LM 5.6: Clinical Evaluation of Urologic Patients Flashcards
what are the systemic symptoms of urologic problems?
- fever
- weight loss
- general malaise
what are the different aspects of a fever you should consider in a urologic patient?
- high grade?
- chills?
- think of parenchymatous organs; kidneys and prostate
- children with high grade fever, think kidneys and get a urine culture
- infection without fever think cystitis (bladder infection) or chronic kidney infection like chronic pyelonephritis
- in
when would you see weight loss in urologic patients?
- advance cases of cancer
- chronic infection
- renal failure
- failure to thrive in children
what could cause general malaise in urologic patients?
- chronic infections
- renal failure
- advanced cacner
what is local pain?
pain in the site of the organ
aka in the kidneys or testicles when it comes to urologic patients
what is the location, character and associated symptoms of local kidney pain?
location: costovertebral angle, towards the umbilicus, ipsilateral lower abdomen
characteristics:
1. acute if sudden obstruction
- dull if slow distention
- painless if very slow progres
what is the location, character and associated symptoms of local ureter pain?
location: costovertebral angle, lower anterior abdomen, referred to ipsilateral groin
character: colicky, sharp
associated symptoms: nausea and vomiting, restlessness
what is the location, character and associated symptoms of local bladder pain?
location: suprapubic, usually related to voiding, referred to the tip of the penis
character:
1. acute due to sudden obstruction
- dull due to slow distention
- painless if very slow progression
associated symptoms: dysuria, hematuria
what is the location, character and associated symptoms of local prostatic pain?
location: perineal, rectal, lower abdomen
character: vague, may be sharp when acute
associated symptoms: nausea and vomiting, fever, urinary changes
what is the location, character and associated symptoms of local testicular pain?
location: testicular
character: acute, sharp, dull ache, discomfort
associated symptoms: nausea, fever, urinary infection
where could you feel referred pain from a stone in the upper ureter?
ipsilateral testicle or labia
where could you feel referred pain from a stone in the lower ureter?
bladder
where could you feel referred pain from inflammation of the bladder?
tip of the penis or urethra in females
what are some of the associated/non-urologic symptoms of urologic diseases?
- nausea
- vomiting
- abdominal pain
- tenderness
- rebound tenderness
what are the components of the lower urinary tract?
- urinary bladder
- urethra
- prostate in men
what are the 2 types of urinary symptoms?
- storage symptoms
2. voiding symptoms
what are storage symptoms?
symptoms that occur during the filling phase of the bladder
it is the time that the bladder is being filled with urine
these are based on urodynamics terms
they include:
1. urinary frequency
- urinary incontinence
- urinary urgency
- nocturia
- urinary incontinence
what is the storage symptom associated with cystitis?
- increased frequency of voiding
- constant desire to void
- burning without voiding
cystitis = bladder inflammation
what is the storage symptom associated with excessive fluid intake?
- increased urinary frequency
- urgency of voiding
- nocturia
what is the storage symptom associated with a bladder stone?
- urinary frequency
- urges desire to urinate
- dysuria
- blood in urine
what are voiding symptoms?
symptoms occurs at the time of voiding; the patient experiences them during passing urine
an older term is obstructive symptoms because it usually occurs when there is obstruction of the urinary stream
- hesitancy
- decreased urinary stream force
- terminal dribbling
- intermittent stream
- sense of incomplete emptying of the bladder
- urinary retention
- straining to void
