Common Urinary Histories Flashcards
Summarise different presenting complaints patients may have:
- frequency, dysuria, nocturia
- haematuria
- polyuria
- incontinence
- retention
describe what you would look for in a urological systems review:
- storage
- frequency
- volume
- urgency
- nocturia - Infection
- dysuria
- haematuria - prostatic / voiding (if male)
- hesitancy
- poor flow/ dribbling
- feeling of incomplete emptying
what questions would you ask about haematuria?
- try to quantify bleeding
- thick blood or discoloured urine
- catheter
- anaemia symptoms: tiredness, breathlessness on exertion
for a patient with polyuria what general symptoms would you ask for?
- fever
- sweat
- malaise
- rashes
- joint pain
- swelling
Frequency/ dysuria/ nocturia
the following points to which differential:
- dysuria
- frequency and urgency
cystitis
Frequency/ dysuria/ nocturia
the following points to which differential:
- dysuria
- purulent urethral discharge
urethritis
Frequency/ dysuria/ nocturia
the following points to which differential:
- loin pain
- dysuria
- fever, chills, rigors
- vomiting
pyelonephritis
Frequency/ dysuria/ nocturia
the following points to which differential:
- poor flow and terminal dribbling
- hesitancy
- overflow incontinence
- elderly male
benign prostatic hyperplasia
Frequency/ dysuria/ nocturia
Other differentials
- anxiety
- detrusor instability
- bladder / lower urethral calculus
- prostatitis
- pregnancy
- drugs (e.g. diuretics)
Haematuria
the following points to what differential:
- painless haematuria
- hx of aromatic amine exposure (e.g. dye washers, painters, decorators)
bladder transitional cell carcinoma
Haematuria
the following points to what differential:
- history of catheter use or trauma
urethral trauma
e.g. by catheter
Haematuria
the following points to what differential:
-frequency / dysuria / urgency
UTI
Haematuria
the following points to what differential:
- dysuria
- purulent urethral discharge
urethritis
Haematuria
the following points to what differential:
- loin to groin pain
calculi
Haematuria
other urological and miscellaneous differentials
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
Polyuria
the following points to what differential:
- polydipsia, thirst
- polyuria
- weight loss and tiredness
- visual disturbance
diabetes mellitus
Polyuria
the following points to what differential:
- polydipsia
- polyuria
diabetes insipidus
Polyuria
the following points to what differential:
non specific symptoms
- fatigue
- weakness
- puritis
- dyspnoea
chronic kidney disease
Polyuria
Other differentials
Cushing’s syndrome
Psychogenic polydipsia
drugs (e.g. diuretics, alcohol, lithium, tetracyclines)
Incontinence
the following points to what differential:
- small losses with effort e.g. coughing, bending, exertion
- risk factors: multiple pregnancies, post-menopause
incompetent sphincter
stress incontinence
Incontinence
the following points to what differential:
- urge to pass urine followed by uncontrollable bladder emptying
- detrusor instability
(e. g. idiopathic, cystitis, stone) - hyperreflexia
(e. g. MS, CVA, spinal cord injury)
urge incontinence
Incontinence
the following points to what differential:
- dribbling and poor stream
- hesitancy
- elderly male
- history of obstruction
prostatic hypertrophy
stricture or stone
overflow incontinence
Incontinence
the following points to what differential:
- continuous urine leak
fistula between bladder and vagina or urethra
true incontinence
Incontinence
other differentials:
- bladder stone / tumour
- fistula
- post-pelvis fracture
- psychogenic
- post-prostatectomy or other pelvic surgery
Retention
the following points to what differential:
- history of hesitancy
- poor flow
- terminal dribbling
- elderly male
prostatic hypertrophy
Retention
the following points to what differential:
- history trauma or recurrent catheterisation
urethral stricture
