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Y4R4 - Surgery II 👨‍⚕️ > L1: Urological History Taking > Flashcards

L1: Urological History Taking Flashcards

1
Q

Parts of Urological History Taking

A
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2
Q

Urological Symptomatology

A
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3
Q

Pain arises from either obstruction or inflammation & rarely Tumors

A

…

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4
Q

Etiology of Renal Pain

A

Caused by acute distention of the renal capsule.

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5
Q

Nerves Carrying Renal Pain

A

Sympathetic nerves convey the pains from the kidney (T10-L1).

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6
Q

Characters of Renal Pain

A

Dull aching pain or Renal colic.

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7
Q

Site & referal of Renal Pain

A
  • Origin: Costo-vertebral angle or loin.
  • Radiation: Umbilicus, lower abdominal quadrant & testis.
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8
Q

Renal Pain may be associated with …..

A
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9
Q

Relation of Renal Pain to posture & eating

A
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10
Q

Upper third Ureteric Pain

A
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10
Q

Mid Third Ureteric Pain

A
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11
Q

Lower Third Ureteric Pain

A
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12
Q

Rolling Sign

A

Characterstic to Ureteric Colic

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13
Q

Nerve Supply to bladder

A

Somatic, Autonomic.

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14
Q

Etiology of Bladder Pain

A
  • Most common cause: Acute Urine Retention (AUR).
  • Other causes: Inflammation, Tumors, Trauma, Neuropathic & Myogenic disorder.
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15
Q

Criteria of pain due to full bladder:

A
  • Constant Suprapubic pain related to act of micturition, terminal dysuria.
  • Referred to distal urethra.
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16
Q

Criteria of pain due to AUR

A
  • Suprapubic severe agonizing, bursting pain.
  • Sudden inability to urinate in spite of desire to do so.
  • The bladder is full and over-distended.
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17
Q

Criteria of pain due to CUR

A
  • Painless (i.e. just Suprapubic discomfort).
  • Dribbling with overflow incontinence.
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18
Q

Criteria of pain due to Cystitis

A
  • Suprapubic intermittent burning pain.
  • Severe when the bladder is full & relieved partially by voiding.
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19
Q

Site of Acute Prostatic Pain

A

Pain in perineal, rectal & may be referred to low back.

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20
Q

Acute Prostatic Pain may be associated with ……

A
  • Irritative &/or obstructive voiding symptoms.
  • Rectal tenesmus.
  • High grade fever.
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21
Q

CP of Chronic Prostatitis

A

Vague discomfort, UTI.

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22
Q

Etiology of Testicular Pain

A
  • Orchitis or epididymo-orchitis, torsion, trauma.
  • Tumors cause pain in only a minority of cases.
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23
Q

When testicular pain Is lost?

A

in leprosy, syphalis, calcified hematoma, testicular tumor,

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24
Q

Can the testis have a referred pain from another site? What is the most common site?

A

refered from kidney or ureter

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25
Q

Can testicular pain be referred to other sites? Where?

A

refered to lower abdomen

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26
Q

Etiology of Epidydimal Pain

A

Most frequently due to epidydimo-orchitis.

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27
Q

Site & Referral of Epidydimal Pain

A
  • Site: In the scrotum, may be felt in the groin, lower abdomen.
  • Referred from inflammation of the vas.
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28
Q

Masses in Urology may be ……

A
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29
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

A
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30
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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31
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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32
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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33
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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34
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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35
Q

How to Differentiate Enlarged Spleen & Lt Renal Mass:

  • Direction of Enlargment
  • Insinuation of finger
  • Notch & Surface
  • Movement with respiration
  • Ballotment
  • Percussion
A
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35
Q

Etiology of Bladder Mass

A

Acute & Chronic Urine Retention.

36
Q

Characters of Bladder Mass

A
  • Rounded or globular swelling.
  • Arising from the pelvis towards the lower abdomen in the midline.
37
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

A
38
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
39
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
40
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
41
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
42
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
43
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
44
Q

Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:

  • Site
  • Shape
  • Size
  • Sulci
  • Rectal Mucosa
  • Consistency
  • Mobility
A
45
Q

Other Urological Masses

A
46
Q

Symptoms Related to the act of Micturation

A
  • Obstructive voiding symptoms (Voiding LUTS)
  • Irritative Voiding Symptoms (Storage LUTS)
46
Q

What is another name of Obstructive voiding symptoms?

A

Voiding LUTS

47
Q

Examples of Obstructive voiding symptoms (Voiding LUTS)

A
48
Q

Examples of Irritative Voiding Symptoms (Storage LUTS)

A
49
Q

Types of Incontinence

A
50
Q

Physical Characters of Urine

A
  • Volume
  • Color
  • Odor
  • Aspect
  • Nature
51
Q

Normal Volume of Urine

A

0.5-1ml/hr?/kg

52
Q

Abnormal Volume of Urine

A
53
Q

Normal Color of Urine

A

Amber yellow

54
Q

Abnormal Color of Urine

A
54
Q

Normal Odor of Urine

A

Urinephrous.

55
Q

Abnormal Odor of Urine

A
56
Q

Normal Aspect of Urine

A

Clear

57
Q

Abnormal Aspect of Urine

A
58
Q

Def of Pneumaturia

A

Passage of gas in urine.

58
Q

Symptoms of CRF

A
58
Q

Etiology of Pneumaturia

A
  1. Post Instrumentation.
  2. Infection with gas forming organism.
  3. Uro-enteric fistula.
59
Q

Symptoms of CRF

  • Late
A

Hiccough & itching (late).

59
Q

Symptoms of CRF

  • Earliest
A
  • Lack of concentration (Earliest)
60
Q

Symptoms of Metastasis

A
61
Q

GIT Symptoms Related to Urology

  • Examples
A
62
Q

Etiology of GIT Symptoms Related to Urology

A
  1. Reno-intestinal reflexes.
  2. Organ relationship.
  3. Peritoneal irritation.
63
Q

GIT Symptoms Related to Urology

  • In Females
A
63
Q

Sexual/Genital Problems Related to Urology

  • In Males
A
64
Q

Other Objective Symptoms Related to Urology

A
65
Q

Urological Physical Examination

A

1) General.
2) Abdominal and DRE.
3) Targeted neurologic examination.

66
Q

Finding in Scrotal Skin

A

Edema, infection, cyst, ulcer, sinus, tumor.

66
Q

Scrotal Examination

A
  • Scrotal Skin
  • Testis
  • Tunica Vaginalis
  • Epidydimis
  • Spermatic Cord
67
Q

Reflexes in Scrotal Skin

A

Cremasteric reflex: L1,2.

68
Q

Normal Testes

A
69
Q

Abnormalities in Testes

A
70
Q

Characters of Hydrocele (in Tunica Vaginalis)

A
71
Q

Types of Hydrocele

A

Congenital or Acquired (idiopathic or secondary).

72
Q

Normal Epidydymis

A
73
Q

Abnormal Epidydymis

A
74
Q

Abnormal Spermatic Cord

A
75
Q

Patient Position in DRE

A

1) Dorsal position.
2) Lithotomy position.
3) Left lateral position.
4) Elbow chest position.
5) Standing and leaning forward.

76
Q

Insperction in DRE

A
77
Q

Anal Canal Examination in DRE

A
77
Q

Finger introduction in DRE

A
78
Q

Prostate Zone Examination in DRE

A
79
Q

Supra-Prostatic Zone Examination in DRE

A
80
Q

Bi-manual Examination in DRE

A
  • Best under anaesthesia
  • For: bladder tumor staging.
81
Q

Bi-Digital Examination in DRE

A
  • Index in anus and thumb in perineum.
  • For:
    Cowper’s gland infection (acute, chronic).
    Fistula: whip-cord induration.
82
Q

Final Steps in DRE

A
  • Finger inspection: Mucous, blood.
  • Cleaning,
  • Say thanks to patient.

Y4R4 - Surgery II 👨‍⚕️ (21 decks)

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