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MD3002 Clinical > History Taking: GU > Flashcards

History Taking: GU Flashcards

1
Q

What is the standard formula for a histroy taking?

A
  • Introduction
  • Presenting complaint
  • History of presenting complaint
  • Past medical history
  • Drug history
  • Family history
  • Social history
  • Systems enquiry
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2
Q

What is dysuria?

A

Pain when urinating

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3
Q

What is haematuria?

A

Blood in urine

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4
Q

What is nocturia?

A

Passing urine during the night

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5
Q

What is anuria?

A

Not passing any urine at all

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6
Q

What is oliuria?

A

Passing smal amounts of urine

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7
Q

What is polyuria?

A

Passing a large amount of urine

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8
Q

What are the two types of haematuria?

A
  • Micro - not visible blood

- Macro/frank - visible blood

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9
Q

What can bladder cancer present with?

A

Macro haematuria w/o pain

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10
Q

How can you ask about / detectpolyuria?

A
  • Ask about passing more urine than normal
  • Excessive urine output of greater than 2.5-3L in 24 hrs
  • Can be detected on catheter
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11
Q

What should you ask in relation to urine outflow?

A
  • Frequency
  • Terminal dribbling
  • Hesitancy
  • Pain (suprapubic/flank/loin)
  • Incontinence
  • Urgency
  • Incomplete emptying
  • Flow/stream
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12
Q

What can be the causes of incontinence?

A
  • Stress
  • Result of sphincter weakness
  • Small leak of urine when intra-abdominal pressure rises
  • E.g coughing, laughing, sneezing, standing up
  • Urge
  • Usual cause is detrusor instability
  • Strong desire to void and rush to go
  • “Didn’t get there in time”
  • Overflow
  • Usually due to outflow obstruction
  • Distended bladder palpable

Neurological

  • Autonomic neuropathy
  • Spinal cord injury
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13
Q

What are the associated symptoms in regards to the urinary system?

A
  • Vomiting
  • Fever
  • Malaise
  • Anorexia
  • Weight loss
  • Fatigue / lack of energy
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14
Q

What symptoms are commonly associated with UTIs and cysitis?

A

Dysuria, frequency, urgency, suprapubic discomfort

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15
Q

What symptoms are commonly associated with pyelonephritis?

A

Systemic upset, fever, rigors, vomitting, flank pain

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16
Q

What symptoms are commonly associated with prostate problems? (bnign prostate hypertrophy, prostate cancer)

A

Slow flow, hesitancy, incomplete emptying, dribbling, nocturia

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17
Q

Desribe the symptoms associated with upper urinary tract obstruction

A
  • Dull ache in flank / loin
  • Polyuria -> anuria
  • Causes can be:
    Tumour (renal, ureter)
    Stricture
    Calculi
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18
Q

Describe the symptoms associated with urinary tract obstruction of the bladder outlet?

A
  • Hesitancy
  • Poor stream
  • Terminal dribbling
  • Sense of incomplete emptying
  • Possible retention (+ overflow)
  • Infection
  • Causes, e.g:
    Benign prostatic hypertrophy
    Prostate cancer
    Pelvic tumour (gynae)
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19
Q

What is a colic pain?

A
  • A pain that starts and stops abruptly
  • Occurs due to muscular contractions of a hollow tube (colon, gall bladder, ureter, etc.) in an attempt to relieve an obstruction by forcing content out.
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20
Q

What questions should you ask about urethral discharge/

A
  • Amount
  • Smell
  • Bloody
  • Associated symptoms
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21
Q

What questions should you ask in relation to testicular pain?

A
  • Any link to trauma
  • Link to other illness / symptoms (e.g mumps)
  • Speed of onset and severity
  • Associated swelling / redness / tenderness / discharge
22
Q

What questions should you ask in relation to testicular lumps?

A
  • Unilateral / bilateral
  • Location
  • Associated symptoms
  • Hard / soft
  • Regular / irregular
  • Consider testicular cancer
23
Q

What syndrome is associated with joint, eye or GI symptoms as well as urethral discharge?

A

Reiter’s syndrome

24
Q

What causes genital warts?

A

Human Papilloma virus

25
What does acute prostatitis commonly present with?
- Pelvic, perineal or scrotal pain - Fever - Systemic upset
26
What does chronic prostatitis commonly present with?
Chronic pelvic/perineal/scrotal pain and urinary symptoms
27
What does urethritis usually present with?
- Discharge - Dysuria - Other urinary symptoms
28
What do testicular tumours commonly present with?
Painless hard swelling of body of testes
29
What does testicular torsion usually present with?
Acutely painful swollen unilateral testicle
30
What is dyspareunia?
Painful intercourse - Deep - Superficial
31
What is dysmenorrhoea?
Painful periods
32
What is menorrhagia?
`Heavy periods - Clots - Flooding
33
What is inter menstraul bleeding (IMB)?
Bleeding between periods
34
What is bleeding after the menopause called (occuring after 12 months of amenorrhoea)?
Post menopausal bleeding
35
What is bleeding after intercourse called?
Post Coital Bleeding (PCB)
36
What is priamary and secondary amenorrhoea?
- Primary - no period by age 14 years (in absence of secondary sexual characteristics) or 16 (if other features are developing normally) - Secondary - had periods but now stopped for 6 consecutive months
37
What is considered premature menopause?
Before 40 years of age = premature menopause or premature ovarian insufficiency
38
What is the usual range of time between periods?
21 to 35 days (average is 28)
39
What is the average blood loss during a period?
50 - 200 mls and averages 70 mls
40
What does gravida mean?
Number of times a woman has been pregnant
41
What does para mean?
Number of times a woman has given birth to a foetus with a gestational age of 24 weeks or more
42
What does NVD mean?
Normal Vaginal Delivery
43
What can unexpected bleeding be related to?
Endometrial or cervical pathology
44
What percentage of PMBs are cervical cancer?
10%
45
What can an ectopic pregnancy present with?
Bleeding early in pregnancy with RIF/LIF pain
46
What would you usually diagnose an individual who has PV discharge + itch and is otherwise well?
Thrush
47
What is libido?
Sexual desire
48
What is coitus interruptus
"pull out method"
49
What should you include in a drug history?
``` - Meds, allergies Also consider - Long term meds - Recent changes - Names of contraceptive pills - HRT - Drugs that cause renal impairment - Drugs associated with sexual dysfunction - OTC meds - NSAIDs ```
50
What should you consider in a Social history?
- Alcohol, cigarettes, occupation, social fnc, ADLs - Exposure to chemical carcinogens (bladder ca) - Foreign travel (schistosomiasis) - Dehydration during holiday in a hot climate (impact on kidneys) - Non prescription drugs; effects of cannabis on sexual function - Working in hot enviroments e.g kitchen, and effect on male fertility

MD3002 Clinical (4 decks)

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