Dysuria/UTI Flashcards
T or F: The pain of renal colic can vary from a mild ache to intense 10/10 discomfort.
True
Which 2 investigations are most appropriate for kidney stones?
urinalysis, low-dose non-contrast CT
classic symptoms of chlamydia and gonorrhea?
purulent discharge, dysuria, abnormal uterine bleeding and lower abdominal pain. However, the majority of women are asymptomatic.
Which investigation is most appropriate for suspicious chlamydia and gonorrhoea infections?
NAAT has become the diagnostic technique of choice for suspected chlamydial and gonococcal infections due to superior sensitivity and specificity, as well as noninvasive collection options. NAAT can be performed on first-catch urine (optimal specimen type for men), self- or physician-collected vaginal swabs (optimal specimen type for women) or on endocervical swabs collected by the physician.
classic symptoms of vulvovaginitis?
vulvovaginal pruritus, burning and dysuria. The vulva and vagina appear erythematous on exam. Discharge is classically thick, white, curd-like and not odourous, or may instead be thin, watery or absent.
What tests are appropriate for vaginal candida infection?
Vaginal PH + Vaginal wet mount microscopy
Vaginal pH in Candida infection is typically normal (4-4.5), which distinguishes candidiasis from trichomoniasis or bacterial vaginosis. If available, a wet mount (+/- KOH) of vaginal discharge will often show candida.
Symptoms of trichomonas vaginitis ?
burning, pruritus, dysuria, frequency, and lower abdominal pain. Physical examination often shows erythema of the vulva and vaginal mucosa. Vaginal discharge is classically described as green-yellow, thin, frothy and malodorous but is not present in all affected women.
What tests are appropriate for vaginal trichomonas infection?
Vaginal pH and wet mount microscopy (if available) of vaginal discharge are often the first steps in investigation of trichomoniasis infection. pH will be elevated (>4.5) and motile trichomonads may be visualized, confirming the diagnosis.
Which of the following infections require reporting to public health?
chlamydia and gonorrhoea
DDx of UTI
cystitis, urethritis, vaginitis, cervicitis, epididymo-orchitis, prostatitis,
UTI clinical decision: when to treat?
if 2/3, treat without culture:
*dysuria, *leukocyte+, *nitrites+
if not, wait for culture before treating
consider asymptomatic bacturiuria, do not treat unless pregnant
“KEEPS” for UTI
klebsiella, E.coli, enterobacter, proteus mirabilis, pseudomonas, staph saprophyticis
Investigations for suspicious gonorrhea/chlamydia infection?
M: urethral discharge swab + urine PCR
F: cervical swab + vaginal wet mount (r/o trichomonas) + urine PCR
