Cardiovascular Review Questions – Dr. Ballew

• Reviewed ITE/Board style questions

Cardiology Review: Tachyarrhythmia Case – Dr. Roberts

• Great review of a patient who presented with a tachyarrhythmia
• Discussed general strategy for how to approach the tachycardic patient
• Reviewed multiple causes of narrow and wide complex tachycardic arrythmias
• Reviewed acute pharmacologic and non-pharmacologic methods for treating tachyarrhythmias
• Reviewed risk assessment tools such as CADS-VASC and HAS-BLED
• Discussed cardioversion and defibrillation

EKG Review – Dr. Stanforth

• Reviewed EKG cases from LITFL

Priapism – Dr. Stanforth

• Lecture followed by procedural SIM
• Discussed ischemic vs nonischemic priapism
• Reviewed risk factors and common causes of priapism
• Reviewed anatomy of penis in preparation for Dorsal Penile Nerve Block and Aspiration +/- Irrigation
• Reviewed alternatives including phenylephrine injections or OR intervention as well as disposition
• Discussed risks/benefits, alternatives (as above), equipment and how to properly perform nerve block and aspiration procedure
• Practiced aspiration during SIM

GU Trauma – Dr. Kuzel

• Non-op management is increasing, but operative management still gold standard
• Renal trauma:
  • High energy blunt trauma is most common
  • Best test: CT Abdomen and Pelvis w/ contrast
    • FAST is limited in renal and retroperitoneal injuries
  • Grade II renal lacerations or higher = admission to trauma
    • Grade I – III usually non-operative injuries
  • Gross hematuria OR microscopic hematuria + shock = CTAP w/ contrast
• Ureter Trauma:
  • 90% are penetrating trauma
  • Best test: Retrograde Pyelography
    • Urinalysis often does not show hematuria and even CTAP w/ contrast can be unhelpful
    • Ex-lap 88.9% sensitive causing increased nephrectomy rate
  • Treatment is always operative (consult urology), but high likelihood of complications (fistula, abscess, peritonitis, urinary leakage)
• Bladder Trauma:
  • High mortality (concomitant injuries)
  • Mechanism: direct blow to distended bladder
  • Best test: Retrograde cystogram
    • Gross hematuria + pelvic fracture = retrograde cystogram
• Urethral Trauma:
  • Anterior vs Posterior injuries
    • Anterior = operative
    • Posterior = Place suprapubic catheter
  • Mechanism: straddle injuries or blunt trauma
  • Blood at urethral meatus = anterior urethral injury
  • Best test: Retrograde urethrography
  • Prostate exam is unreliable to evaluate urethral injury
• Testicular or scrotal trauma
  • Best test: Doppler U/S
  • Consult urology
  • Testicular rupture = OR
• Penile Trauma
  • Zipper entrapment most common
  • Penile Fracture:
    • Rupture of corpus cavernosum from forceful bending
    • Mechanism: intercourse
    • Consult Urology for operative management
  • Penile Amputation:
    • Usually self-inflicted
    • Operative management
• Discussed Peyronie’s Disease and Foreign Bodies