Genitourinary #1

Question 1

dysuria def

Answer 1

difficult or painful urination or voiding

Question 2

ddx for dysuria

Answer 2

infectious, neoplasm, inflammatory, endometriosis, trauma

Question 3

Gross, Painless hematuria in adults is what?

Answer 3

Bladder Cancer until proven otherwise

Question 4

management acute severe cases of macroscopic (gross) Hematuria?

Answer 4

emergency!!

Question 5

microscopic hematuria def

Answer 5

2 RBCs/HPF(high power field) on urinalysis of at least TWO separate samples

Question 6

risk factors of a stone disease

Answer 6

peak incidence 30-50yold

• HEreditary (gul 6 phos def)
• Minimal fluid intake
• meds

Question 7

main clinical symptom of stone disease

Answer 7

flank pain, and sudden onset of back pain

bladder stones cause terminal hematuria and suprapubic pain

Question 8

most common type of stone?

Answer 8

calcium oxalate

Question 9

calcium oxalate stones- what do they develop in and causes

Answer 9

acidic urine

• -hyperparathyroidism
• -hypercalcemia

Question 10

Calcium phosphate stones- what do they develop in, % and what do they look like

Answer 10

dirty white porcupine-shaped stones
10% of stones
Develop in alkaline urine
(hyperparathyroidism, hypercalcemia)

Question 11

Struvite stones- how do they look, %, where do they form and causes

Answer 11

dirty white coffin shapped
10% of all stones
formed in alkaline urine

caused by UTIs with urea splitting organisms
suspect struvite stone if pt has fever and high urin PH

Question 12

Uric acid stones- look, where do they develop, %

Answer 12

5%
develop in acidic urine due to high serum uric acid/gout
yellow brown diamond shape

Question 13

cystine stone- look and how do they develop

Answer 13

Hexagonal in shape

due to genetic disorder

Question 14

stone size for spontaenous passing

Answer 14

<5mm

Question 15

some interventional treatment for kidney stones

Answer 15

extracorporeal shock wave ESWL if stone <2cm

Percutaneous Nephrolithotomy (PCNL) if stone >2cm

Question 16

if you find UTI in men, what should you do?

Answer 16

check up for anatomical abnormality

Question 17

most common UTI causing bacteria

Answer 17

E.Coli (75-95%)

Question 18

cystitis (bladder infection) clinical pictures know

Answer 18

suprapubic tenderness
absent fever
no flank pain

Question 19

recurrent cystitis def

Answer 19

> 3 UTIs a year

Question 20

Interstitial cystitis features

Answer 20

Bladder pain with chronic urgency + freq

• Unknown etiology
• 90% of cases females

__will have negative urinalysis, urine culture + sensitivity

Question 21

Pylonephritis (kidney infection) clinical features

Answer 21

rapid onset <24h

fever, chills, nausea, vomiting

CVA TENDERNESS AND FLANK PAIN

Question 22

when does asymptomatic bacteriuria require treatment?

Answer 22

only in pregnancy b/c increased risk of pyelonephritis and preterm labor

Question 23

best test for UTI

Answer 23

urinalysis

Question 24

most accurate test for UTI

Answer 24

urine culture

Question 25

dysuria + white cells in urine + suprapubic tenderness =?

Answer 25

cystitis

Question 26

dysuria + white cells in urine + flank pain + fever =

Answer 26

pyelonephritis

Question 27

if we find numerous squamous epithelial cells suggests?

Answer 27

improperly collected specimen

Question 28

positive dipstick for leukocyte esterate + nitrites is for?

Answer 28

UTI!

Question 29

In a symptomatic pt negative nitrite can be due to? (3)

Answer 29

• Inf with nitrite negative bacteria
• infection w nitrite pos bacteria but urin <4hrs in bladder
• Inf with nitrite pos bac + absorbic acid (false neg)

Question 30

What is hydronephrosis

Answer 30

Dialation of the renal pelvis and calyces caused by the impairment in urin flow

Question 31

4 types of urinary incontenence

Answer 31

stress urinary inconteninence, urgency, mixed,overflow

Question 32

stress urinary incontinence

Answer 32

involuntary discharge of urine during coughing, straining, or sudden movements

more common in women, no symptoms at night, no uregency or frequency

Question 33

typical person with stress urianry inconteninece

Answer 33

typically those women are postemenopausal as decresaed estrogen levels causes weakness of pelvic wall

Question 34

Urgency incontinence

Answer 34

inability to hold back urination when feeling the urge to void

-detrussor overactivity

Question 35

Mixec Incontinence

Answer 35

Mixec Incontinence

combination of stress and urgency incontinence