3. Nocturia-Hematuria Flashcards
(30 cards)
Transient causes of urinary incontinence is DIAPPERS Delirium Infection Atrophic urethritis Pharmaceuticals Psychological factors Excess urinary output Restricted mobility Stool?
impaction
There are three types of urinary incontinenece, including destrusor overactivity (urge incont), Urethral incompetence (stress incont), and destrusor underactivity which is what type of incontinence?
Overflow
the most important aspect from a physician standpoint is symptom management of BPH and ensuring there is no evidence of?
CANCER
Lower urinary tract symptoms (LUTS) are suggestive of prostatic hyperplasia and can include urinary frequency, urgency, trouble starting urine, weak stream, dibbling, nocturia, urinary retention/incontinence, pain after ejaculation and urine that
has an unusual color or smell
Symptomatic relief is the most common reason men seek treatment for BPH, and therefore symptomatic relief is usually the goal for?
treatment of BPH (w sildenafil, vardenafil, avanafil)
DRE and PSA are not recommended in routine screening, determine the patients risk of BPH and prostate cancer before performing a PSA. For men with 4-7ng/ml PSA refer to urology if their symptom score is?
moderate to severe (8-19, 20-35)
Cystitis is lower urinary tract infection and has a DDx of:
pylenephritis, urethreitis, vaginitis, prostatitis, Asx bacteriuria (ASB), interstitial cystitis, pelvic inflam dz, urinary calculi, radiation or cyclophosphamide, bladder cancer, and urinary?
urinary incontinence
A dx of what can be considered when there is no local or systemic symptoms, and there is bacteriuria detected incidentally when a patient undergoes routine screening urine culture?
Asymptomatic bacteriuria
What is characterized by dysuria, urinary frequency and urgency?
cystitis
What presents with low grade fever, with or without low back/ costovertebral pain, or if severe will present with high fever (*distinguishing feature from cystitis), rigors, nausea, vomitting and flank pain?
Pyelonephritis
What presents with dysuria, frequency, and pain in the prostatic pelvic or perineal area, sometimes with fever and chills and symptoms of bladder outlet obstruction?
Acute bacterial prostatitis
What presents as symptomatic episodes of cystitis or pyelonephritis in a man or woman with an anatomic predisposition to infection, with a foreign body in the urinary tract, or w factors predisposing to a delayed response to therapy?
Complicated UTI
What causes sever flank pain, nausea and vomitting, and identification can be done on non contrast CT scan or US?
Urinary stones (MC in males in 30/40s)
urinary stones present with *colicky pain in the flank- severe, N/V, sharp pain
Meow
What can be diagnosed with symptoms including fever, irritative voiding symtpoms, perineal or suprapubic pain, tenderness on rectal exam, and a positive urine culture?
Acute bacterial prostatitis
*usually d/t E. Coli and pseudomonas
Lab tests for acute bact prostatitis would have pyuria, bacteriuria, hematuria and a positive urine culture, how is it treated?
Abx specific for type of bacteria
If there is microscopic hematuria, get a CT. Risk factors for bladder cancer include cigarette smoking, occupation exposure such as arylamine, phenacetin use, past tx with high doses of cyclophosphamide and ingestion of?
aristolochic acid (herbal weight loss products)
The MCC of gross hematuria is urologic cancer and UTI. What are the MCC of microscopic hematuria?
Urologic Cancer and prostatic hyperplasia
All of the following are what associated with hematuria?
increased age and male
constitutional symptoms (wt loss, app loss, fatigue)
heavy smoking history/aniline dye exposure
+ fam history of deafness/renal disease?
Alarm symptoms
whenever the urine dipstick is positive for blood and the microscopic exam of the urine does not show RBCs, myoglobinuria and what should be considered?
hemoglobinuria
All patients with hematuria should have what performed, regardless of the likelihood of infection?
Urine culture performed
What is diagnosed by gross/microscopic hematuria, flank pain or mass, systemic symptoms like fever and weight loss, and a solid renal mass on imaging?
Renal Cell carcinoma
RCC peaks in the 60s, male 2x as much as females, cigarette smoking is a huge risk factor. What is the most common syndrome it is associated with?
VHL syndrome - deletion on chr 3
A triad of hematuria, flank pain and mass occurs in 15% of people with RCC, but what is the most common?
Hematuria
