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APN1 > GU > Flashcards

GU Flashcards

1
Q

What is needed to diagnose UTI?

A

At least 100,000 organisms in asymptomatic pt and more thatn 100 org/ml iwth pyuria in symptomatic pt

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2
Q

UTIs are more common in sexually active woman? T/F

A

True

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3
Q

What is the leading cause of UTI in young men?

A

STI

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4
Q

What is the leading cause of UTI in older men?

A

Prostate issues

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5
Q

What is findings on urine dip are associated with UTI?

A

+ Nitrites & leukocytes

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6
Q

What is the first line therapy in female uncomplicated UTI?

A

Nitrofurantoin (macrobid) 100mg bid x 7d (5d)
Keflex
Bactrim DS bid X 3 days

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7
Q

What is the standard treatment for UTI in males?

A

Young men: Doxycycline 100mg bid x 7-10 days

Older men: cipro 500mg bid x 7-10 days

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8
Q

What are the common causative organisms for UTI in women?

A 
E Coli #1
Klebsiella
Proteus 
Staph/Strep (usually sexual activity)
B strep in pregnant females are always treated
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9
Q

What findings are present in acute pyelonephritis?

A

Systemic findings: Fever, tachycardia, N/V and general illness
Flank pain & CTA tenderness

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10
Q

When should a pt w/ pyelonephritis be referred to the ED & admitted?

A

Pregnancy, severe N/V and dehydration, or fever >101

Also- ill elderly

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11
Q

What is the recommended treatment for pyelonephritis?

A

Rocephin 500-1000mg IM then:

  • Cipro 500mg bid 5-7 days
  • levofloxacin 750mg qd x 5-7d
  • Bactrim DS 7-10day (only if known pathogen)
  • Augmentin bid 10-14 days
  • cefdinir 300mg bid 10-14 days
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12
Q

How often should an OP pyelonephritis return for re-eval?

A

In 24-48 hrs then in 3-5 days for repeat UA if improving

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13
Q

What 2 tests are standard to elevalute prostate for CA/BPH?

A

DRE & PSA

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14
Q

What is the normal PSA?

A

<4

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15
Q

What is the first line treatment for BPH and how does it work?

A

Alpha 1 receptor agonist relax the smooth muscle of the bladder neck and prostate/urethra: (terazosin, doxazosin, tamulosin)

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16
Q

What drugs reduce the size of the prostate gland?

A

5alpha reductase inhibitors: Finasteride & dutasteride blocks DHT

17
Q

Can 5 alpha reductase inhibitors and alpha-1 blockers be combined?

A

Yes

18
Q

What other type of drugs can be used to treat sx of BPH?

A

Anticholinergics: Oxybutynin and Tolterodine help with urinary sx (frequency, nocturia and urgency)

19
Q

If a patient is on finasteride, would an elevated PSA be considered normal?

A

No

20
Q

+ Phren sign is commonly found in_____?

A

Epididymitis (pain is relieved w/ testicular elevation)

21
Q

What would be the recommended treatment for a man under the age of 35 for epidymitis?

A

Rocephin 500mg IM x1
And
Axithromycin1g PO once
OR Doxycycline 100mg bid x 10 days

22
Q

What would be the recommended treatment for a man over the age of 35 with low risk for STI for epidymitis?

A

Cipro 500mg bid x10d
OR
Levofloxacin 500mg qd x10d

23
Q

Testicilar torsion usually lacks which two signs

A

Absent cremasteric sign

-phren sign

24
Q

What are the common presenting symptoms with acute prostatitis?

A 
decreased urine flow & dysuria
Lower back/rectal pain
Pain with ejaculation or defecations
Increased pain with sitting
Fever/chills/malaise
25
Q

What is the treatment for prostatitis unlikely to be related to STI?

A

Cipro 500mg bid x 3-4 weeks
Doxycycline 100mg bid x 3-4 weeks
Bactrim DS bid x 3-4 weeks
Levaquin 500mg q day x 3-4 weeks

26
Q

If prostatitis is possible related to Gonorrhea or Chlamydia, what is the treatment of choice?

A

Rocephin 1gm x 1

Doxycycline 100mg bid x7days

27
Q

What can be used to treat the discomfort of prostatitis?

A

NSAIDS & stool softners

28
Q

Testicular torsion generally presents as?

A

Young atheletic male sudden onset severe unilateral testicular pain without cremasteric sign and - phren sign.

29
Q

What are two differentiators between epidymitis and torsion?

A

epidymitis with have + prehns sign and + cremasteric sign

Torsion will be negative to both

30
Q

At what age should both testicles be decended?

A

1 year

31
Q

A varicele is_____?

A

A dilated spermatic vein, resembles a “bag of worms”
Can be painless or painful
Reproduced when standing and resolves w/ sitting
Tx w/ NSAIDS and referral

32
Q

Functional incontinence is when?

A

There is a physiologicial or cognitive disability

33
Q

Sudden sensation of urge, difficulty in making it to the bathroom in time, and leakage is usually found in this type of incontinence?

A

Urge

34
Q

Overflow incontinence causes _____?

A

Dribbing from over-distended bladder due to chronic distention & poor emptying of urine

35
Q

Overactive and unstable detrusor muscle causes what type of incontinence?

A

Urge incontinence

36
Q

Stress incontinence is generally treated with?

A

Kegel exercises, bladder training, and timed voiding. Estrogen cream twice weekly for post menopausal women.

37
Q

Urge incontinene is usually treated with?

A

Toviaz, Vesicare, Ditropan and oxybutynin to treat over-active bladder

38
Q

Overflow incontinence is commonly seen with _____ conditions?

A

Neurological disorders (spinal cord, myesthenia gravis, dementia, parkinsons)
Outlet obstruction (prostate, mass, cystocele)
Fecal impaction
Medications (sedatives/opiates)

APN1 (10 decks)

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