The Genitourinary Conditions Flashcards
What anatomy is affected by Hematuria?
(1) Kidneys
(2) Ureters
(3) Bladder
(4) Urethra
Hematuria is defined as what?
The presence of blood in the urine
Gross hematuria is visible to what?
Visible to the naked eye
Microscopic hematuria is detectible by what method? Only detectible by examination of the urine sediment by
microscopy, or urinalysis
Only detectible by examination of the urine sediment by
microscopy, or urinalysis
In patients with gross or microscopic hematuria, what other diseases can be identified ?
What are their percentages?
An upper urinary tract source (kidneys and ureters) can be identified in 10% of patients
Stone disease accounts for 40%,
Medical kidney disease for 20%,
Renal cell carcinoma for 10%,
Urothelial cell carcinoma of the ureter or renal pelvis for 5%
The lower tract source (bladder and urethra) of gross hematuria (in the absence of
infection) is most commonly from what?
Urothelial carcinoma of the bladder.
Microscopic hematuria in the male is most commonly from what?
Benign prostatic hyperplasia
Define initial hematuria?
The presence of blood at the beginning of the urinary stream that
clears during the stream, implies an anterior (penile) urethral source.
Define Terminal hematuria?
The presence of blood at the end of the urinary stream,
implies a bladder neck or prostatic urethral source.
Define total hematuria.
The presence of blood throughout the urinary stream, implies a
bladder or upper tract source
Hematuria associated with renal colic suggests what?
Ureteral stone.
Irritative voiding symptoms in a young woman may suggest what?
Acute bacterial infection and associated cystitis.
In the absence of other symptoms, gross hematuria may be more indicative of what?
Tumor
Irritative voiding symptoms, bacteriuria, and a positive urine culture in the female suggest what?
Urinary Tract Infection
What labs are you looking for when dealing with a patient with Hematuria?
- Urinalysis
- Urine Culture
- BUN and Creatinine
What imaging are you going to order for a patient with hematuria?
(1) CT scan of the upper tract without contrast
(2) Cystoscopy
A CT scan of the upper tract w/out contrast has been ordered for your patient with hematuria, what are you evaluating for with this CT scan?
1) Neoplasm of the kidney or ureter
2) Urolithiasis
3) Obstructive uropathy
4) Intrinsic kidney disease
What is indicated in patients with gross hematuria or those over 35 years with asymptomatic
hematuria?
Cystoscopy
Cystoscopy in patients with gross hematuria, or those over 35 years w/ asymptomatic hematuria is evaluating for what?
1) Bladder or urethral neoplasm
2) Benign prostatic enlargement
3) Radiation or chemical cystitis
Treatment of a patient with gross hematuria will be dependent on what?
The underlying disease process
Urinary Tract Infections can affect which parts of the body’s anatomy?
(1) Kidneys
(2) Ureters
(3) Bladder
(4) Urethra
(5) Prosthetic Urethra in males
(6) Prostate
(7) Testicle
(8) Epididymis
(9) Urethral Opening
What are among the most common entities encountered in medical
practice?
Urinary tract infections
What bacteria are responsible for most Urinary Tract Infections?
Coliform bacteria are responsible for most.
Of the coliform bacteria, what is the most common for causing Urinary Tract Infections?
Escherichia coli- being the most common
What is the most common route for urinary tract infection?
Ascending infection from the urethra
What kind of spread to the urinary tract is uncommon?
Hematogenous spread
What kind of spread to the urinary tract is rare?
Lymphatic spread
Define Acute Cystitis
Definition: Infection of the bladder.
Acute cystitis is most commonly due to what bacteria?
Coliform Bacteria
E coli, gram positive bacteria (enterococci)
What is the route of infection for acute cystitis?
The route of infection is typically ascending from the urethra.
Uncomplicated cystitis in men is rare and implies a pathologic process such as what?
Infected stones, prostatitis, or chronic urinary retention requiring further investigation.
List some signs and symptoms of a patient with acute cystitis.
(a) Irritative voiding symptoms
(b) Suprapubic discomfort
(c) Women may experience hematuria and symptoms often appear following sexual
intercourse
(d) Usually afebrile
(e) P.E. may elicit suprapubic tenderness with palpation
What are irritative voiding symptoms?
Frequency
Urgency
Dysuria
