Urogenital and Gynecologic Screening

Question 1

Urologic or renal pathology may yield pain in one or more of these areas (3)

Answer 1

Flank
Low back
Pelvis

Question 2

What organs are involved in the upper urinary tract? Lower?

Answer 2

Upper: kidneys and ureter
Lower: bladder and urethra

Question 3

T/F: S/s of genitourinary dx can present as constitutional (think flu+ weight loss), urinary or MSK in nature. A seemingly random but unique presentation can be ipsilateral shoulder pain.

Answer 3

True

Question 4

Risk factors for urogenital disease include age (>60), race (AA, PI, and Native American descent), low birth weight and what else? (2)

Answer 4

PMH- DM, Heart Disease, Kidney Pathology, Autoimmune Dx
Exposure- chemical or environmental

Question 5

Describe the pain presentation for an Upper urinary tract pathology.

location, sensation, s/s

Answer 5

Localized ~ T10-L1
Feels aches/dull» can be boring at worst
May produce ipsilat spasms with rebound tenderness

Question 6

___or ___ following trauma, such as lifting or sustained blow may result in pesudorenal pain. The key difference between this and actual renal originated pain is that the former is affected by___.

Answer 6

1. radiculitis or costal N. irritation
2. body positioning

S/L and prolonged sitting inc p!

Question 7

additional s/s of pseudorenal p! include

further differentiating from true renal origin

Answer 7

ABSENT bowel/bladder change
negative kidney percussion test

Question 8

Describe the pain presentation for an lower urinary tract pathology

location, sensation, s/s

Answer 8

• localized aroud pubic/lower abdomen (and potentially back)
• sharp
• urinary urge and/or dysuria

Question 9

A serious complication of UTI is when a(n) ___(upper/lower) UTI progresses into a(n) ___(upper/lower) UTI.

Answer 9

lower
upper

upper is greater than lower in severity due to potential for damaged renal tissue

Question 10

Both upper and lower UTIs are often identified by fever and the presence of what in the urine? (3)

Answer 10

blood (hematuria)
pus (pyuria)
bacteriuria

Question 11

lower UTI RFS include gender (F>M), age,
inc sexual activity, and what PMH factors? (5)

Answer 11

DM, Gout, HTN, Obstructive urinary problems and catheterization.

Question 12

This nonspecific symptom is often a hallmark for UTI, especially in older adults. It may even be the only obvious presentation.

Answer 12

AMS

Question 13

vertebral osteomyelitis can be a result of a ____infection of the lower urinary tract.

Answer 13

staph

Question 14

characteristic s/s of an upper UTI include (3)

Answer 14

unilateral costovertebral tenderness, ipsi shoulder pain,skin hypersensitivity

Question 15

characteristic s/s of a lower UTI include (3)

Answer 15

urinary frequency/urge
LBP (unrelated to movement)
pelvic+ lower abd p!

also p! w/ intercourse

Question 16

describe the differneces between cystitis, interstital cystitis and urethritis.

Answer 16

• cystitis = active bladder infection + inflammation
• urethritis: active utrethral infection + inflammation
• I.C (aka painful bladder syndrome )= just inflammation

Question 17

T/F: Someone with interstitial cystitis (IC) is likely to present with an abnormal urination frequency between 8-10x/day.

Answer 17

false. 5-10x/day is normal. these indivuals can go up to 20-60x/day.

Question 18

Conditions associated with I.C. include IBS, Lupus, Vulvodynia, and ___

Answer 18

fibromyalgia, allergies and sensitive skin

Question 19

T/F: Calculi primarily form in the kidney and they stay there, decreaseing urine flow.

Answer 19

false, they can also lodge anywhere downstream.

Question 20

____stones are considered the most painful and can cause permanent kidney damge. Where does the pain orignate from?

Answer 20

• uretal
• deep in lumbar w/ radiation around side and into genitals

Question 21

characteristic s/s of kidney and uretal stones include acute and sharp pain, severe N/V
palpable mass, and (3)

Answer 21

lumbar discomfort
hyperesthesia (T10-L1)
abdominal spasms

Question 22

____ is a primary symptom of urinary tract neoplasm and ALWAYS requires a referral. Inc in urinary frquency and pain

Answer 22

hematuria

Question 23

Our screening procedures for kidney pathology include palpation and percussion. What are we assessing for each?

neither have great resesrch properties tbh

Answer 23

palpation: tenderness, enlargement and roughness
percussion:symptom provocation

Question 24

The most common urinary tract pathology fo r men >50y/o, ____produces pain, voiding complaints, and pain with ejaculation secondary to the narrowed urethra impinged by the inflamed prostate. List 5 common causes.

Answer 24

• prostatitis
• infection, trauma, autoimmune fn, stress and chronic PF spasms.

Question 25

along with general signs of infection, characteristic s/s of prostititis include:

Answer 25

LBP/inner thigh/perineal p! weak stream/ inability to fully void

Question 26

How do prostititis and BPH differ?

Answer 26

prostititis is characterized by pain + inflammation whereas BPH is characterized by voiding issues and 'noncancerous' enlargement.

Question 27

Like prostatitis, BPH presents with LBP/upper thigh p! and urinary problems but characteristic s/s unique to BPH include:

Answer 27

* palpable bladder and p! above p. symphysis, * blood in urine/semen

Question 28

Screening questions for BPH should empahsize what 3 main points?

Answer 28

voiding quality and frequency stream quality /effort nocturia

Question 29

T/F: Nearly 1/3 of all men are dx are diagnosed with prostate cancer by the age of 50.

Answer 29

true.

Question 30

prostate tumors tend to be osteo-___(blastic/lytic) and often cause back pain and sciatica.

Answer 30

osteoblastic

Question 31

characteristic s/s unique to prostate cancer include

Answer 31

lymphedema of the LEs and scrotum neuro change assoc with SC

Question 32

list the primary types of urinary and fecal incontinence

Answer 32

urinary: stress, urge, mixed, overflow and functional fecal: urge and passive | overall fecal is les prevalent and constipation is more common.

Question 33

reversible causes of urinary incontinence include **DIAPERS**, cog/psych deficits, infection, reduced mobility, and what else? (3)

Answer 33

atrophic vaginitis/ urethritis drugs/chemicals stool impaction

Question 34

Which of the following is irreversible? * acute renal failure (hours-days) * chronic renal failure Via what treatments are available? (3)

Answer 34

chronic renal failure; dialysis, transplant, meds

Question 35

Chronic intake of ___ and ___ serve as risk factors for renal failure. PT considerations for this include dehydration, depression and ___

Answer 35

* acetaminophen and NSAIDs * cardiac arrhythmias

Question 36

bladder cancer is strongly linked to ___ with more frequent incidence in what populations? ( | age, race, gender, lifestyle

Answer 36

SMOKING >40, caucasian, M>F, exposure to workplace carcinogens

Question 37

The age of onset for testicular cancer is relatively young and has a major risk factor of __. However it's highly treatable and often asymptomatic.

Answer 37

cryptorchidism (undescended testicles)

Question 38

If symptoms are present in testicular cancer, unique characterisitcs include: changes in testicular size, dull ache or heaviness in the groin, and (2)

Answer 38

LBP and infertility

Question 39

Because endometriosis can present similar to MSK or neuromuscular impairment, a hallmark characteristic of the related pain is that it's often ____ and ____

Answer 39

cyclic and intermittent | can also be constant.

Question 40

S/S unique to endometriosis include (4)

Answer 40

* painful w/ bowels and intercourse * heaving and irregular menstruation * fatigue * GI

Question 41

Similar to people with endometriosis, those with ovarian cysts experience cyclical pain assoc w/ their cycle. However they differ in having ____

Answer 41

sharp pain with rupture or hemorrhage

Question 42

the most common symptoms of an ectopic pregnancy are sharp or constant one-sided pain, lower abs/pelvis and __. **It is life threatening and requires a med referral**

Answer 42

ipsi shoulder p!

Question 43

RFs for ovarian cancer include not having kids, or having them late (post 35y/o), obesity, and abnormal timing of menstuation years (early or prolonged). Characteristic s/s include:

Answer 43

persistent vague GI complaints and changes in bowel/bladder

Question 44

___is the most common cause of death from gynecological cancer in the world.

Answer 44

cervical cancer

Question 45

guidelines for **IMMEDIATE** medical attention include (3)

Answer 45

* cervical spine pain accompanying urinary incontinence * sudden bowel/bladder incontinence * saddle anesthesia (think cauda equine lesion)

Question 46

guidelines for **physician referral** (3)

Answer 46

* blood in urine or post menopause * positive kideny percussion * trauma to surrounding structures