Genitourinary and Reproductive - DDx

Question 1

Urinary frequency, urgency, FLANK PAIN w/ NO HEMATURIA, no dysuria?

Answer 1

Nephrolithiasis

Question 2

Urinary frequency, urgency, FLANK PAIN w/ HEMATURIA, dysuria, fever?

Answer 2

Pyelonephritis

Question 3

Urinary frequency, urgency, hesitancy, no dysuria, NO FEVER?

Answer 3

Cystitis

Question 4

Urinary frequency, urgency, oliguria or anuria, high blood pressure, edema (eyelids, back, hip)?

Answer 4

Renal failure

Question 5

Urinary frequency, urgency, hematuria, dysuria, dyspareunia, dysmenorrhea, spotting, back pain?

Answer 5

Endometriosis

Question 6

Urinary frequency, urgency, menorrhagia, metrorrhagia, pelvic pain or pressure, constipation?

Answer 6

Uterine fibroids

Question 7

Urinary frequency, urgency, hematuria, dysuria, PYURIA, pelvic pain?

Answer 7

Bladder cancer - may also be painless hematuria

Question 8

Urinary frequency, urgency, hesitancy, incomplete voiding/dribbling, nocturia, NO dysuria, NO hematuria?

Answer 8

BPH

Question 9

Urinary frequency, urgency, hesitancy, incomplete voiding/dribbling, nocturia, dysuria, hematuria?

Answer 9

Prostate cancer

Question 10

Urinary frequency, urgency, incomplete voiding/dribbling, dysuria, dyspareunia, fever?

Answer 10

Acute bacterial prostatitis

Question 11

Urinary frequency, urgency, dysuria, ejaculatory pain, pelvic pain for 3 months out of last 6 months, no bacteria on Urinalysis?

Answer 11

CPPS - Chronic Pelvic Pain Syndrome prostatitis

Question 12

Proteinuria (less than 3.5g), Hematuria, AZOTEMIA (high BUN, Creatinine),
RBC CASTS IN URINE, Oliguria, Hypertension, EDEMA PERIORBITALLY/EYES PUFFY?

PHAROH EP

Answer 12

Nephritic syndrome

Question 13

Hematuria, proteinuria (less than 3.0 g), RBC casts in urine, PITTING EDEMA, Hypertension, Fatigue, Nausea/Vomiting?

Answer 13

Post-Strep Acute Proliferative Glomerulonephritis - - follows Strep Pharyngitis or Impetigo - Type III hypersensitivity reaction to basement membrane of glomerulus

Question 14

Proteinuria (3.0g or more), HYPOALBUMINEMIA, fatty casts in urine (d/t Hyperlipidemia), Edema, more often in kids 1.5 to 5 yoa?

PALE Kid

Answer 14

Nephritic syndrome

Question 15

Causes of nephritic syndrome?

Answer 15

IgA Nephropathy - Berger’s Dz

Strep Infection - Acute Proliferative Glomerulonephritis (even if Abx to treat strep)

Question 16

Causes of nephrotic syndrome?

Answer 16

Focal Segmental Glomerulosclerosis (m/c)
Diabetes (Diabetic Nephropathy)
SLE Lupus

Question 17

Nephritic syndrome w/ abrupt onset of edema?

Answer 17

Minimal change disease w/ diffuse loss of foot processes of podocytes surrounding capillaries of glomerulus

Question 18

Nephritic syndrome w/ slow onset?

Answer 18

Membranous glomerulonephritis w/ immune complex deposits on glomerular basement membrane causing membrane to thicken

Question 19

Membrenoproliferative glomerulonephritis vs Membranous glomerulonephritis?

Answer 19

Membranoproliferative -> Immune rxn results in proliferation and thickening of glomerular mesangium and basement membrane

Membranous glomerulonephritis -> immune complex deposits on glomerular basement membrane causing membrane to thicken

Question 20

Glomerulonephritis w/ hematuria, proteinuria etc appearing a day after infection?

Answer 20

Berger’s Dz in which IgA deposits attack glomerulus

Question 21

RBC Casts in urine?

Answer 21

Nephritic syndrome

Question 22

WBC Casts in urine?

Answer 22

Pyelonephritis

Question 23

Waxy Casts in urine?

Answer 23

Chronic Kidney Disease

Question 24

Fatty casts in urine?

Answer 24

Nephrotic syndrome (Hyperlipidemia)

Question 25

Brown, granular casts in urine?

Answer 25

Intrarenal azotemia / Acute Tubular Necrosis

Question 26

Flank pain and gross hematuria?

Answer 26

Renal papillary necrosis - necrosis of renal papillae

Question 27

Dysuria w/ milky discharge?

Answer 27

Chlamydia

Question 28

Dysuria w/ green, creamy discharge?

Answer 28

Gonorrhea

Question 29

Itchy, yellow, frothy, foul smelling vaginal discharge, strawberry cervix?

Answer 29

Trichomoniasis

Question 30

White, cheesy, odorless vaginal discharge?

Answer 30

Candidiasis