Brian Miller Uro Flashcards
Symptoms of this often mimic UTI
Dysfunctional voiding
Symptoms of dysfunctional voiding?
- Interrupted stream
- Frequency
- Urgency
- Hesitancy
- Abd pain/discomfort
Imaging for Dysfunctional voiding?
-KUB
Imaging for Dysfunctional voiding if hx UTI?
U/S
Eval/ Procedures for Dysfunctional voiding?
- Uro Flow (bladder fxn test)
2. Bladder scan (post void residual)
First line treatment for Dysfunctional voiding?
Bowel/Bladder program to help learned behavior about how/when to pee and avoiding irritants
First line medication for Dysfunctional voiding for elevated PVR?
Doxazosin
-Tamsulosin for kids >7
WHat med is contraindicated in kids for NOT elevated PVR?
Anticholinergics
Symptoms of this condition are nonn-specific or with a FEVER:
- Dysuria
- Enuresis
- Frequency
- Urgency
- Hematuria
- Hesitancy
UTI
What is the first line way to test for a UTI
Urinalysis (microscopic better than dipstick)
If a patient has a UTI, there is a greater liklihood of what?
Renal involvement
What imaging should be done for a patient with a UTI?
-Renal and bladder U/S
What imaging should be done for a patient with a UTI that is >4 years old?
KUB
What imaging should be done for a patient with a UTI but NOT if the patient has a fever?
-VCUG (voiding cyrouretogram)- contrast
Treatment for UTI?
-Treat underlying cause and abx based on cultures
Reflux of urine from the bladder, up the ureters and at times, into the kidney
Vesicoureteral Reflux
Imaging for Vesicoureteral Reflux ?
- VCUG (voiding cyrouretogram)- contrast
- Renal U/S after diagnosis
- MAG 3 Renal Scan
Treatment for Vesicoureteral Reflux?
- *we want to AVOID surgery
- Lower grade: wait and see
- -> grades I to II
- Higher grade: abx & wait and see
- -> grades III to V
When to do surgery for a circumcision?
SURGERY if:
- Breakthrough UTI
- UTI following d/c of pabx
- Family preference
- When the urethra is under the head of the penis instead of at the tip
- Often won’t have complete foreskin on exam
HYDROSPADIAS
Testes should be desdended by ____ months of age otherwise they need referral to a specialist?
6 months
-Refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone
BPH
Labs and imaging for BPH?
- PSA needed–> elevation can be malignancy or inflammation
- Cytoscopy used to look inside bladder
- UroFlow
- Bladder Scan
Treamtment for BPH?
Flomax
S/e flomax?
s/e: hypotension, syncope, dizziness, arrhythmias, retrograde ejaculation
What is the tx for BPH with irritative symptoms?
anticholinergic med (Oxybutynin)
These are symptoms of what?
- Severe back/flank pain
- N/V
- Hematuria
- Resolves after stone passes
Urolithiasis
Imaging for Urolithiasis?
-Non-Contrast CT abdomen/pelvis = BEST
Treatment for pain and urolithiasis?
-Analgesic = Ketorolac
Treatment for nausea and urolithiasis?
Onsansteron (Zofran)
A varicocele is caused by dilation of the panpinoform plexus veins and almost exclusively on the ____
Left
These are symptoms of what?
- Pain (dull ache)
- Aggrivated by standing and worse at the end of the day
Varicoele
Labs for varicocele?
Semen analysis
