Genitourinary #1 Flashcards
dysuria def
difficult or painful urination or voiding
ddx for dysuria
infectious, neoplasm, inflammatory, endometriosis, trauma
Gross, Painless hematuria in adults is what?
Bladder Cancer until proven otherwise
management acute severe cases of macroscopic (gross) Hematuria?
emergency!!
microscopic hematuria def
2 RBCs/HPF(high power field) on urinalysis of at least TWO separate samples
risk factors of a stone disease
peak incidence 30-50yold
- HEreditary (gul 6 phos def)
- Minimal fluid intake
- meds
main clinical symptom of stone disease
flank pain, and sudden onset of back pain
bladder stones cause terminal hematuria and suprapubic pain
most common type of stone?
calcium oxalate
calcium oxalate stones- what do they develop in and causes
acidic urine
- -hyperparathyroidism
- -hypercalcemia
Calcium phosphate stones- what do they develop in, % and what do they look like
dirty white porcupine-shaped stones
10% of stones
Develop in alkaline urine
(hyperparathyroidism, hypercalcemia)
Struvite stones- how do they look, %, where do they form and causes
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
Uric acid stones- look, where do they develop, %
5%
develop in acidic urine due to high serum uric acid/gout
yellow brown diamond shape
cystine stone- look and how do they develop
Hexagonal in shape
due to genetic disorder
stone size for spontaenous passing
<5mm
some interventional treatment for kidney stones
extracorporeal shock wave ESWL if stone <2cm
Percutaneous Nephrolithotomy (PCNL) if stone >2cm
if you find UTI in men, what should you do?
check up for anatomical abnormality
most common UTI causing bacteria
E.Coli (75-95%)
cystitis (bladder infection) clinical pictures know
suprapubic tenderness
absent fever
no flank pain
recurrent cystitis def
> 3 UTIs a year
Interstitial cystitis features
Bladder pain with chronic urgency + freq
- Unknown etiology
- 90% of cases females
__will have negative urinalysis, urine culture + sensitivity
Pylonephritis (kidney infection) clinical features
rapid onset <24h
fever, chills, nausea, vomiting
CVA TENDERNESS AND FLANK PAIN
when does asymptomatic bacteriuria require treatment?
only in pregnancy b/c increased risk of pyelonephritis and preterm labor
best test for UTI
urinalysis
most accurate test for UTI
urine culture
dysuria + white cells in urine + suprapubic tenderness =?
cystitis
dysuria + white cells in urine + flank pain + fever =
pyelonephritis
if we find numerous squamous epithelial cells suggests?
improperly collected specimen
positive dipstick for leukocyte esterate + nitrites is for?
UTI!
In a symptomatic pt negative nitrite can be due to? (3)
- Inf with nitrite negative bacteria
- infection w nitrite pos bacteria but urin <4hrs in bladder
- Inf with nitrite pos bac + absorbic acid (false neg)
What is hydronephrosis
Dialation of the renal pelvis and calyces caused by the impairment in urin flow
4 types of urinary incontenence
stress urinary inconteninence, urgency, mixed,overflow
stress urinary incontinence
involuntary discharge of urine during coughing, straining, or sudden movements
more common in women, no symptoms at night, no uregency or frequency
typical person with stress urianry inconteninece
typically those women are postemenopausal as decresaed estrogen levels causes weakness of pelvic wall
Urgency incontinence
inability to hold back urination when feeling the urge to void
-detrussor overactivity
Mixec Incontinence
Mixec Incontinence
combination of stress and urgency incontinence
