Topic: Haemothorax, stones of Gall bladder, Kidney, Ureter and Urinary Bladder
Question: Describe the management of acute urinary obstruction and investigations that have to be performed in a patient presenting with acute urinary obstruction.
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Investigations:
– Urinalysis
– Assesses for signs of infection like leukocytes, nitrites.
– Urine culture
– Identifies causative bacteria for urinary tract infection.
– Renal function tests
– BUN, creatinine to assess kidney function.
– Blood count
– Leukocytosis may indicate infection.
– Imaging
– Renal ultrasound evaluates hydronephrosis, stones, mass.
– CT abdomen/pelvis further characterizes obstruction.
– Retrograde pyelography locates level of obstruction.
Management:
– ABCs – Assess airway, breathing, circulation. Stabilize the patient if in distress. Give oxygen, IV fluids.
– Catheterization – Insert urethral or suprapubic catheter to relieve obstruction. Monitor urine output.
– Manage pain – Give analgesics like NSAIDs or opioids. Local anesthetic gel prior to catheterization.
– Correct electrolyte abnormalities – Potassium, phosphate and metabolic acidosis from renal impairment.
– Antibiotics – Give broad spectrum antibiotics if infection is suspected. Treat based on cultures.
– Renal dialysis – If acute kidney injury or renal failure develops from prolonged obstruction.
Urological procedures:
– Cystoscopy – Visualize inside of bladder and urethra to find obstruction cause. Can insert stent.
– Ureteral stenting – Place stent across ureter obstruction using cystoscopy to drain urine.
– Percutaneous nephrostomy – Place drain directly into renal pelvis through skin for urgent drainage.
– Lithotripsy – Break up large kidney stones causing obstruction using shock waves externally.
– Nephrostomy/pyelostomy – Surgically create opening in kidney/ureter for drainage.
– Surgery – May be needed for large stones, strictures, masses, etc. causing obstruction.
The priority is urgent decompression and relief of obstruction combined with appropriate antibiotics and kidney function support. Investigations help determine the underlying cause.
Medicivils Medical Science Optional Test Series: Better Than UPSC Medico? Introduction The UPSC Civil Services Examination (CSE) is one of the most competitive exams in the world. The Medical Science optional is a popular choice for many candidates, as it covers a wide range of topics that are relevant to the UPSC syllabus. There are many different test series available for the Medical Science optional, but one of the most popular is the Medicivils test series. Medicivils is a coaching institute that specializes in the Medical Science optional, and their test series is known for its high quality and comprehensive coverage of the syllabus. In this article, we will compare the Medicivils Medical Science Optional Test Series to the UPSC Medico Test Series, and discuss why Medicivils is the better choice for UPSC CSE aspirants. Quality of Questions The quality of the questions in the Medicivils test series is very high. The questions are well-drafted and cover a wide range of topics from the syllabus. The questions are also challenging enough to test the candidates’ knowledge and understanding of the subject. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions. Some candidates have complained that the questions are too repetitive and do not adequately cover the syllabus. Comprehensiveness The Medicivils test series covers the entire Medical Science syllabus in great detail. The test series includes full-length tests, subject-wise tests, and topic-wise tests. This ensures that the candidates are thoroughly prepared for all aspects of the exam. The UPSC Medico test series, on the other hand, is not as comprehensive. The test series does not cover all of the topics in the syllabus in equal detail. Additionally, the test series does not include any topic-wise tests. Model Answer Sheets The Medicivils test series provides high-quality model answer sheets for all of its tests. The model answer sheets are written by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series, on the other hand, does not provide model answer sheets for all of its tests. Even for the tests that do have model answer sheets, the quality is often not up to par. Personal Mentorship Medicivils offers personal mentorship to all of its students. The students can get their papers evaluated by experienced faculty members and receive personalized feedback. This helps the students to identify their strengths and weaknesses and to improve their performance. The UPSC Medico test series does not offer personal mentorship to its students. The students do not have the opportunity to get their papers evaluated by experienced faculty members and receive personalized feedback. Video Solutions Medicivils provides video solutions for all of its subject-wise tests. The video solutions are taught by experienced faculty members and provide detailed explanations for all of the questions. The UPSC Medico test series does not provide video solutions for its tests. Evaluation Medicivils evaluates the students’ papers within 7 days. The students’ papers are evaluated by experienced faculty members and they receive a detailed evaluation report. The UPSC Medico test series takes longer to evaluate the students’ papers. The students often have to wait for 10-15 days to receive their evaluation reports. Conclusion Overall, the Medicivils Medical Science Optional Test Series is the better choice for UPSC CSE aspirants. The Medicivils test series offers high-quality questions, comprehensive coverage of the syllabus, model answer sheets, personal mentorship, video solutions, and prompt evaluation. The UPSC Medico test series, on the other hand, has been criticized for the quality of its questions, lack of comprehensive coverage of the syllabus, lack of model answer sheets, lack of personal mentorship, lack of video solutions, and delayed evaluation. If you are serious about cracking the UPSC CSE with the Medical Science optional, then the Medicivils Medical Science Optional Test Series is the best choice for you.
