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CAD II Flashcards

(51 cards)

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1
Q

pertinent ROS (19)

A
  • urinary frequency/ urgency/ hesitancy
  • nocturia
  • hematuria
  • incontinence
  • color/ odor of urine
  • suprapubic pain
  • fever
  • N/V
  • flank/ low back pain
  • genital discharge/ irritation/ itching
  • ulcerations/ blisters
  • rash
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2
Q

pertinent hx for M & F (7)

A
  • pyelo
  • nephrolithiasis
  • STI’s
  • GU procedures
  • GU CA
  • sexual activity/ protection
  • new meds
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3
Q

pertinent hx for M only

A

BPH

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4
Q

pertinent hx for F only (5)

A
  • contraception
  • LMP
  • menses schedule (flow, duration, intermenstrual bleeding)
  • pregnancy
  • last pap
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5
Q

other ROS (16)

A
  • chills
  • fatigue
  • malaise
  • sweats
  • sleep interruptions
  • unintentional weight changes
  • dysmenorrhea
  • eye redness/ pain/ blurring/ discharge
  • abd pain
  • change in bowel habits
  • jaundice
  • joint pain/ stiffness
  • swollen lymph nodes
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6
Q

inspect/ palpate penis for…

A

localized GU dermatitis, penile discharge, penile lesions

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7
Q

inspect/ palpate scrotum for…

A

epididymal/ testicular tenderness

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8
Q

palpate inguinal region (M) for…

A

LAD, masses, hernia

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9
Q

inspect pubic region (F) for…

A

localized GU dermatitis

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10
Q

palpate inguinal region (F) for…

A

LAD

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11
Q

inspect introitus for…

A

vulvar lesions, vaginal discharge, vaginal atrophy

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12
Q

speculum exam for…

A

cervical discharge, discoloration/ erythema

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13
Q

bimanual exam for…

A

cervical motion tenderness, uterine tenderness

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14
Q

rectal exam/ palpate prostate for…

A

swollen, tender

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15
Q

labs to order (4)

A

pregnancy test, UA, urine culture, STD screening

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16
Q

bladder/ renal US for…

A

bladder distention, hydronephrosis

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17
Q

CT abd/ pelvis WITHOUT contrast for…

A

nephrolithiasis

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18
Q

CT abd/ pelvis WITH and without contrast for…

A

hematuria, malignancy

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19
Q

cystoscopy for…

A

malignancy, interstitial cystitis

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20
Q

pain at start of void indicates

A

urethral source

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21
Q

pain at end of void indicates

Study These Flashcards
A

bladder source

22
Q

what makes acute cystitis complicated (8)

Study These Flashcards
A
  • sxs > 7 days
  • pregnancy
  • DM
  • male
  • elderly
  • IMC
  • indwelling catheter
  • anatomic abn

(risk of therapeutic failure)

23
Q

MC etiology

24
Q

2nd MC etiology in sexually active women

Study These Flashcards
A

Staph. saprophyticus

25
findings on UA suggestive of acute cystitis (6)
- pyuria (> 10 WBCs/ hpf) - hematuria - leukocyte esterase - nitrites - cloudy urine - increased pH (if proteus)
26
when is urine culture indicated for acute cystitis
if complicated
27
1st line management for acute cystitis
Nitrofurantoin (Macrobid) ER 100 mg PO BID x 5 days OR Trimethoprim-sulfamethoxazole (Bactrim) 160 mg TMP/ 800 mg SMX PO BID x 3 days
28
1st line management for acute cystitis in MEN
Nitrofurantoin (Macrobid) ER 100 mg PO BID x 7 days OR Trimethoprim-sulfamethoxazole (Bactrim) 160 mg TMP/ 800 mg SMX PO BID x 7 days
29
1st line management for acute cystitis if comorbid conditions
Ciprofloxacin ER 1000 mg QD x 7-14 days
30
2nd line management for acute cystitis
Amoxicillin-clavulanate (Augmentin) 500 mg/ 125 mg BID x 7 days OR Ciprofloxacin 250 mg BID x 3 days
31
1st line management for acute severe cystitis in MEN
Ciprofloxacin 500 mg BID x 5 days
32
1st line management for acute cystitis if PREGNANT
Amoxicillin-clavulanate (Augmentin) 500 mg/ 125 mg BID x 7 days
33
adjunct treatment for symptom control of acute cystitis
Phenazopyridine (Pyridium) 200 mg TID PRN x 2 days
34
pt edu if giving Pyridium
do not use > 48 hours due to SE's, turns urine orange
35
when will pts experience sx relief with abx tx of acute cystitis
within 48 hrs
36
pt edu for acute cystitis
- increase fluid intake - void when feel urgency - void after intercourse - proper hygiene
37
when do you need a f/u urine culture for acute cystitis
pregnancy
38
f/u for acute cystitis
48-72 hrs if no sx relief
39
signs of pyelo in addition to lower tract sxs (6)
- fever > 99.9 - chills - back/ flank pain - CVA tenderness - N/V - tachycardia
40
signs of pyelo in MEN in addition to lower tract sxs
pelvic/ perineal pain | can suggest accompanying prostatitis
41
findings on UA unique to pyelo
WBC casts
42
findings on CBC suggestive of pyelo
leukocytosis with L shift
43
outpatient tx for pyelo
Ciprofloxacin 500 mg BID x 7 days
44
outpatient tx for pyelo if concerns of resistance
Ceftriaxone 1 g IV/ IM PLUS Ciprofloxacin 500 mg BID x 7 days
45
outpatient tx for pyelo if concerns of resistance and FLQ allergy
Ceftriaxone 1 g IV/ IM PLUS Bactrim 160/800 mg PO BID x 7-10 days
46
f/u for pyelo if treated outpatient
48-72 hrs
47
when is inpatient management indicated for pyelo (10)
- septic/ critically ill - persistently high fever > 101 - pain/ marked debility - older age - pregnant - signs of obstruction - comorbid conditions - inability to tolerate PO - renal dysfunction - compliance concerns
48
management of pyelo if pregnant
admit for IV abx (amp/ gent or ceftriaxone) until afebrile for 24-48 hrs and sxs improved
49
diagnostic test of choice for chlamydia
NAAT via vaginal swab in women or first-catch urine in men
50
tx for chlamydia/ gonorrhea
Doxycycline delayed release 200 mg QD x 7 days OR Azithromycin 1 g single dose OR Ceftriaxone 500 mg IM x 1 dose
51
complications of pyelo
- sepsis with shock - renal failure - scarring/ chronic pyelo - renal abscess if inadequate therapy

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