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Obstruction is unrelieved for >4 weeks (Because after 4 weeks the obstruction will cause necrosis) 6 antibiotics for urinary retention order 200mg cefpodoxime amex. Epididymitis is inflammation of the epididymis Orchitis is inflammation of the Testicle Epididymo-orchitis is inflammation of both 2 antibiotics for uti zithromax cheap cefpodoxime 100 mg otc. Torsed testis with transverse or oblique lie Types: (not important) Extra-vaginal Intra-vaginal Presentation: o Acute onset of scrotal pain Sharp and severe May be intermitting due to torsion then detorsion o Majority have a history of prior episodes of severe bacteria that causes acne order cefpodoxime cheap, self limited scrotal pain and swelling o Nausea and vomiting due to the pain o Referred to the Ipsilateral lower quadrant of the abdomen o Children may present with abdominal pain antibiotic resistance of bacillus subtilis cheapest generic cefpodoxime uk. So any child that complains of severe abdominal pain may need to have a genital examination Doctor mentioned a scenario: a mother brought her child to the clinic and said "my son went to school and ate bad food and now he has abdominal pain and nausea/vomiting" after further inspection the child had Torsion of the cord. Figure 7 o Radionuclide imaging: (figure 9) o Assesses testicular blood flow o Shows a photopenic area in cases of torsion o False impression from hyperemia of scrotal wall o Sensitivity of 90% and specificity of 89% o Not helpful to determine a hydrocele or hematoma (does not assess anatomy) Surgical exploration: o Diagnostic and therapeutic o A scrotal incision is done and the affected site is examined first a needle prick is done and if there is no blood coming out or black tissue it means it is dead o the cord should be detorsed. With contrast: imaging modality of choice + other abdominal injuries can be assessed 3. Cannot accurately identify parenchymal tears, collecting system injuries, or extravasations of urine until a later stage when a urine collection has had time to accumulate. Surgical exploration (indications for surgery): o Persistent bleeding: tachycardia and/or hypotension failing to respond to appropriate fluid and blood replacement o An expanding peri-renal hematoma after laparotomy o Pulsatile peri-renal hematoma after laparotomy 3. External trauma Rare because severe forced is required Can be blunt or penetrating Blunt external trauma severe enough to injure the ureters will usually is associated with multiple other injuries. Internal trauma More common but it is still uncommon Iatrogenic: causes by doctors during surgeries (hysterectomy, oopherectomy, sigmoidcolectomy, urertoscopy, cesarean section, laparoscopies and orthopedic operations Diagnosis: o Requires high index of suspicion 144 12 Emergencies in Urology Usually diagnosed intra-operatively Late diagnosis: (these are suggestive of ureter injuries): 1. Persistent drainage of fluid from abdominal or pelvic drains, from a wound or the vagina. Presentation: o Recognized intra-operatively the classic triad of symptoms and signs that are suggestive of a bladder rupture: 1. Majority can be managed by suprapubic urinary diversion for one week Penetrating partial disruption. Stable patient: the urethra may either be immediately repaired or a suprapubic catheter is placed o Penetrating Anterior Urethral Injuries are generally managed by surgical debridement and repair Retrograde urethrogram: contrast is injected through the urethra using a catheter and images are taken. If the diagnosis is testicular torsion how would you further proceed with your work up The commonest renal cell carcinoma histological subtype is clear cell carcinoma the renal cell carcinoma arising from the collecting duct cells is collecting duct carcinoma of the kidney. Familial papillary cell carcinoma is hereditary and runs in families (all family members should be screened). We use the groin incision to remove large tumors, because that way we do not need to cut muscle, it is a muscle splitting incision. For post-menopausal women who have undergone hysterectomy > Transvaginal approach Very clear, impacted cells with dark nuclei and clear cytoplasm. This is the commonest histopathological subtype Staging of kidney tumor includes: 1. Pathological staging Grading system for kidney cancer is called: Fuhrman system 1. Hematuria 159 12 Genitourinary Oncology 2) Which of the following is the commonest malignancy in young men Greenish, sticky, dark o Consistency Loose / watery diarrhea Firm & dry constipation o Color Very pale Crying baby o Babies communicate their needs by crying Hungry Wet (Urinated) o At >6 month emotions they learn to cry for other reasons Want to be carried Want to play o Baby who continue to cry, refuse feeding and dry "irritable baby" o pain Abdominal pain Other causes Ear ache o Non-crying baby with reasons can be worrisome very sick Development o Growth (height and weight) Chronic problems (Metabolic, Nutrition => gut health) o Psychological Mental problem, chromosomal abnormalities o Motor Syndrome Metabolic Meconium is the early feces (stool) passed by a newborn soon after birth, before the baby has started to digest breast milk (or formula). Parents indicated that the baby vomits with significant force all the milk he had ate completing the feed. Boundaries: o Anterior: External oblique muscle o Posterior: Transversalis fascia o Inferior wall (floor): Inguinal ligament o Superior wall (roof): Internal oblique and transversus abdominis the deep ring is lateral to the inferior epigastric vessels. Strangulated: the swelling does not get reduced + there is a decrease of the blood supply to the herniated sac thus resulting in ischemia (this type is painful) 1. Because the obstruction is distal to the ampulla of vater (2nd part of duodenum), so the bile will go to the bowel where there is obstruction which prevents it from going down.
Diseases
- Dislocation of the hip dysmorphism
- Diabetes, insulin dependent
- Potassium deficiency (hypokalemia)
- Trichostasis spinulosa
- Hypertrophic myocardiopathy
- Porokeratosis punctata palmaris et plantaris
- Mastocytosis
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Oxytocin has been recognized recently as a significant mediator of endogenous analgesia89 virus zona discount cefpodoxime 100 mg amex,90 and it can reduce frequency of headache and pain in chronic migraine antibiotics for sinus infection pregnancy buy cefpodoxime 100 mg low price. It was also proposed that this association was an active process underlying acupuncture-induced analgesia antibiotic guide pdf buy 200mg cefpodoxime visa. Oxytocin is of potential use in well-being and applications in neuropsychiatric disorders virus repair trusted 200 mg cefpodoxime. Further studies are required to find out the role of oxytocin in cancer and eating behaviours. Presence of vasopressin, Oxytocin and neurophysin in the retina of mammals, effect of light and darkness, comparison with neuropeptide content of neurohypophysis and the pineal gland. The neuroendocrine thymus: coexistence of Oxytocin and neurophysin in human thymus. Transgenesis and the study of expression, cellular targeting and function of oxytocin, vasopressin and their receptors. Molecular mechanisms regulating the effects of oxytcin on myometrial intracellular calcium. Characterization of Oxytocin system regulating affiliative behavior in female prairie voles. Oxytocin is required for nursing but is not essential for parturition or reproductive behaviour. The acute effects of intranasal oxytocin administration on endocrine and sexual function in males. Neurophysiology and neuropharmacology of hypothalamic magnocellular neurons secreting vasopressin and Oxytocin. Characterization of Oxytocin, vasopressin and neurophysin from bovine corpus luteum. Estrogens, but not androgens, regulate expression and functional activity of Oxytocin receptor in rabbit epididymis. Oxytocin and vasopressin expression in the ovine testis and epididymis: changes with the onset of spermatogenesis. Oxytocin, oxytocin associated neurophysin and the oxytocin receptor in human prostate. Afferents originating from the dorsal penile nerve excite Oxytocin cells in the hypothalamic paraventricular nucleus of the rat. Oxytocin and vasopressin in rodent behaviour related to social dysfunctions in autism spectrum disorders. Oxytocin mediates rodentsocial memory within the lateral septum and the medial amygdaladepending on the relevance of the social stimulus: male juvenile versus female adult conspecifics. Induction of maternal behavior in virgin rats after intracerebroventricular administration of oxytocin. Evidence for a neuroendocrinological foundation of human affiliation: plasma oxytocin levels across pregnancy and the postpartum period predict mother-infant bonding. Maternal and paternal plasma, salivary, and urinary oxytocin and parent-infant synchrony: considering stress and affiliation components of human bonding. Inhibitory effect of oxytocin on corticotrope function in humans: are vasopressin and oxytocin ying-yang neurohormones Effects of oxytocin on the function and morphology of the rat adrenal cortex: in vitr o and in vivo investigations. Behavioral consequences of intracerebral vasopressin and oxytocin: focus onlearning and memory. Dissociation of oxytocin, vasopressin, and corticotropin secretion during different types of stress. Selective serotonin reuptake inhibitors and their effects on relationship satisfaction. Diagnostic and Statistical Manual of Mental Disorders: Diagnostic Criteria for Autistic Disorder.
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