Genitourinary 3 Flashcards
What is prostatitis?
Inflammation and swelling of the prostate gland, most commonly caused by E Coli
How does prostatitis present?
Very tender prostate on DRE
Fever, chills, malaise
Voiding symptoms
How is prostatitis investigated?
Urinalysis and culture
Blood cultures if febrile
How is prostatitis managed?
Ciprofloxacin or levofloxacin for 14 days
What is the most common bacterial STI?
Chlamydia
What causes chlamydia?
Chlamydia trachomatis
How does chlamydia present in men?
Testicular pain
Voiding symptoms, dysuria
50% asymptomatic
How does chlamydia present in women?
Vaginal discharge and dysuria
White, yellow or green discharge
70% asymptomatic
How is chlamydia diagnosed?
Nucleic acid amplification testing
How is chlamydia treated?
Avoid sex until treatment finished and contact tracing
Single 1g dose of azithromycin and 7 days of doxycycline
What is the 2nd most common STI in the UK?
Gonorrhoea
What causes gonorrhoea?
Neisseria gonorrhoea
How is gonorrhoea likely to present?
More likely to by asymptomatic
How is gonorrhoea investigated?
NAAT
Microscopy - gram -ve diplococci
Culture - all infected areas with swab
How is gonorrhoea treated?
Single ceftriaxone IM dose
What is urolithiasis?
Presence of crystalline stones in the urinary tract
Where do you find kidney stones?
Pelviocoureteric junction
Pelvic brim
Vesicoureteral junction
What are kidney stones made of?
Form from crystal in supersaturated urine - most often composed of calcium oxalate (80% of cases)
What can urolithiasis lead to?
Blockage of urinary tract which can cause hydropnephrosis
What are the risk factors for urolithiasis?
Dehydration High salt intake Obesity - lowers pH Congenital horseshoe kidney Oxalate rich diet Gout - uric acid stones
How does urolithiasis present?
Most are asymptomatic
Causes severe colicky unilateral pain from loin to groin
N+V
Haematuria - 85%
Assume ruptured AAA until proven otherwise
How is urolithiasis investigated?
KUBXR - first line
Non contrast CTKUB - gold standard
Urine dipstick
Blood tests
How is urolithiasis managed?
Strong analgesia - diclofenac
Antibiotics
Tamsulosin/nifedipine - relaxes smooth muscle and helps expulsion
Percutaneous nephrolithotomy - used to expulse stones over 10mm
How is urolithiasis prevented?
Thiazide diuretics
Hydration, reduce salt + oxalate intake
What does urinalysis in pyelonephritis show?
White cells and microscopic haematuria
What do bloods show for pyelonephritis?
Elevated ESR and CRP
What does US show for pyelonephritis?
Rule out urinary tract obstruction or stones
What does urinalysis and culture in prostatitis show?
Blood, WBCs and bacteria
What is the degree of proteinuria in nephrotic syndrome?
> 3g/24 hours
What causes hypoalbuminaemia in nephrotic syndrome?
Loss of albumin in urine
What causes oedema in nephrotic syndrome?
Loss of oncotic pressure
What causes frothy urine in nephrotic syndrome?
Proteinuria
What does urine dipstick show for urolithiasis?
Haematuria
What do blood tests show for urolithiasis?
Raised calcium and phosphate
What do blood tests show for nephrotic syndrome?
Renal function, elevated lipids
Why is the urine creatinine:protein ratio taken in nephrotic syndrome?
To measure degree of proteinuria
How does gonorrhoea present in men?
Dysuria, frequency, discharge
How does gonorrhoea present in women?
Vaginal discharge, dysuria, pelvic pain
Why are ACEi and ARBs used to treat nephritic syndrome?
BP control, reduces proteinuria and preserves renal function
Why are steroids used to treat nephritic syndrome?
Reduces inflammation causing damage to kidney
