Clinical Toxicology and Urology Quick Reference: Diagnosis and Treatment

Written on October 24, 2026 in English with a size of 12.12 KB

Toxicology: Metabolic and Toxic Ingestion Overview

(MetA) (Blindness, CNS inj)	CVS
-Hx -Smell -Serum -CBC -BioC -L Enzymes	-Hx -Fundoscopic -ABG (MA) -Serum -CBC, BioC	Hx ECG ABG (MA) UA
-Glucose + Thiamine 100 mg	(C)(C) -- M-A Ethanol 100 ml 4H Folic Acid 50 mg 4H	Ethanol 100 ml (4H) Pyridoxine, Thiamine, Folic Acid

TCA: CNS? ?, pupils CVS toxicity V aRR ? BP	Anti-P: -Sedation -Dyskinesis -Neuroleptic Sx	*Amphetamine/Cocaine BP (+) & HR (+)**
Dx: Hx CBC BioC ECG: Sinus? HR (? QRS > 0.12) -Urine toxicology	Dx: Hx ECG ?QT Blood level Urine test CK ? (muscle damage)	Dx: Hx Blood [C] CBC BioC ECG

Tx:
Lavage 8 H!!
(+) Coal 0.5-1 mg/kg
Vomiting
Vasopressor/NA
(Dy aRR)
Bicarbonate for ? QRS!

Tx:
A+V
Lavage 4 H
(+) Charcoal
Diazepam ---> muscle rigidity
(C)(C) --> Cardiotoxic

Tx:
Lavage (2H)
(+) Coal (2H)

Agitation <-- Benzo
Tachy aRR <--- Beta blockers

Urology: Prostate Disease Assessment and Management

Dx:
-IPSS
-DRE
-Uroflowmetry

Dx:
-PSA (>3 ng/ml)
-DRE
-Biopsy

Risk: IPSS (0-7 / 8-19 / 20-35) Qmax (>15 / 10-14 / <10)	RISK: Low: PSA <10 + Gleason <6 <50% cores / Int1 (+) core Mod: PSA 10-20 / Gleason = 7 >50% core High Risk: PSA >20 / Gleason >8
Tx: -Lifestyle (2 hour) -X 40- (Tamsulosin 0.4 mg/day) 40+ (Dutasteride, Finasteride) (Combodart) (Phyto) -TURP 70- -Open prostatectomy 70+	Tx: I-Observation (PSA 6M, DRE 12M) (Low risk, Asx) II-Radical Prostatectomy (E Dysfunction, incontinence) -Brachytherapy -Beam III-Chemo (CRPC) IV-Hormone (Old + DM)

Urology: Bladder Cancer and Cystitis

**Bladder

-Superficial: Urine cytology 1 M / Cystoscopy + TUR every 3 M
-T2A: Open cystectomy + Chemo
-Ta = TUR
-Ta3G1, T1
TUR + 6W IV of BCG
-Tis: ...
-T1: ... / Radical cystectomy
Bilateral LN dissection!

^^Tx:

I-Noninvasive:
I-TURBT
2-Intravesical therapy:
-BCG
-Doxorubicin / Mitomycin
-Gemcitabine

3 Cystectomy

II-Invasive
Chemo (cisplatin)
Radical cystectomy

***Cystitis:

Chronic (post-menopausal women):

#1-Fosfomycin
(+ve culture)
#2-Cephalosporin G2
#3-Cefuroxime
#4-Fluoroquinolones

I-Empiric (Nitrofurantoin)
II-Specific (X, AbN, Estrogen)

Prophylaxis:
-Trimethoprim
-Nitrofurantoin
-Cefalexin

Urology: Ureter Trauma

***Ureter Trauma:

^^Sx:
-No fever
-Flank pain
-Hematuria (+/-)

^^Dx:
-CT + contrast
-IVP
-Methylene Blue

^^Tx:
Temporary PCN
-Remove suture / clip
-Ureteral stent insertion!

^^Complications (early & late)
Hydronephrosis / Urinoma / Infection
Stricture / RI / Calculi

Urology: Scrotal and Penile Emergencies

Torsion:	***Epididymo-orchitis:	***Priapism:
-Medical ER 4-6 Necrosis -Sx: acute pain ^^Sx: Cremaster reflex (-) Acute hydrocele, scrotal edema ^^Dx: -US^^Tx: Detorsion	-Scrotal swelling, erythema, pain -Dysuria & fever Epididymal tenderness -(+) Cremaster ^^Tx: -Bed rest 1-3 days -Scrotal elevation -Antibiotics IV if UTI documented	>4 hours -Ischemic: low flow, more pain -Non-ischemic = painless -Glans penis flaccid ^^Dx: -Arterial blood gas (Low vs high flow) CBC -Hb -US (cavernous artery flow) ^^Tx: -Conservative first 1-Ischemic: (Alpha-1 adrenergic antagonist) -Phenylephrine -Normal saline -Surgical shunt

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