A Place for short cases/ SAQ's, handy tips & good resources on the web. Short bites of information relevant to EM.

Tuesday, 24 September 2013

Can't Pee...

Another of the CT3 additional presentations:


Urinary retention is a fairly common presentation, but it is not the most glamorous of topics, there is however a CEM standard for its management and it easily could make an SAQ.


There is a nice summary article on the BMJ website http://www.bmj.com/content/318/7188/921


Question:

A 72 year old man presents with increasing lower abdominal pain and the inability to pass urine for the past 24 hours. He is in obvious distress and is tachycardic and hypertensive, a bladder scan is performed and shows in excess of 800mls. You successfully pass a urethral catheter and the patient is quickly relieved.

1) List 3 differentials for this man's problem. (3)
2) What clinical features would suggest a history of prostatism? (2)
3) Following insertion of a urethral catheter list three things you should document. (3)
4) Give two features that would require hospital admission. (2)



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