Dysuria

Question 1

Symptoms (3) that have the highest likelihood ratio for UTI in females

Answer 1

Dysuria, frequency, no vaginal signs/sxs

Question 2

Positive nitrite on UA/urine dipstick means possible ____

Answer 2

Enteric gram negative rod UTI

*may be negative if gram positive cocci

Question 3

Positive leukocyte esterase means possible ___

Answer 3

UTIs, urethritis

Question 4

NPV (73%) for UTI if dipstick ___

Answer 4

negative for nitrite, blood, LE

Question 5

PPV (92%) for UTI if dipstick ___

Answer 5

positive for nitrite and (blood/LE)

Question 6

Key lab for cystitis

Answer 6

Urine dipstick w/ or w/o micro

Question 7

Likely diagnosis of females with dysuria in adolescents w/ sexual activity, w/ or w/o vaginal symptoms

Answer 7

STI > UTI

Question 8

Likely diagnosis of females with dysuria in adult positive for vaginal symptoms

Answer 8

Vulvovaginitis

Question 9

Likely diagnosis of females with dysuria in adult w/o vaginal symptoms

Answer 9

UTI

Question 10

Likely diagnosis of females with dysuria in older pts w/ vaginal symptoms

Answer 10

Noninfectious cause (atrophic vaginitis)

Question 11

Tzanck prep used to diagnose ___

Answer 11

HSV genital ulcers

PCR used most often for dx

Question 12

Darkfield microscopy used to diagnose ___

Answer 12

Syphilis

Serology most used but can see false negative early (b/c Darkfield microscopy often not available)

Question 13

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

Answer 13

C. Absent urine nitrites (Caveat: Gram positive cocci)
D. External dysuria

Also:
abnormal pelvic exam (cervix/adnexa/labia)
Vaginal discharge or abnormal bleeding

Question 14

_____ is important if features suggest possible STI

Answer 14

Pelvic examination

Question 15

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

Answer 15

B. Used to diagnose prostatitis

Nucleic acid test for Gonococcus, Chlamydia trachomatis, trichomonas vaginals

Question 16

Name 2 categories of agents in male urethritis

Answer 16

Gonococcal (Neisseria gonorrhoeae)

Non-gonococcal

Question 17

“Early” dysuria w/ urethral drainage suggests ____ in males.

Answer 17

Urethritis (STI)

Assess for urethral discharge, epidiymitis, orchitis, prostatitis

Question 18

Which of the following is NOT a diagnostic test for prostatitis?
A. UA/micro and culture
B. 2 glass test
C. Urethral swab

Answer 18

C. Used for urethritis

2 glass test = 1) midstream urine, 2) post-prostatic massage void

Question 19

Chronic syndromes of prostatitis

Answer 19

Recurrent UTI, dysuria

Perineal discomfort

Question 20

Acute syndromes of prostatitis

Answer 20

Fever, chills, pain

Question 21

T/F: Prostatitis is caused by infectious causes only

Answer 21

False: can also have noninfectious causes

Question 22

Most common cause of female GU inflammation/irritation

Answer 22

Infection