Hematuria, Nocturia and Dysuria Flashcards
What are some Ddx for hematuria from the upper urinary tract?
Renal malignancy, renal cysts, urinary stones, glomerulonephritis, UTI (pyelonephritis, cystitis)
What are some Ddx for hematuria from the lower urinary tract?
Bladder cancer, bladder stone, hemorrhagic cystitis (cyclophosphamide), BPH, prostate cancer, urethritis, urethral trauma (urinary catheter, etc)
What is an uncomplicated UTI?
acute cystitis or pyelonephritis in a non-pregnant out pt woman without any anatomic abnormalities or urinary instrumentation
What is a complicated UTI?
all other urinary infections are considered complicated; essentially these are UTIs associated with factors increasing colonization and decreasing efficacy of therapy such as pregnancy, urinary retention or obstruction, renal failure or transplant, males, anatomic abnormalities, catheters, immunocompromised pt
What is a recurrent UTI?
Greater than or equal to 2 infections in 6 months or greater than or equal to 3 infections in one year
What is asymptomatic bacteriuria?
bacteriuria present on urine culture but no clinical UTI sx present in pt
What is catheter associated UTI (CA-UTI)?
UTI associated with placement of urinary catheter or within 48 hours of removal
What is the pathogenesis for UTIs?
uropathogenic bacteria colonizing the GI tract, perineum or vagina inoculate the urethra and ascend into the bladder
What are common gram negative bacilli that cause UTI?
E coli (75%), Klebsiella, proteus, psuedomonas
What are common gram positive cocci that cause UTIs?
Enteroccocus, staph saprophyticus, group B strep
What are some Ddx for UTIs?
Vaginitis (candida vulvovaginitis, bacterial vaginosis, trichomonas, etc), urethritis (chlamydia, gonorrhea, trichomonas, herpes simplex, etc), pelvic inflammatory disease (chlamydia, gonorrhea, etc), cystitis, pyelonephritis, prostatitis, epididymitis, interstitial cystitis (irritative voiding sx but no evidence of infection)
What is acute bacterial prostatitis?
acute infection of the prostate gland
What is chronic bacterial prostatitis?
chronic infection of the prostate gland (>3 mo)
What is chronic pelvic pain syndrome?
chronic pelvic pain with no detectable infection of the prostate gland
What is asymptomatic prostatitis?
infection present in prostate gland but pt is asymptomatic
What is the pathogenesis for prostatitis?
Bacteria in the urethra will migrate via the prostatic ducts in the prostate gland; there can also be direct bacterial entry into the prostate from transrectal prostate biopsy
What are the common bacteria that cause prostatitis?
Gram negative include E coli, Klebsiella, proteus and pseudomonas; gram positive include enterococcus and normal skin flora
BPH results from what?
from an increased total number of stromal and glandular epithelial cells within the prostate
Lower urinary tract sx result likely from what?
bladder outlet obstruction (BOO) from BPH and detrusor muscle overactivity secondary to BOO
What are some Ddx for nocturia?
Urinary incontinence, diuretics, BPH, UTIs, primary polydipsia, polyuria (DI or DM), sleep apnea, fluid intake before bed
What is the likelihood of a second kidney stone occurring after the first one?
15% at 1 year, 35-40% at 5 years and 50% at 10 years
What is the MC type of kidney stone?
calcium stones
