Uro conditions Flashcards
What triad of symptoms will someone with a UTI classically present with?
Dysuria (painful urine)
Cloudy urine
New nocturia
What general symptoms will someone with a UTI present with?
Dysuria Cloudy urine New nocturia Haematuria Urgency Confusion Fever Suprapubic pain
Who is at more risk of UTIs?
Women
Patients who are sexually active
Those with a past history or family history of UTIs
Post menopause
What are first line investigations if you suspect someone has a UTI? What results will confirm your diagnosis?
Urine dipstick- presence of nitrates or leukocytes will indicate UTI
Urine culture- will identify the causative agent
How are UTIs managed?
Empirical antibiotics
These can be altered to be more specific one the urine culture comes back
Supportive treatment such as tell them to drink lots of fluid, paracetamol/ibuprofen for pain
What are the main complications of UTIs?
Pyelonephritis
What symptoms will someone with urinary tract calculi present with?
Severe loin to groin pain Patient will be writhing in pain Haematuria Nausea and vomiting is possible There may be urinary frequency and urgency
What are some risk factors for urinary tract calculi?
Dehydration High calcium levels High protein diet Structural abnormalities of the ureter Mostly idiopathic
What is the first line investigation for urinary tract calculi?
In GP setting abdominal exam and urine dipstick (will show hematuria)
Then if suspected, urgent non contrast CT KUB (ultrasound if pregnant or child)
What must you always do in a GP setting when examining someone if you suspect kidney stones?
Examine the external genitalia- check for testicular torsion as this is a medical emergency
How are kidney stones managed?
If less than 5mm usually just watchful waiting under urology
If over 5mm but under 10mm give an alpha blocker and wait for it to pass
If over 10mm or not passing surgical intervention may be needed eg shockwave lithotripsy PCNL
Also measure their calcium levels and check for cystinuria
How can you differentiate peritonitis vs kidney stone when assessing a patient’s pain?
Peritonitis= patient will lie very still
Kidney stone= patient will be writhing in pain
What are the 2 types of haematuria?
Microscopic (can’t be seen)
Macroscopic (can be seen)
What are some questions you might ask in the hx if someone presents with haematuria?
Dysuria, nocturia, cloudy urine, urgency
Cancer symptoms- fever, weight loss, night sweats
Sexual hx
Ask about their occupation and travel
What are some differentials when someone presents with haematuria?
Infection- UTI, pyelonephritis
Renal- kidney stones, glomerular disease
Cancer- bladder, prostate, renal,
Prostate- BPH
