Dysuria Flashcards
Symptoms (3) that have the highest likelihood ratio for UTI in females
Dysuria, frequency, no vaginal signs/sxs
Positive nitrite on UA/urine dipstick means possible ____
Enteric gram negative rod UTI
*may be negative if gram positive cocci
Positive leukocyte esterase means possible ___
UTIs, urethritis
NPV (73%) for UTI if dipstick ___
negative for nitrite, blood, LE
PPV (92%) for UTI if dipstick ___
positive for nitrite and (blood/LE)
Key lab for cystitis
Urine dipstick w/ or w/o micro
Likely diagnosis of females with dysuria in adolescents w/ sexual activity, w/ or w/o vaginal symptoms
STI > UTI
Likely diagnosis of females with dysuria in adult positive for vaginal symptoms
Vulvovaginitis
Likely diagnosis of females with dysuria in adult w/o vaginal symptoms
UTI
Likely diagnosis of females with dysuria in older pts w/ vaginal symptoms
Noninfectious cause (atrophic vaginitis)
Tzanck prep used to diagnose ___
HSV genital ulcers
PCR used most often for dx
Darkfield microscopy used to diagnose ___
Syphilis
Serology most used but can see false negative early (b/c Darkfield microscopy often not available)
Which TWO of the following does NOT suggest STIs > UTIs?
A. Lack of urinary frequency, urgency
B. Absence of pyuria
C. Presence of urine nitrites
D. Internal dysuria or dysuria early in void
E. Dyspareunia
C. Absent urine nitrites (Caveat: Gram positive cocci)
D. External dysuria
Also:
abnormal pelvic exam (cervix/adnexa/labia)
Vaginal discharge or abnormal bleeding
_____ is important if features suggest possible STI
Pelvic examination
Which of the following is NOT a diagnostic test used to diagnose male urethritis?
A. Urethral swab
B. 2-glass test
C. Nucleic acid test
B. Used to diagnose prostatitis
Nucleic acid test for Gonococcus, Chlamydia trachomatis, trichomonas vaginals
