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GU-male > UTI disorders > Flashcards

UTI disorders Flashcards

1
Q

who most commonly gets UTIs

A

infants <1yo (males)
females 1-65
>65yo (equal)

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2
Q

what causes UTIs

A

E coli and positive nitrites will be seen on UA

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3
Q

risk factors for UTI?

A

sexual activity, hygiene, hormones, BMI, low fluid intake, delayed voiding, GU anomalies, catherization

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4
Q

symptoms/signs of lower tract UTIs

A

urgency, incontinence, frequency, suprapubic/flank/low back pain,
dysuria, microscopic hematuria

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5
Q

signs/symptoms of upper tract UTIs

A

fever, chills, N/V, flank pain or CVA tenderness, lethargy, myalgia,
odorous urine, macroscopic hematuria

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6
Q

diagnosis of UTI: what must you rule out

A

STI, IC, stones, epididymitis, prostatitis, vagnitis

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7
Q

diagnosis of UTI: labs

A

UA dipstick and microscopic tests, Urine culture

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8
Q

diagnosis of UTI: imaging

A

US, KUB, MRI, IVP/IVU, cystoscopy, renogram

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9
Q

treatment considerations for UTI includes…

A

age, gender, complicated vs uncomplicated, risk factors, pregnancy (must treat pregnant women with/without symptoms)

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10
Q

what is usual treatment for UTIs?

A

antibiotics varying in duration depending on complexity

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11
Q

prevention of UTIs: for men

A

urinate frequently, saw palmetto, cranberry, hydration, lactobacillus

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12
Q

prevention of UTIs in women

A

D-mannose, cranberry, hydration, lactobacillus

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13
Q

what is pyelonephritis

A

infection/inflammation of kidney/renal pelvis

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14
Q

causes of pyelonephritis?

A

infection secondary to ascending lower UTI

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15
Q

signs/symptoms of pyelonephritis

A

: fever (>102 F), CVA tenderness/flank pain, chills, tachycardia, N/V,
leukocytosis, bacteriuria, hematuria, WBC casts

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16
Q

DDx for pyelonephritis

A

: cystitis, appendicitis, cholecystitis, pancreatitis, diverticulitis, epididymitis, prostatitis,
ectopic pregnancy, PID

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17
Q

treatment for pyelonephritis

A

oral or IV antibiotics

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18
Q

complications of pyelonephritis

A

recurrence of pyelonephritis, perinephric abscess (infection around
kidney), sepsis, acute renal failure

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19
Q

urinary stones: what are nephrolithiasis vs ureterolithiasis

A

nephrolithiasis: calculi in kidney while ureterolithiasis is calculi in ureter (usually originate in kidney)

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20
Q

urinary stones: who gets them

A

male/caucasian 35 (30-55 females)

21
Q

cause of urinary stones

A

supersaturation=salts become concentrated if volume of urine is significantly reduces or if high amounts of crystal-forming salts are present

22
Q

urinary stones risk factors:

A

pregnancy, urinary tract abnormalities, Southern U.S., specific foods,
obesity, stress, bedridden, medical conditions (HTN x3, IBD, etc), meds (thyroid
hormones, diuretics, antacids, etc)

23
Q

urinary stones: signs and symptoms

A

sudden onset of acute/colicky/flank or back pain radiating to groin, CVA
tenderness, location of pain travels w/ stone, rebound tenderness, dysuria, urgency,
increased frequency, hematuria, systemic symptoms (diarrhea, N/V, diaphoresis)

24
Q

are bigger stones more painful?

A

signs of stone does not predict severity of pain

25
Q

labs for urinary stones?

A

UA → ~85% exhibit hematuria, CBC, Blood chem (serum electrolytes, creatinine,
Ca, uric acid, phosphorus)
• If recurrent → 24 hour collection

26
Q

imaging for urinary stones

A

plain film of abdomen will often show stone and watchful waiting is OK for
asymptomatic stones, non-contrast spiral CT, IVP

27
Q

DDx for urinary stones in males

A

testicular torsion, pyelonephritis, acute prostatitis, appendicitis, pancreatitis

28
Q

DDx for urinary stones in females

A

ovarian cyst or torsion, ectopic pregnancy, pyelonephritis, appendicitis,
pancreatitis

29
Q

treatment for urinary stones

A

NSAIDs with medical expulsive therapy (MET) and wait for stone to pass (<5 mm
diameter should pass within 3 weeks). Do not use opioids for pain.
• If obstruction and infection present → ER surgery.

30
Q

prevention of urinary stones

A 
increase fluids (~2L/day), diet low in sodium/protein/purine/oxalate, increase
EFAs
31
Q

for prevention of urinary stones: if hypercalcuria what do you not want to limit and what should you take

A

do not limit Ca intake, and take dandelion lead

32
Q

for prevention of urinary stones: if hyperoxaluria what do you want to limit and what should you take

A

limit oxalates and take magnesium and B6

33
Q

who most often gets incontinence?

A

women twice as likely to get them . MC in homebound/instinutionalized elderly (>50%)

34
Q

causes of incontinence

A

carious neuro disorders from CNS, spinal cord, or peripheral n causing uncoordinated detrusor contraction with external sphincter relaxation

35
Q

what are 4 types of incontinence? (which is MC?)

A

stress (MC), urge, mixed, and overflow

36
Q

what causes stress incontinence?

A

poor sphincter function and or urethral mobility

37
Q

what causes urge incontinence?

A

detrusor overactivity/instability or related to BPH

38
Q

what is mixed incontinence? and who gets it MC

A

mix of both stress and urge incontinence seen in women over 65

39
Q

what causes overflow incontinence?

A

detrusor paralysis or bladder outflow obstruction

40
Q

what are risk factors for incontinence?

A

: any damage to pelvic floor mm or nn, vaginal deliveries, chronic increase in
intra-abdominal pressure, pelvic organ prolapse, smoking, pelvic/prostate surgery,
estrogen deficiency, BPH, UTI, bladder outlet obstruction, foreign bodies, neuro
disorders, DM, meds

41
Q

what are management options for incontinence

A

pelvic floor exercises, electrical stim/biofeedback, barriers, behavioral
modification, absorbent products, surgery, meds
• Anticholinergic, antispasmodic, antidepressant, Ca channel blocker, betaagonist, estrogen

42
Q

what is interstitial cystitis?

A

a painful bladder condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region

43
Q

who gets interstitial cystitis MC

A

women (90%), Caucasian, 40yo

44
Q

conditions that can lead to interstitial cystitis in women?

A

chronic pelvic pain, dyspareunia, vulvodynia, improves w/ pregnancy

45
Q

conditions that can lead to interstitial cystitis in men?

A

chronic NB prostatitis, BPH, prostadynia

46
Q

signs/symptoms of interstitial cystitis?

A

mild discomfort, pressure, tenderness or intense pain in the bladder and pelvic
area which may vary with bladder filling or emptying. Also urgency, nocturia, frequency
(>60x/day!!), (pre)menstrual exacerbation, dyspareunia

47
Q

causes of interstitial cystitis

A

Unclear. Possibly: infectious, autoimmune, mechanical injury, mast cell activation,
alteration in bladder lining (GAGs)

48
Q

how to dx interstitial cystitis

A

r/o other causes and confirm via cystoscopy w/ hydrodistention and bladder biopsy

49
Q

treatment for interstitial cystitis

A

relieve symptoms since causes unknown. Bladder distension is diagnostic and early treatment. possibly anti-inflamm diet, quit smoking, exercise, bladder training, support GAGs, decrease NO, increase bioflavonoids. meds

GU-male (8 decks)

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