Exam 3 Flashcards
What lab result would approximate the GFR?
creatinine clearance
What is an early finding of chronic renal disease?
Persistent proteinuria
What finding could rule out diagnosis of testicular cancer?
Trans-illumination of suspected mass
What is the primary treatment for a patient diagnosed with testicular cancer?
Radical orchiectomy
What is the appropriate treatment for a patient with benign BPH and an AUSI score of 6?
Reevaulate symptoms in 1-4 months
What is the most common diagnosis for a 63 year old male with chief complaint of nocturia?
BPH
What finding could indicate testicular torsion?
Absent cremasteric reflex
What would finding during illumination of the scrotum would indicate hydrocele?
Scrotum would appear light pink or yellow
A 19-year old male is seen with complaints of severe testicular pain. What should the clinician suspect?
Testicular torsion; this is a urologic emergency
What lab would you test on a young male with complaints of low libido?
Testosterone level
What is the most common gram negative bacteria that causes acute and chronic bacterial prostatitis?
E. Coli
How long should a 56 year old male with chronic bacterial prostatitis be treated with Bactrim?
6-12 weeks
What is the most common causative organism for a sexually active male with epididymitis?
Chlamydia
What is the most common organism causing UTI in women?
E. Coli (gram negative)
Diagnostic tests for UTI
Urinalysis: shows cloudy urine, alkaline pH, hematuria, elevated nitrates, leukocytes, and sediments of bacterial overgrowth
Urine culture
Antibiotic sensitivities
Treatment for UTI
-Bactrim for three days OR 10-day course of ampicillin
-Nitrofurantoins (macrodantin/macrobid) for 7 days in patients with sulfa allergy or ABX use in last 3 months
How to differently diagnose UTI, interstitial cystitis, and pyelonephritis
-Pyelonephritis: WBC casts (neutrophils passing through the renal tubules) on UA; kidney infection. These patients will be ill-appearing with fever and more severe symptoms
-UTI: Would show leukocytes on UA but not WBC casts
-Interstitial cystitis: similar presentation as UTI but UA would be normal
Patient education for UTI
-Complete full course of ABX
-Increase fluid intake to 10 8oz glasses/day
-Cotton instead of nylon panties
-Avoid harsh soaps
-Void after sex
-Proper hygeine
-Showers instead of baths
Diagnosis for BPH
-UA
-PSA (should be less than 10ng/mL)
S&S of hydrocele
-Scrotal swelling
-Often is painless, described as heaviness
-Transillumination shows trapped fluid
-swelling in groin or upper scrotum
S&S of prostate cancer
-Often patients are asymptomatic
-bone pain, weight loss, lymphedema, anemia
Diagnosis for prostate cancer
-PSA (not cancer specific)
-If CA is suspected, referral to urology for transrectal biopsy or TRUS
What should you suspect in a patient presenting for the 3rd time with dysuria and frequency but normal UA?
Interstitial cystitis
What is a pre-disposing factor for pyelonephritis?
pregnancy
Patient education point for a patient with stress incontinence
stop smoking
What medication is known to be a bladder irritant?
Sudafed
Define overflow incontinence
Inability to empty the bladder resulting in over-distention and frequent loss of small amounts of urine
A 42 YOf is seen in the clinic with fever, chills, vomiting, and severe dysuria and is diagnosed with acute pyelonephritis and dehydration. How should she be treated?
Hospitilization
What would you do if ABX treatment for UTI is failing (symptoms persisting)?
Order urine cultures
Patient education for overactive bladder diagnosis
Decrease or eliminate caffeine intake
What information is essential to know before prescribing Bactrim DS for UTI?
Date of last menstrual period (contraindicated in lactation or late pregnancy)
What diagnosis is most likely for a patient with CVA tenderness and several days of fever, chills, and dysuria?
Pyelonephritis
UA shows more than 10 leukocytes/ml and dipstick + for nitrates. What is the most likely diagnosis?
Lower UTI