Urinary Symptoms (Not Hematuria)

Question 1

Key History

Answer 1

Duration
Obstructive Symptoms
Irritative Symptoms
Constitutional
Bone pain
Medications
UTI Hx
Urethral stricture
UT instrumentation
Stones
Diabetes 
Alcoholism

Question 2

Obstructive symptoms

Answer 2

Hesitancy
Diminished stream
Sense of incomplete bladder emptying
Straining
Postvoid dribbling
Leakage with cough or sneeze
Incontinence

Question 3

Irritative symptoms

Answer 3

Urgency
Frequency
Nocturia

Question 4

Key Physical Exam

Answer 4

VS
Abdominal 
Genital
Rectal
Focused neuro

Question 5

Key part of abdominal exam

Answer 5

Percussing the bladder

Question 6

60 YO Male
Nocturia
Urgency
Weak stream
Terminal dribbling
- Weight loss/Fatigue/Bone pain
\+ Urinary retention hx

Answer 6

BPH - PSA/US/Alk phos
Prostate Cancer- PSA/US/Alk phos
UTI- UA w/ culture
Bladder stones

CBC
BUN/Cr

Question 7

70 YO Male
Nocturia
Urgency
Weak stream
Terminal dribbling
Hematuria
Lower back pain
\+ Weight loss
\+ Fatigue

Answer 7

Prostate Cancer- PSA/US/Alk phos/CT Pelvis/MRI Spine
BPH - PSA/US/Alk phos
Renal Cell Carcinoma
UTI - UA w/ Cultures
Bladder Stones

CBC
BUN/Cr

Question 8

20 YO Male
Burning sensation
+ Discharge
+ Unprotected Sex

Answer 8

Urethritis
Cystitis
Prostatitis

UA w/culture
Gram stain discharge
Chlamydia and gonorrhea PCR

Question 9

40 YO Female
\+ Diabetes
Dysuria
Frequency
Fever/Chills/Nausea x 3 days
\+ CVA tenderness

Answer 9

Acute pyleonephritis
Nephrolithiasis
Urethritis/Cystitis

UA w/ culture and sensitivity
Blood culture
US - Renal
CT - Abdomen

CBC
BUN/Cr

Question 10

50 YO Female
Leakage w/ exercise/coughing/laughing/sneezing
Vague low back pain
Multiple vaginal deliveries
\+ Family hx (Mom after menopause)

Answer 10

Stress incontinence
Mixed incontinence
Urge incontinence
Overflow incontinence
UTI 
Diabetes Mellitus

Urodynamic testing
IVP
Cystourethroscopy

UA w/ culture
BUN/Cr

Question 11

30 YO Female
Leakage w/ urge/large volume
\+ Hx of UTIs
\+ FMHx of Diabetes
8 cups of coffee/day
Recent death in family

Answer 11

Urge incontinence
Mixed incontinence
Stress incontinence
Overfloww incontinence
Functional incontinence
UTI
Diabetes Mellitus

Urodynamic testing
IVP
Cystourethroscopy

UA w/ culture
BUN/Cr
Electrolytes
Glucose

Question 12

Constant leakage

+ Recent surgery or Prolonged labor

Answer 12

Fistula

Dye into bladder results in vaginal discoloration