UTI and Other Genitourinary conditions Flashcards
What are the signs and symptoms?
Dysuria
Frequency
Flank pain
What are the presenting symptoms of UTI?
In infants?
classic symptoms :
o Dysuria
o Frequency
o Flank pain
infants?
- fever
- vomiting
- lethargy
- poor feeding
- jaundice
- septicaemia
children
- dysuria, frequency,urgency
- abdominal pain
- fever
- lethargy
- d+v
- haematuria
Investigations for UTI?
Nitrite stick test – very specific
§ Leucocyte esterase test
· +ve in children with febrile illness without UTI Less specific than nitrites
· +ve in balanitis and vulvovaginitis
URINE MC + S - will diagnose what type of UTI
What is the difference between upper and lower UTI?
Upper = pyelonephritis -
Bacteriuria + fever >38 degrees
Bacteriuria + loin pain/tenderness
Lower = cystitis anything else (i.e. dysuria but NO systemic symptoms)
How to manage UTI?
under 3 months - admit to hospital, IV ABx, 5-7 days, then switched to oral prophylaxis
urgent ultrasound
over 3 months - consider hospital admission and IV ABx; OR oral ABx, 7-10 days
What is Phimosis?
inability to retract foreskin, “tight” foreskin
normal at birth,
50% by 1 year
10% by 4 years
if at puberty can increase risk of infection and cause problems with urination
Management of phimosis?
<2yo à reassure and review in 6 months (personal hygiene promotion)
§ >2yo à circumcision or topical steroid creams (depends on severity
What is paraphimosis?
foreskin becomes trapped in retracted position
- restricts blood flow to penis head - turns purple - emergency
management of paraphimosis?
1st line = adequate analgesia, attempt to reduce foreskin (gentle compression with saline soaked swab)
§ 2nd line = emergency referral to urologist
What is hypospadias?
wrongly positioned meatus
foreskin not fused
can have:
- hooded foreskin
- chordee (downward curving penis)
management of hypospadias?
Do nothing / surgery is not mandatory
Hypospadias repair surgery
What is balanoposthitis?
inflamed/purulent discharge from foreskin
single attacks common
management of balanoposthitis?
Warm baths
§ Broad spectrum ABX
§ Recurrent (rare) à circumcision
What is testicular torsion?
testicle rotates twisting the spermatic cord that brings blood to scrotum
risk factors: undescended testes
Signs and symptoms of testicular torsion?
Redness, oedema, N&V
Sudden onset pain – localised in testis or in the abdomen
