gyno

Question 1

urogenital screen c/o

Answer 1

Complaints of flank pain, low back pain or pelvic pain

Question 2

MSK genitourinary

Answer 2

Unilateral costovertebral tenderness
Low Back, pelvic, flank, inner thigh, or leg pain
Ipsilateral shoulder pain

Question 3

women genitourinary

Answer 3

may refer low back, sacral, pelvic, shoulder or abdomen

Question 4

upper urinary tract
pain localized where
described as
may result in

Answer 4

Typically localized to T10-L1

Described typically as
Aching or
Dull
Occasionally severe and described as Boring

Both may result in abdominal muscle spasm with rebound tenderness on same side

Question 5

pseudo renal pain
mimics
most common site
onset and associated with
affected by

Answer 5

Mimics renal and/or ureteral pain
Occurs secondary to radiculitis or irritation of costal nerves

Most common sites are T10 and T12

Usually an acute onset associated with trauma (fall onto the buttocks, sustained blow to the costovertebral area, or lifting a heavy object)

Usually affected by body position - true renal pain not affected by body position

Question 6

kidney pain pattern

Answer 6

lowback, flank around to the stomach down to the genitals

Question 7

ureteral pain

Answer 7

low back flank aroudn to the stomach down to the genitals and into the L1 dermatome (upper thigh)

Question 8

s/s pseudorenal pain

Answer 8

Bowel and bladder changes are unlikely
Negative kidney percussion test

Question 9

lower urinary tract
refer to
described as
characterized by

Answer 9

Felt above the pubis or in lower abdomen

Can refer to the back

Described as
Sharp

Characterized by
Urinary urgency
Sensation to void
Dysuria - mild stinging to buring urination

Question 10

upper UTI
s/s

Answer 10

Include kidney or ureteral infections

Unilateral costovertebral tenderness
Flank pain
Ipsilateral shoulder pain

Question 11

lower UTI
risk factors
more common in
older people s/s
s/s

Answer 11

Includes bladder or urethral infections

DM
HTN

More common in women

altered mental status

LBP
pelvic lower abdominal pain

Question 12

staph infection of urinary tract can cause

Answer 12

cause osteomyelitis in the vertebrae

Question 13

cystitis

interstitial cystitis

urethritis

Answer 13

Cystitis: inflammation + bladder infection

Interstitial Cystitis: inflammation only

Urethritis: inflammation + urethral infection

Question 14

interstitial cystitis
s/s
more common in
associated disorders

Answer 14

recurring pelvic pain
severe bladder pain

women

vulvodynia
allergies
IBS

Question 15

obstructive disorders
primary vs secondary

Answer 15

primary:
Occurs within the urinary tract

secondary
Results from disease process outside of urinary tract

Question 16

renal calculi

Answer 16

Decreased urine flow results in stagnation

Stone formation can result

primarily form in kidney

Question 17

ureteral stones

Answer 17

Most painful
If stone blocks urine, pressure builds upstream in the kidney causing it to swell
can cause permanent damage

Question 18

ureteral stones most characterized by

Answer 18

sudden, sharp, severe pain
Originates deep in the lumbar area and radiates around the side and into genitals

Question 19

kidney/ureteral stones s/s

Answer 19

lumbar discomfort
hyperesthesia of T10-L1
abdominal mm spasms
acute uretral or renal blockage reported to be excruciating - accompanied by n/v

Question 20

renal CA
detection
primary s/s

Answer 20

Unexplained weight loss
Fever
Hematuria

Hematuria is primary symptom of urinary tract neoplasm
Reports of blood in urine ALWAYS requires MD referral

Question 21

clinical s/s of renal CA

more common in

Answer 21

blood in urine
flank or side pain

males

Question 22

prostatitis
c/o
impact
pain

Answer 22

common inflammation of the prostate causing prostate enlargement

Voiding complaints

Impact on sexual function
Painful ejaculation

Low back, inner thigh, and perineal pain

Question 23

BPH (benign prostatic hyperplasia)
occurance
s/s

Answer 23

Defined as an enlarged prostate
Common occurrence in men > 50 yrs

Low back or upper thigh pain/stiffness
ED
Urinary problems
Hesitancy, weak stream, dribbling, frequency, nocturia

Question 24

prostate CA
present where

Answer 24

Present in 50-75% of all men by age 75

Back pain and sciatica can be caused by cancer metastasis

Question 25

s/s of metastatic prostate CA

Answer 25

bone pain
anemia
weightloss
sciatica

Question 26

renal failure
risk factors
s/s

Answer 26

acetaminophen/NSAIDs

Dehydration
Cardiac arrhythmias
Depression

Question 27

bladder CA
linked to
s/s

Answer 27

Strongly linked to tobacco smokers

blood in urine
feeling urinary urgency w/o urination
MD referral

Question 28

testicular CA
most common
major risk factor
s/s

Answer 28

Relatively rare but most common in white males, ages 15-35
Major risk factor is cryptorchidism – boys born with undescended testicles

often asymtomatic
low back pain more common in late stages

Question 29

endometriosis
pain occur
mistaken for
key to recognition
s/s

Answer 29

Pain can occur anywhere but often in back, pelvis, hip or sacrum

Can be mistaken for a MSK, musculoligamentious or neuromuscular impairment of lumbar supine

Key to recognition is that it is often cyclic

Intermittent, cyclical or constant pelvic and/or back pain

Question 30

ovarian cysts
may cause
associated w/
s/s

Answer 30

May cause back pain
However, lower abdominal/pelvic pain more common

Cyclical pattern associated with menstrual cycle

Dull aching low back, buttock or groin pain
Sudden, sharp pain with rupture or hemorrhage

Question 31

ectopic pregnancy pain

Answer 31

Commonly associated with shoulder pain
May cause back, hip, sacral, abdominal , pelvic and/or shoulder pain
Most common symptom is sudden, sharp or constant one-sided pain in lower abdomen/pelvis lasting more than a few hours
Shoulder pain usually does not occur alone without preceding or accompanying abdominal pain

Question 32

ectopic pregnancy
when to refer
s/s

Answer 32

Females of childbearing age that are sexually active and present with clinical signs and symptoms require immediate medial referral

Diffuse, aching lower abdominal quadrant or low back pain; can cause ipsilateral shoulder pain

Question 33

ovarian CA
risk factors
s/s

Answer 33

2nd most common reproductive cancer in women

Nulliparity (never being pregnant), giving birth to fewer than 2 children, giving birth for the first time after 35 yo

Pelvic discomfort or pressure; back pain
b/b changes

Question 34

cervical CA

Answer 34

Most common cause of death from gynecological cancer in the world

Question 35

Cervical CA s/s

Answer 35

Painful intercourse or pain after intercourse
Postcoital, coital, or intermenstrual bleeding
Watery, foul-smelling vaginal discharge
Hemiparesis, headache

Question 36

clues to renal/urological disease

Answer 36

In men, back pain with burning on urination difficulty urinating and fever
May be associated with prostatitis

Blood in urine

Change in urinary pattern (frequency, flow, nocturia, etc)

Pain that is unchanged with body position

Question 37

clues for gynecologic disease

Answer 37

Pelvic pain correlated with menses or sexual intercourse
Low back/pelvic pain after first menstrual cycle is missed with shoulder pain also present

Question 38

immediate medical attention for urino/gyno

Answer 38

Presence of cervical spine pain at same time that urinary incontinence develops

Bowel/Bladder incontinence

Saddle anesthesia secondary to cauda equine lesion

ectopic pregnancy
blood in urine