This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Kidney & Ureturs, Subject name: Surgery
[{'content': 'During renal rupture the nephrectomy is NOT attempted until \nSelect and explain. \nA. Fluid replacement, B. Antibiotics covers, C. Contralateral renal function is ascertain, D. Renal angiogram', 'role': 'user'}, {'content': 'Answer: C \nExplanation: (Contra-lateral renal function is scertain)Nephrectomy is a possibility so it is important to establish that the contralateral kidney is functioning (1291- Bally & Love 25th)Injury to the Kideny * Haematuria is a cardinal sign of a damaged kidney *** Meterorism - abdominal distension comes on about 24-48 hours after the accident (retroperitoneal haematoma implicating splanchnic nerves)* An Intravenous urogram (IVP) should be obtained urgently to show that the other kidney is normal. A leak of urine on the damaged side is often demonstrated* Before proceeding to surgical procedure for bleeding a renal arteriogram should be performed if possible. If the bleeding vessel is visualized it may be embolised with small starch microspheres to stop bleeding* Should the necessity for a urgent operation arise and facilities for urography not be available, the presence of a functioning kidney on the contralateral side can often be confirmed by chromo- cystoscopyTREATMENT1. Nephrectomy - Kidney is found to rupture in several places or kidney pedicle is damaged2. Small tear can be sutured over oxycel or a piece of detached muscle3. Nephrostomy - Larger single rents in the middle of the kidney4. Partial Nephrectomy - laceration is confined to one pole of the kidney', 'role': 'assistant'}]