Other urinary symptoms Flashcards

1
Q

Key history in other urinary symptoms

A

Duration
Obstructive symptoms (hesitancy, diminished stream, sense of incomplete bladder emptying,
straining, postvoid dribbling)
Irritative symptoms (urgency, frequency, nocturia)
Constitutional symptoms
Bone pain
Medications
Hx of UTIs, urethral stricture, or urinary tract instrumentation; stones, diabetes, alcoholism

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2
Q

Key physical exam in other urinary symptoms

A

Vital signs; abdominal exam (including suprapubic percussion to assess for a distended bladder); genital
and rectal exams; focused neurologic exam

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3
Q

60 yo M with nocturia, urgency, weak stream and terminal dribbling
+ no weight loss, fatigue or bone pain
+ two prior episodes of urinary retention requiring catheterization

A

Benign prostatic hyperplasia (BPH)
Prostate cancer
UTI
Bladder stones

Rectal exam
UA
CBC, BUN/Cr, PSA
U/S—prostate (transrectal)
Alkaline phosphatase
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4
Q

71 yo M with nocturia, urgency, weak stream, terminal dribbling, hematuria and lower back pain for last four months
+ weight loss and fatigue

A
Prostate cancer
BPH
Renal cell carcinoma
UTI
Bladder stones
Rectal exam
UA
CBC, BUN/Cr, PSA
U/S—prostate (transrectal)
CT—pelvis
Prostate biopsy
Alkaline phosphatase
MRI - spine
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5
Q

18 yo M with burning sensation during urination and urethral discharge
+ unprotected sex with new partner

A

Urethritis
Cystitis
Prostatitis

Genital and rectal exams
UA and urine culture
Gram stain and culture of urethral discharge
Chlamydia and gonorrhea PCR

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6
Q

45 yo diabetic F with dysuria, urinary frequency, fever, chills and nausea over last three days
+ left CVA tenderness on exam

A

Acute pyelonephritis
Nephrolithiasis
Renal cell carcinoma
Lower UTI (cystitis, urethritis)

UA, urine culture and sensitivity
Blood culture
CBC
BUN/Cr
U/S—renal
CT—abdomen
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7
Q

55 yo F with urinary leakage after exercise
+ loses small amount of urine when coughing, laughing or sneezing
+ vague low back pain
+ Hx of multiple vaginal deliveries
+ mother had same problem after menopause

A
Stress incontinence
Mixed incontinence
Urge incontinence
Overflow incontinence
Functional incontinence
UTI
DM
UA, urine culture
BUN/Cr
Urodynamic testing
IVP
Cystourethroscopy
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8
Q
33 yo F with urinary leakage
\+ unable to suppress urge to urinate and loses large amounts of urine without warning
\+ Hx of UTIs and FHx of DM
\+ drinks eight cups of coffee daily
\+ under stress
A
Urge incontinence
Mixed incontinence
Stress incontinence
Overflow incontinence
Functional incontinence
UTI
DM

CBC, electrolytes, BUN/Cr, glucose, UA, urine culture, urodynamic testing, IVP, cystourethroscopy

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