Urinary

Question 1

UTI

Answer 1

Uncomplicated: only bladder

Complicated: Structural or functional problem (stones, AKI, CKD etc.)

Question 2

Normal bladder pH

Answer 2

Under 6

Question 3

Cystitis

Answer 3

Frequency
Urgency
Suprapubic pain
Dysuria
Hematuria
Fever

Dx: Leukocyte esterase dipstick
Urinalysis, culture and sensitivity

treatment: antibiotics, fluids

Question 4

Pyelonephritis (upper UTI)

Answer 4

Hematuria
Flank pain
Dysuria
Fatigue, malaise
Chills/fever
Vomiting
Pain at costovertebral angle

Same dx and tx as cystitis

Question 5

Phenazopyridine for UTI

Answer 5

Pain relief, stains secretions orange

Coats walls of bladder w/analgesic

if symptoms not good within 2 days call doctor
Take with food

Question 6

UTI management

Answer 6

Inc. fluids to 3L/day
Void q2h
Assess urine
Warm Sitz baths

Question 7

Pyelo vs Cystitis

Answer 7

Pyelo can give permanent renal damage
Pyelo is usually bacterial
Pyeo has blunt percussion pain

Question 8

Gerontological considerations for UTI

Answer 8

Can cause CONFUSION/AMS

fever

Question 9

Bladder cancer

Answer 9

90% over 55
mostly cigarette smokers
Hematuria common sign

Surgery: TURBT (Transurethral resection bladder tumor)

• Segmental cystectomy (partial)
• Radical cystectomy: Remove bladder, prostate, seminal vessels, ovaries

Question 10

Drug therapy for urinary incontinence

Answer 10

anticholinergics (ditropan)

Adrenergics: Cardura

Question 11

Acute urinary retention

Answer 11

Unable to start

Question 12

Chronic urinary retention

Answer 12

Incomplete emptying

Question 13

Reflex incontinence

Answer 13

Detrusor hyperreflexia, s2 spinal cord lesion

Question 14

Renal calculi

Answer 14

Inc risk in males
N/V
MEGA flank pain, sharp and sudden
Hematuria
dysuria

Question 15

Renal calculi risk factors

Answer 15

Infection
Urinary stasis
Immobility
Inc. uric acid
Inc. urinary oxalate
Family hx

Question 16

Urinary stone prophylaxis

Answer 16

Limit oxalates

Limit purines for uric acid stones

Question 17

How big of a urinary stone is necessary to use lithotripsy laser

Answer 17

over 4mm

Question 18

Benign prostatic Hypertrophy

Answer 18

Lots of old dudes have it
Difficulty starting stream, weak urine stream

Check PSA to rule out cancer

Meds: Alpha adrenergic (FLOMAX) or erectogenic (Cialis)

Question 19

Prostate FUN

Answer 19

Frequency
Urgency
Nocturia

Question 20

Catheter needed for BPH

Answer 20

Coude

Question 21

TURP for BPH

Answer 21

Transurethral Resection of Prostate

Continuous or intermittent bladder irrigation

Close observation of drainage to prevent bladder rupture

Maintain cath patency
Pain control with analgesics and rest first 24hr
Avoid straining with BMs

Watch for hemorrhage: bleeding should be light pink w/in 24 hr
Watch for infections/DVT

Question 22

Prostate cancer

Answer 22

Biggest problem metastasis

Symptoms similar to BPH