Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Urology


Answer 4
  1. Bilateral percutaneous nephrostomy tube placement. This patient needs acute management of her renal failure and hyperkalemia. The goal in the management of RPF depends on the severity of the disease at diagnosis, with the primary goal of preserving renal function. Patients presenting with uremia should be urgently decompressed with indwelling ureteral stents or percutaneous nephrostomy tubes to protect renal function.4 If the patient is critically ill with anuria and hyperkalemia, nephrostomy tubes can be placed under ultrasound guidance with local anesthesia. High-dose steroid therapy, CT-guided biopsy of the retroperitoneal mass, and surgical ureterolysis are therapeutic options for presumed RPF but are not performed in the acute setting. Spontaneous resolution is rare unless a known inciting drug is discontinued in a patient with a mild form of RPF.

    REFERENCES
    4. Varkarakis IM, Jarrett TW. Retroperitoneal fibrosis. AUA Update Series 2005;24:18-23.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj