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