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Differential Dx > Urogenital and Gynecologic Screening > Flashcards

Urogenital and Gynecologic Screening Flashcards

1
Q

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

A

Flank
Low back
Pelvis

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2
Q

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

A

Upper: kidneys and ureter
Lower: bladder and urethra

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3
Q

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.

A

True

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4
Q

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

A

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

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5
Q

Describe the pain presentation for an Upper urinary tract pathology.

location, sensation, s/s

A

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

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6
Q

___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___.

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

S/L and prolonged sitting inc p!

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7
Q

additional s/s of pseudorenal p! include

further differentiating from true renal origin

A

ABSENT bowel/bladder change
negative kidney percussion test

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8
Q

Describe the pain presentation for an lower urinary tract pathology

location, sensation, s/s

A
  • localized aroud pubic/lower abdomen (and potentially back)
  • sharp
  • urinary urge and/or dysuria
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9
Q

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

A

lower
upper

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

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10
Q

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

A

blood (hematuria)
pus (pyuria)
bacteriuria

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11
Q

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

A

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

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12
Q

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

A

AMS

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13
Q

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

A

staph

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14
Q

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

A

unilateral costovertebral tenderness, ipsi shoulder pain,skin hypersensitivity

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15
Q

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

A

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

also p! w/ intercourse

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16
Q

describe the differneces between cystitis, interstital cystitis and urethritis.

A
  • cystitis = active bladder infection + inflammation
  • urethritis: active utrethral infection + inflammation
  • I.C (aka painful bladder syndrome )= just inflammation
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17
Q

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

A

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

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18
Q

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

A

fibromyalgia, allergies and sensitive skin

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19
Q

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

A

false, they can also lodge anywhere downstream.

20
Q

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

A
  • uretal
  • deep in lumbar w/ radiation around side and into genitals
21
Q

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

A

lumbar discomfort
hyperesthesia (T10-L1)
abdominal spasms

22
Q

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

A

hematuria

23
Q

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

neither have great resesrch properties tbh

A

palpation: tenderness, enlargement and roughness
percussion:symptom provocation

24
Q

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.

A
  • prostatitis
  • infection, trauma, autoimmune fn, stress and chronic PF spasms.
25
Q

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

A

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

26
Q

How do prostititis and BPH differ?

A

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

27
Q

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

A
  • palpable bladder and p! above p. symphysis,
  • blood in urine/semen
28
Q

Screening questions for BPH should empahsize what 3 main points?

A

voiding quality and frequency
stream quality /effort
nocturia

29
Q

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

A

true.

30
Q

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

A

osteoblastic

31
Q

characteristic s/s unique to prostate cancer include

A

lymphedema of the LEs and scrotum
neuro change assoc with SC

32
Q

list the primary types of urinary and fecal incontinence

A

urinary: stress, urge, mixed, overflow and functional

fecal: urge and passive

overall fecal is les prevalent and constipation is more common.

33
Q

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

A

atrophic vaginitis/ urethritis
drugs/chemicals
stool impaction

34
Q

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

A

chronic renal failure; dialysis, transplant, meds

35
Q

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

A
  • acetaminophen and NSAIDs
  • cardiac arrhythmias
36
Q

bladder cancer is strongly linked to ___ with more frequent incidence in what populations? (

age, race, gender, lifestyle

A

SMOKING

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

37
Q

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.

A

cryptorchidism (undescended testicles)

38
Q

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

A

LBP and infertility

39
Q

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

A

cyclic and intermittent

can also be constant.

40
Q

S/S unique to endometriosis include (4)

A
  • painful w/ bowels and intercourse
  • heaving and irregular menstruation
  • fatigue
  • GI
41
Q

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

A

sharp pain with rupture or hemorrhage

42
Q

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

A

ipsi shoulder p!

43
Q

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:

A

persistent vague GI complaints and changes in bowel/bladder

44
Q

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

A

cervical cancer

45
Q

guidelines for IMMEDIATE medical attention include (3)

A
  • cervical spine pain accompanying urinary incontinence
  • sudden bowel/bladder incontinence
  • saddle anesthesia (think cauda equine lesion)
46
Q

guidelines for physician referral (3)

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

Differential Dx (6 decks)

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