Hematuria, Dysuria, Nocturia Flashcards
Asymptomatic Bacteriuria
Bacteriuria present on urine culture but NO symptoms
Uncomplicated UTI
Acute cystitis/pyelonephritis in a non-pregnant, outpatient FEMALE with no abnormalties
A Complicated UTI is essentially all other UTI’s that are not the uncomplicated patient. What can be classified as complicated or uncomplicated?
Pyelonephritis
Cather-Associated UTI (CA-UTI)
UTI associated with catheter placement or within 48 hours of removal
Females are affected more often by UTI’s due to the anatomic setup. How does bacteria cause UTIs and which bacteria is usually to blame?
Bacteria inoculates the urethra and ascends into bladder
– E. coli!
What are the symptoms of cystitis with a UTI?
- Dysuria (pain)
- Urinary urgency
- Urinary frequency
- Suprapubic pain
- +/- hematuria
What are the symptoms of pyelonephritis with a UTI?
The cystitis symptoms +
- fever/chills/rigors
- flank pain
- fatigue
- N/V
- confusion common in the elderly
What are some possible UTI complications?
- Sepsis
- AKI/perinephric abscess
- Emphysematous pyelonephritis
- Papillary necrosis
With a UTI, what (+) findings on a urine dipstick can arise?
(+) leukocyte esterase
(+) nitrites
UA with microscopy and a urine culture are also commonly ordered with a UTI. What does the Urine Culture usually show?
> 10^5 CFU
What diagnostic test is usually ordered for complicated UTIs or pyelonephritis?
CT of abdomen/pelvis with and without contrast
Prostatitis
Infection of the prostate gland
- can be acute, chronic, asymptomatic
Chronic pelvic pain syndrome
Suprapubic pain without detectable infection
What are the common symptoms of Prostatitis?
- Fever
- Irritative voiding (dysuria/freq/urgency)
- Obstructive (dribbling/poor stream)
- Suprapubic pain
If Prostatitis is chronic, how will the symptoms compare to acute?
Chronic = more subtle and not as sick as acute patients
How is Prostatitis diagnosed?
DRE
UA and urine culture
Benign Prostatic Hyperplasia (BPH) increases with?
AGE
What are the main risk factors for men to develop BPH besides increasing age?
- Metabolic syndrome/obesity
- Genetics
- Caffeine intake
BPH can be asymptomatic or symptomatic. If symptomatic, what classifies it?
LUTS
lower urinary tract symptoms
What are the storage symptoms of BPH/LUTS?
- Urinary incontinence
- Urinary frequency and urgency
- Nocturia
What are the voiding symptoms with BPH/LUTS?
- Straining
- Intermittency
- Splitting of stream and dribbling
Between the storage and voiding symptoms with BPH/LUTS, which is usually more bothersome?
Storage symptoms
- UI, urinary frequency/urgency, nocturia
What are some diagnostic tests to order for BPH?
DRE, UA, BMP, PSA, PVR US
What are the options for BPH that is moderate/severe?
Medications
Surgery – prostate resection
Nephrolithiasis
Kidney stones
With Nephrolithiasis, there is an increased risk of recurrence. What are the stones usually made of?
Calcium
What are some general risk factors for kidney stones?
Diet
Genetics
Urine supersaturation
Other metabolic disorders
Nephrolithiasis is often detected how?
On accident with imaging
– asymptomatic
If Nephrolithiasis is symptomatic, what are the common symptoms?
Flank pain
Hematuria
N/V
What are the diagnostic imaging studies to get for Nephrolithiasis?
- CT of abdomen/pelvis
- KUB xray
- Ultrasound
What urine diagnostic tests can be obtained for kidney stones?
UA with micrsoscopy
Urine strain
Treatment for kidney stones depends on?
Size and location
– smaller and more distal usually pass spontaneously
What are the general treatments for kidney stones?
Fluids
NSAIDs for pain
Surgery
Flank pain, hematuria, N/V suggests?
Nephrolithiasis (kidney stones)
UI, urinary urgency/frequency and nocturia suggests?
Storage symptoms of BPH
Straining, intermittency, splitting of stream and dribbling suggests?
Voiding symptoms of BPH
Fever, irritative voiding and obstructive symptoms like dribbling/poor stream suggest?
Prostatitis
Cystitis + fever, flank pain, fatigue, N/V, confusion suggests?
Pyelonephritis
Dysuria (pain), urinary urgency/frequency and suprapubic pain suggests?
Cystitis
Uncomplicated UTI
Non-pregnancy, outpatient woman with no anatomical abnormalities or devices
