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Zero to Finals > Common Urinary Histories > Flashcards

Common Urinary Histories Flashcards

1
Q

Summarise different presenting complaints patients may have:

A
  1. frequency, dysuria, nocturia
  2. haematuria
  3. polyuria
  4. incontinence
  5. retention
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2
Q

describe what you would look for in a urological systems review:

A
  1. storage
    - frequency
    - volume
    - urgency
    - nocturia
  2. Infection
    - dysuria
    - haematuria
  3. prostatic / voiding (if male)
    - hesitancy
    - poor flow/ dribbling
    - feeling of incomplete emptying
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3
Q

what questions would you ask about haematuria?

A
  1. try to quantify bleeding
  2. thick blood or discoloured urine
  3. catheter
  4. anaemia symptoms: tiredness, breathlessness on exertion
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4
Q

for a patient with polyuria what general symptoms would you ask for?

A
  • fever
  • sweat
  • malaise
  • rashes
  • joint pain
  • swelling
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5
Q

Frequency/ dysuria/ nocturia

the following points to which differential:

  • dysuria
  • frequency and urgency
A

cystitis

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6
Q

Frequency/ dysuria/ nocturia

the following points to which differential:

  • dysuria
  • purulent urethral discharge
A

urethritis

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7
Q

Frequency/ dysuria/ nocturia

the following points to which differential:

  • loin pain
  • dysuria
  • fever, chills, rigors
  • vomiting
A

pyelonephritis

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8
Q

Frequency/ dysuria/ nocturia

the following points to which differential:

  • poor flow and terminal dribbling
  • hesitancy
  • overflow incontinence
  • elderly male
A

benign prostatic hyperplasia

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9
Q

Frequency/ dysuria/ nocturia

Other differentials

A
  • anxiety
  • detrusor instability
  • bladder / lower urethral calculus
  • prostatitis
  • pregnancy
  • drugs (e.g. diuretics)
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10
Q

Haematuria

the following points to what differential:

  • painless haematuria
  • hx of aromatic amine exposure (e.g. dye washers, painters, decorators)
A

bladder transitional cell carcinoma

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11
Q

Haematuria

the following points to what differential:

  • history of catheter use or trauma
A

urethral trauma

e.g. by catheter

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12
Q

Haematuria

the following points to what differential:

-frequency / dysuria / urgency

A

UTI

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13
Q

Haematuria

the following points to what differential:

  • dysuria
  • purulent urethral discharge
A

urethritis

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14
Q

Haematuria

the following points to what differential:

  • loin to groin pain
A

calculi

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15
Q

Haematuria

other urological and miscellaneous differentials

A

urological

  • glomerulonephritis
  • BPH , prostate cancer
  • renal cell carcinoma
  • polycystic kidney disease
  • schistomosomiasis
  • renal TB

misc

  • haematological e.g. anticoagulation, sickle cell, coagulation disorders
  • strenuous exercise
  • infective endocarditis
  • drugs
  • menstruation
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16
Q

Polyuria

the following points to what differential:

  • polydipsia, thirst
  • polyuria
  • weight loss and tiredness
  • visual disturbance
A

diabetes mellitus

17
Q

Polyuria

the following points to what differential:

  • polydipsia
  • polyuria
A

diabetes insipidus

18
Q

Polyuria

the following points to what differential:

non specific symptoms

  • fatigue
  • weakness
  • puritis
  • dyspnoea
A

chronic kidney disease

19
Q

Polyuria

Other differentials

A

Cushing’s syndrome

Psychogenic polydipsia

drugs (e.g. diuretics, alcohol, lithium, tetracyclines)

20
Q

Incontinence

the following points to what differential:

  • small losses with effort e.g. coughing, bending, exertion
  • risk factors: multiple pregnancies, post-menopause
A

incompetent sphincter

stress incontinence

21
Q

Incontinence

the following points to what differential:

  • urge to pass urine followed by uncontrollable bladder emptying
A
  1. detrusor instability
    (e. g. idiopathic, cystitis, stone)
  2. hyperreflexia
    (e. g. MS, CVA, spinal cord injury)

urge incontinence

22
Q

Incontinence

the following points to what differential:

  • dribbling and poor stream
  • hesitancy
  • elderly male
  • history of obstruction
A

prostatic hypertrophy

stricture or stone

overflow incontinence

23
Q

Incontinence

the following points to what differential:

  • continuous urine leak
A

fistula between bladder and vagina or urethra

true incontinence

24
Q

Incontinence

other differentials:

A
  • bladder stone / tumour
  • fistula
  • post-pelvis fracture
  • psychogenic
  • post-prostatectomy or other pelvic surgery
25
Q

Retention

the following points to what differential:

  • history of hesitancy
  • poor flow
  • terminal dribbling
  • elderly male
A

prostatic hypertrophy

26
Q

Retention

the following points to what differential:

  • history trauma or recurrent catheterisation
A

urethral stricture

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