3. Nocturia-Hematuria

Question 1

Transient causes of urinary incontinence is DIAPPERS
Delirium
Infection
Atrophic urethritis
Pharmaceuticals
Psychological factors
Excess urinary output
Restricted mobility
Stool?

Answer 1

impaction

Question 2

There are three types of urinary incontinenece, including destrusor overactivity (urge incont), Urethral incompetence (stress incont), and destrusor underactivity which is what type of incontinence?

Answer 2

Overflow

Question 3

the most important aspect from a physician standpoint is symptom management of BPH and ensuring there is no evidence of?

Answer 3

CANCER

Question 4

Lower urinary tract symptoms (LUTS) are suggestive of prostatic hyperplasia and can include urinary frequency, urgency, trouble starting urine, weak stream, dibbling, nocturia, urinary retention/incontinence, pain after ejaculation and urine that

Answer 4

has an unusual color or smell

Question 5

Symptomatic relief is the most common reason men seek treatment for BPH, and therefore symptomatic relief is usually the goal for?

Answer 5

treatment of BPH (w sildenafil, vardenafil, avanafil)

Question 6

DRE and PSA are not recommended in routine screening, determine the patients risk of BPH and prostate cancer before performing a PSA. For men with 4-7ng/ml PSA refer to urology if their symptom score is?

Answer 6

moderate to severe (8-19, 20-35)

Question 7

Cystitis is lower urinary tract infection and has a DDx of:
pylenephritis, urethreitis, vaginitis, prostatitis, Asx bacteriuria (ASB), interstitial cystitis, pelvic inflam dz, urinary calculi, radiation or cyclophosphamide, bladder cancer, and urinary?

Answer 7

urinary incontinence

Question 8

A dx of what can be considered when there is no local or systemic symptoms, and there is bacteriuria detected incidentally when a patient undergoes routine screening urine culture?

Answer 8

Asymptomatic bacteriuria

Question 9

What is characterized by dysuria, urinary frequency and urgency?

Answer 9

cystitis

Question 10

What presents with low grade fever, with or without low back/ costovertebral pain, or if severe will present with high fever (*distinguishing feature from cystitis), rigors, nausea, vomitting and flank pain?

Answer 10

Pyelonephritis

Question 11

What presents with dysuria, frequency, and pain in the prostatic pelvic or perineal area, sometimes with fever and chills and symptoms of bladder outlet obstruction?

Answer 11

Acute bacterial prostatitis

Question 12

What presents as symptomatic episodes of cystitis or pyelonephritis in a man or woman with an anatomic predisposition to infection, with a foreign body in the urinary tract, or w factors predisposing to a delayed response to therapy?

Answer 12

Complicated UTI

Question 13

What causes sever flank pain, nausea and vomitting, and identification can be done on non contrast CT scan or US?

Answer 13

Urinary stones (MC in males in 30/40s)

Question 14

urinary stones present with *colicky pain in the flank- severe, N/V, sharp pain

Answer 14

Meow

Question 15

What can be diagnosed with symptoms including fever, irritative voiding symtpoms, perineal or suprapubic pain, tenderness on rectal exam, and a positive urine culture?

Answer 15

Acute bacterial prostatitis

*usually d/t E. Coli and pseudomonas

Question 16

Lab tests for acute bact prostatitis would have pyuria, bacteriuria, hematuria and a positive urine culture, how is it treated?

Answer 16

Abx specific for type of bacteria

Question 17

If there is microscopic hematuria, get a CT. Risk factors for bladder cancer include cigarette smoking, occupation exposure such as arylamine, phenacetin use, past tx with high doses of cyclophosphamide and ingestion of?

Answer 17

aristolochic acid (herbal weight loss products)

Question 18

The MCC of gross hematuria is urologic cancer and UTI. What are the MCC of microscopic hematuria?

Answer 18

Urologic Cancer and prostatic hyperplasia

Question 19

All of the following are what associated with hematuria?
increased age and male
constitutional symptoms (wt loss, app loss, fatigue)
heavy smoking history/aniline dye exposure
+ fam history of deafness/renal disease?

Answer 19

Alarm symptoms

Question 20

whenever the urine dipstick is positive for blood and the microscopic exam of the urine does not show RBCs, myoglobinuria and what should be considered?

Answer 20

hemoglobinuria

Question 21

All patients with hematuria should have what performed, regardless of the likelihood of infection?

Answer 21

Urine culture performed

Question 22

What is diagnosed by gross/microscopic hematuria, flank pain or mass, systemic symptoms like fever and weight loss, and a solid renal mass on imaging?

Answer 22

Renal Cell carcinoma

Question 23

RCC peaks in the 60s, male 2x as much as females, cigarette smoking is a huge risk factor. What is the most common syndrome it is associated with?

Answer 23

VHL syndrome - deletion on chr 3

Question 24

A triad of hematuria, flank pain and mass occurs in 15% of people with RCC, but what is the most common?

Answer 24

Hematuria

Question 25

For RCC, what are the most valuable imaging tests, to confirm the character of the mass and stage of the lesion?

Answer 25

MRI and CT

Question 26

Gross hematuria is uncommon with intrinsic kidney disease but is commonly encountered in what, and cyst rupture in autosomal dominant PCKD?

Answer 26

IgA nephropathy

Question 27

IgA nephropathy is not entirely benign, 40% reach end stage kidney disease after 20 years. What is a classic presentation for IgA nephropathy?

Answer 27

After and URI/GI infection along with EPISODIC gross hematuria

Question 28

What is a relatively benign disorder, present at birth, AD - MCKD1/2 on chr1/16 , irregular enlarged medullary and interpapillary collecting ducts?

Answer 28

Medullary Sponge Kidney MSK

Question 29

Medullary Sponge Kidney MSK presents with gross/micro hematuria, recurrent UTIs, or nephrolithiasis. Common abnormalities including urinary concentrating ability and?

Answer 29

Nephrocalcinosis

Question 30

Medullary Sponge Kidney MSK see cystic dilation of distal collecting tubules, striated appearance, and what in the renal collecting system?

Answer 30

calcifications