80%, penetrating trauma 18%

                   – Bladder: associated with pelvic fractures

                                      – needs CT cystography, RUG

                                      – Depends on intraperitoneal (needs surgery) vs extra (may not need surgery)

                   – Genitals: need good PE

                   – Pelvic injuries:

                                      – lateral compression, anterior/post, vertical shear

                                                         – binders with AP compression

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