Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

clin med > urology > Flashcards

urology Flashcards

1
Q

MC nosocomial infection in hospitals and nursing homes

A

UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acute cystits uncomplicated women?

A

Infection of the urothelium (lining or urinary tract)bc bacteria ascends up the urethra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

cause of Acute cystitis = bladder infection, uncomplicated women

A

MC e coli
Enterococcus, Klebsiella, proteus
Staph saprophyticus- young sexually active women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Acute cystitis = bladder infection, uncomplicated women

sx

A

Dysuria, frequency, urgency, suprapubic discomfort, foul smelling urine, cloudy urine
NO fever or vaginal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute cystitis = bladder infection, uncomplicated women

dx

A

Nitrate + → 90% chance of UTI, but UTI does not r/o - results
Nitrates are converted to nitrite
Leukocyte esterase + → bladder is irritated from pyuria
Good sensitivity
pH → acidic can indicate urolithiasis and basic can indicate urea splitting organism
*Urine culture- gold std; 100,000 organisms midstream catch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute cystitis = bladder infection, uncomplicated women

trmt

A

Gold std- macrobid or bactrim DS

Keflex and cipro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute cystitis, pregnant women

cause

A 
#1 e coli
#2 strep B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute cystitis, pregnant women

dx

A

Urine culture only needs 10,000 organisms

+ UA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acute cystitis, pregnant women

trmt

A

Treat everyone
Macrobid, ampicillin, Keflex for 7 days
NO fluoroquinolone or sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute cystitis, men

cause

A

E coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Acute cystitis, men

sx

A

Dysuria, frequency, urgency, suprapubic discomfort, foul smelling urine, cloudy urine
NO fever or penile discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute cystitis, men

dx

A

Send all male urines for culture
Meares stamey test
Only need 1-2 WBC to dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute cystitis, men

trmt

A

Cipro or bactrim DS 7-14 days
Tailor trmt once urine cult comes back
Swab for std before getting urine sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acute cystitis, complicated

cause

A

E coli MC
Gram - rods Klebsiella, proteus
Gram + bacteria enterococci, staph aureus
Yeasts
Gas forming organism like ones above
*DM are predisposed to emphysematous pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acute cystitis, complicated

dx

A

CT

Gas in urinary tract with UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Acute cystitis, complicated

trmt

A

Elective nephrectomy

Antimicrobial therapy 7-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pyelonephritis?

A

Acute cystitis spread to the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Pyelonephritis cause

A

Gram - : e coli, proteus, klebsiella, enterobacter, pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pyelonephritis sx

A 
CVA tenderness
Fever
NV
Malaise
tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pyelonephritis dx

A 
CBC- leukocytosis
UA- pyuria, bacteriuria, hematuria
Urine culture- heavy growth
US- hydronephrosis (possibly)
Abdomen and pelvis CT with oral and IV contrast- GOLD std
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pyelonephritis trmt

A

IV ampicillin or quinolone

PO fluoroquinolone 14-21 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Hemorrhagic cystitis

sx

A

Frank hematuria- use wine scale

No fever, CVA tenderness, abdominal mass, tachycardia, appearing acutely ill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hemorrhagic cystitis

dx

A

+ UA with blood
Send for urine culture
Proteinuria and casts? Renal origin
Bacteriuria and + urine culture? UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hemorrhagic cystitis

trmt

A

Gold std- macrobid or bactrim DS
Keflex and cipro
Keflex and macrobid are in urine
Cipro and bactrim are in tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Recurrent cystitis?
Women who have over 3 episodes of cystitis in 1 year | Make sure pt does not have stones, reflux, or fistula
26
Recurrent cystitis | dx
Urine culture PVR- post void residual Cystoscopy CT urogram
27
Recurrent cystitis | trmt
Treat infection Treat stones, reflux, or fistula if present PPX ATB 30 days-6mo (Bactrim, Macrobid, Keflex) Postcoital ATB
28
Catheter associated bacteriuria | cause
E coli is MC Polymicrobial 50% Candiduria is common
29
Catheter associated bacteriuria | sx
Fever, chills, AP, altered LOC, HoTN, hypo/hyperglycemia | Foul or cloudy urine is NOT an indication of a catheter
30
dx Catheter associated bacteriuria
+ urine culture from the catheter NOT the bag
31
Catheter associated bacteriuria trmt if caused by bacteria
Elective nephrectomy Antimicrobial therapy 7-14 days Begin with fluoroquinalone
32
Catheter associated bacteriuria trmt if caused by fungi
If candida infection… Asymptomatic: remove catheter Symptomatic: Fluconazole or amphotericin (both antifungals)
33
Don't treat unless pregnant, pt is about to have urologic surgery, after renal transplant
Asymptomatic bacteriuria
34
OAB cause
Detrusor overactivity or early sensation
35
``` Overactive bladder (OAB) sx ```
Peeing over 8 times a day or over 1 time a night
36
``` Overactive bladder (OAB) trmt ```
1. Behavioral modifications 2. Meds 3. Alternative trmt
37
``` Overactive bladder (OAB) meds ```
anticholinergic/antimuscarinic, beta agonist (myrbetriq)
38
``` Overactive bladder (OAB) alternative therapy ```
Percutaneous nerve stimulation (PTNS)- tibial stimulation thing Interstim- like bladder pacemaker Botox
39
Stress Urinary incontinence | cause
Bad vesicourethral ligament support
40
Stress Urinary incontinence | sx
Incontinence with activity: coughing, lighting, bending, sneezing, intercourse, changing positions
41
Stress Urinary incontinence | PE
Q tip test grade 1-4 | Assess for cystocele, rectocele, enterocele
42
Stress Urinary incontinence | trmt
Repair vesicourethral ligament MC sling Pessary
43
Urinary urgency incontinence | cause
Detrusor is not stable
44
Urinary urgency incontinence | sx
Losing urine right after you feel the need to pee | “Can't make it in time”
45
Urinary urgency incontinence | trmt
1. Behavioral modification- no caffeine, manage fluid, bladder training, pelvic wall strengthen 2. Medication Anticholinergic 1st line 3. Alternative trmt Percutaneous nerve stimulation (PTNS)- tibial stimulation thing Interstim- like bladder pacemaker Botox
46
Overflow incontinence | cause
Don't sense pee Something is blocked so you don't feel the need to pee Nerve damage interrupts signal from the brain to bladder so you don't feel like you need to pee
47
Overflow incontinence | sx
Leaking without urgency- not sensing you need to pee
48
Overflow incontinence | dx
History, cystoscopy, urodynamics
49
Overflow incontinence | trmt
Remove obstruction | Stimulate nerve
50
Urinary retention | cause
MC in elderly men bc of BPH Inc resistance to urine flow or dec detrusor muscle contractility Enlarged prostate, phimosis, paraphimosis, meatal stenosis
51
what can urinary retention lead to
reurrent uti
52
urinary retention sx and PE
``` Unable to void Suprapubic and abd pain Crede- Positional voiding need to lean forward to get pee out Medications abdominal distension on PE ```
53
Urinary retention | dx
US Cath CRE/BUN if prolonged
54
Urinary retention | trmt
Find the source | Alpha agonist- flomax
55
____ innervate smooth bladder muscle, internal sphincter, and proximal urethra
T10-L2
56
Neurogenic bladder | cause
MC MS, spinal cord injury, TIA/stroke, parkinsons, DM, ALS, injury to pelvis
57
Neurogenic bladder | sx
Don't feel need to pee Flooding episodes Bladder spasm
58
Neurogenic bladder | dx
*Urodynamics
59
Neurogenic bladder | trmt
``` Catheter Bethanechol- inc tone in detrusor Interstim Botox Cystectomy ```
60
hematuria sx
Blood in urine
61
antyime you have hematuria you should do this for a dx
3 C’s CT urogram Cytology Cystoscopy
62
trmt hematuria
Find the cause Infection- hemorrhagic cystitis Stones Malignancy- bladder, urethral, ureteral , renal CA Damage- radiation, cystitis, interstitial cystitis
63
Interstitial cystitis / “painful bladder syndrome” | sx
Pain with bladder filling and relieved by emptying | Frequency, urgency, nocturia
64
Interstitial cystitis / “painful bladder syndrome” | PE
Check for vaginitis and urethral diverticulum | Pelvic pain usually present
65
Interstitial cystitis / “painful bladder syndrome” | dx
UA- normal or hematuria *K sensitivity test *Cystoscopy- hunner's ulcers and patches which are red angry patches in bladder Biopsy
66
Interstitial cystitis / “painful bladder syndrome” | trmt
Hydrodistention- stretch bladder nerves Meds Amitriptyline, elmiron, heparin, dimethyl sulfoxide Dietary changes- ETOH, caffeine, spicy food, acidic food
67
meds for Interstitial cystitis / “painful bladder syndrome”
Amitriptyline, elmiron, heparin, dimethyl sulfoxide
68
Vesicoureteral reflux ?
Urine goes back into the ureters and kidney
69
Vesicoureteral reflux grades and trmt
``` Grades 1-5 1 and 2- resolve in infants 3- may resolve 4 and 5- don't resolve Need deflux or implant surgery Adults- none resolve alone ```
70
TST made where and by who?
Made by Leydig cells in seminiferous tubules
71
cause low tst
Aging Dec 1% annually after age 50 Dec libido, male aggression, verbal memory, visuospatial, muscle strength and growth, maturation of sexual organs and penile growth
72
sx low tst
Flushes or sweating, breast discomfort or gynecomastia, infertility Fatigue depression, decline in memory, inc body fat, dec work performance, sleep issues
73
pe low tst
Breast tenderness and gynecomastia Dec in lean body mass Dec chest hair and skin Testicular atrophy
74
dx low tst
Serum TST lower than 230 | Reference ranges not age dependent
75
if TST is low you must get this
dexa scan
76
trmt low tst
Oral, injectable, transdermal, SQ, buccal | Most popular: transdermal gels → injectables → transdermal patches
77
risks with TST supplements
``` *Azoospermia Prostate cancer BPH Gynecomastia Acne Mood swing Polycythemia CV disease ```
78
monitoring TST
Check 1-2 mo after initial trmt 3-6 mo in 1st yr Annually DRE, serum PSA, Hg, voiding assessment, liver function
79
when is TST highest and lowest?
Highest in am and lowest at 3pm
80
___ and ___ are in urine | ____ and ____ are in tissue
Keflex and macrobid | cipro and bactrim

clin med (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions