Ddx

Question 1

Voiding difficulty ddx

Answer 1

Bladder outlet obstruction

Dec detrusor muscle contraction

Question 2

Anatomic BOO

M

F

Answer 2

M- large prostate
Urethral stricture

F- Urethral stricture is rare
Iatrogenic (urehtra made too tight during surgery 4 SI)

Question 3

Male Urethral stricture

Cause
Treat

Answer 3

Congenital
Trauma- surgery/instru
Gonno

Surgical

Question 4

Functional BOO

Answer 4

A1a agonists (pseudo)
DESD- es and detrusor contracts
lesion between pons/spinal cord

Question 5

Dec detrusor contraction Neurogenic causes

Answer 5

Lesion of sacrum/Cauda equine- lesion of cord or L spine/nerves

Lesion of pelvic splanchnic nerves- PS to bladder
Radical pelvic surgery

Question 6

Dec detrusor contraction causes myogenic

Answer 6

DM
Chronic overdistension
Antimuscarinic drugs (oxybutinin)

Question 7

Flank pain ddx

Answer 7

Renal colic

Steady pain

Question 8

Kidney pain not Renal colic

Answer 8

Infection
R tumor
trauma
Renal infarction- with pain

Question 9

Flank pain beyond kidney

Answer 9

MSK
Zoster with pain b4 rash
Ab do- aortic anuerysm, pancreatitis, gallstones, appendicitis

Question 10

Urge incontinence Ddx

Answer 10

Idio
Neuro lesion above sacrum
Bladder iritation (urine infection, bladder/ureter stone, bladder tumor)

Question 11

Differentiate Urge incontinence

UA

Answer 11

No neuro symptoms- not lesion

normal- UTI/stone/tumor not likely
Abnormal- send culture

Question 12

Hematuria sources

Answer 12

K
Ureter
B
Urethra

Question 13

Hematuria from kidney

Ureter

Answer 13

Stone
Tumor- RCC, UC, angio
Pyelonephritis
Glomerular do

Stone, tumor (UC)

Question 14

Hematuria from bladder

Answer 14

Stone, tumor (UC), cystitis

Question 15

Hematuria main point

MC

Painless visible hematuria

Answer 15

K/B infection
K/U stone

Think cancer

Question 16

Hematuria from urethra

Answer 16

Female urethral prolapse- benign, mucosa of urethra protrudes
After menopause/prepubertal

Tumor- usually carcinoma (urethra)

Question 17

Prostate

Hematuria & large prostate

Answer 17

Not common source for hematuria

look for other cause

Question 18

Hematuria sorting

Answer 18

Urine culture to look for infection

Anatomic evaluation- ct urogram, cytoscopy

Renal dz

Question 19

Before CT urogram 3 things

Answer 19

Pregnancy test of woman of childbearing potential
Allergy- contrast/iodine/seafood
Check renal function

Question 20

Low GFR

Answer 20

Avoid IV iodine contrast (Toxicity)
Avoid gadolinium (nephro fibrosis)

Do US/non cont CT + retrograde pyelograms