L1: Urological History Taking Flashcards
1
Q
Parts of Urological History Taking
A
2
Q
Urological Symptomatology
A
3
Q
Pain arises from either obstruction or inflammation & rarely Tumors
A
…
4
Q
Etiology of Renal Pain
A
Caused by acute distention of the renal capsule.
5
Q
Nerves Carrying Renal Pain
A
Sympathetic nerves convey the pains from the kidney (T10-L1).
6
Q
Characters of Renal Pain
A
Dull aching pain or Renal colic.
7
Q
Site & referal of Renal Pain
A
- Origin: Costo-vertebral angle or loin.
- Radiation: Umbilicus, lower abdominal quadrant & testis.
8
Q
Renal Pain may be associated with …..
A
9
Q
Relation of Renal Pain to posture & eating
A
10
Q
Upper third Ureteric Pain
A
10
Q
Mid Third Ureteric Pain
A
11
Q
Lower Third Ureteric Pain
A
12
Q
Rolling Sign
A
Characterstic to Ureteric Colic
13
Q
Nerve Supply to bladder
A
Somatic, Autonomic.
14
Q
Etiology of Bladder Pain
A
- Most common cause: Acute Urine Retention (AUR).
- Other causes: Inflammation, Tumors, Trauma, Neuropathic & Myogenic disorder.
15
Q
Criteria of pain due to full bladder:
A
- Constant Suprapubic pain related to act of micturition, terminal dysuria.
- Referred to distal urethra.
16
Q
Criteria of pain due to AUR
A
- Suprapubic severe agonizing, bursting pain.
- Sudden inability to urinate in spite of desire to do so.
- The bladder is full and over-distended.
17
Q
Criteria of pain due to CUR
A
- Painless (i.e. just Suprapubic discomfort).
- Dribbling with overflow incontinence.
18
Q
Criteria of pain due to Cystitis
A
- Suprapubic intermittent burning pain.
- Severe when the bladder is full & relieved partially by voiding.
19
Q
Site of Acute Prostatic Pain
A
Pain in perineal, rectal & may be referred to low back.
20
Q
Acute Prostatic Pain may be associated with ……
A
- Irritative &/or obstructive voiding symptoms.
- Rectal tenesmus.
- High grade fever.
21
Q
CP of Chronic Prostatitis
A
Vague discomfort, UTI.
22
Q
Etiology of Testicular Pain
A
- Orchitis or epididymo-orchitis, torsion, trauma.
- Tumors cause pain in only a minority of cases.
23
Q
When testicular pain Is lost?
A
in leprosy, syphalis, calcified hematoma, testicular tumor,
24
Can the testis have a referred pain from another site? What is the most common site?
refered from kidney or ureter
25
Can testicular pain be referred to other sites? Where?
refered to lower abdomen
26
Etiology of **Epidydimal Pain**
Most frequently due to epidydimo-orchitis.
27
Site & Referral of **Epidydimal Pain**
- Site: In the scrotum, may be felt in the groin, lower abdomen.
- Referred from inflammation of the vas.
28
Masses in Urology may be ......
29
How to Differentiate Enlarged Spleen & Lt Renal Mass:
30
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- **Direction of Enlargment**
- Insinuation of finger
- Notch & Surface
- Movement with respiration
- Ballotment
- Percussion
31
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- Direction of Enlargment
- **Insinuation of finger**
- Notch & Surface
- Movement with respiration
- Ballotment
- Percussion
32
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- Direction of Enlargment
- Insinuation of finger
- **Notch & Surface**
- Movement with respiration
- Ballotment
- Percussion
33
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- Direction of Enlargment
- Insinuation of finger
- Notch & Surface
- **Movement with respiration**
- Ballotment
- Percussion
34
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- Direction of Enlargment
- Insinuation of finger
- Notch & Surface
- Movement with respiration
- **Ballotment**
- Percussion
35
How to Differentiate Enlarged Spleen & Lt Renal Mass:
- Direction of Enlargment
- Insinuation of finger
- Notch & Surface
- Movement with respiration
- Ballotment
- **Percussion**
35
Etiology of **Bladder Mass**
Acute & Chronic Urine Retention.
36
Characters of **Bladder Mass**
- Rounded or globular swelling.
- Arising from the pelvis towards the lower abdomen in the midline.
37
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
38
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- **Site**
- Shape
- Size
- Sulci
- Rectal Mucosa
- Consistency
- Mobility
39
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- **Shape**
- Size
- Sulci
- Rectal Mucosa
- Consistency
- Mobility
40
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- Shape
- **Size**
- Sulci
- Rectal Mucosa
- Consistency
- Mobility
41
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- Shape
- Size
- **Sulci**
- Rectal Mucosa
- Consistency
- Mobility
42
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- Shape
- Size
- Sulci
- **Rectal Mucosa**
- Consistency
- Mobility
43
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- Shape
- Size
- Sulci
- Rectal Mucosa
- **Consistency**
- Mobility
44
Diffrentiate between Normal Prostate, BPH, Prostate Cancer in terms of:
- Site
- Shape
- Size
- Sulci
- Rectal Mucosa
- Consistency
- **Mobility**
45
Other Urological Masses
46
**Symptoms Related to the act of Micturation**
- **Obstructive voiding symptoms (Voiding LUTS)**
- **Irritative Voiding Symptoms (Storage LUTS)**
46
What is another name of **Obstructive voiding symptoms**?
Voiding LUTS
47
Examples of **Obstructive voiding symptoms (Voiding LUTS)**
48
Examples of **Irritative Voiding Symptoms (Storage LUTS)**
49
Types of Incontinence
50
Physical Characters of Urine
- Volume
- Color
- Odor
- Aspect
- Nature
51
Normal Volume of Urine
0.5-1ml/hr?/kg
52
Abnormal Volume of Urine
53
Normal Color of Urine
Amber yellow
54
Abnormal Color of Urine
54
Normal Odor of Urine
Urinephrous.
55
Abnormal Odor of Urine
56
Normal Aspect of Urine
Clear
57
Abnormal Aspect of Urine
58
Def of **Pneumaturia**
Passage of gas in urine.
58
Symptoms of CRF
58
Etiology of **Pneumaturia**
1. Post Instrumentation.
2. Infection with gas forming organism.
3. Uro-enteric fistula.
59
Symptoms of CRF
- Late
Hiccough & itching (late).
59
Symptoms of CRF
- Earliest
- Lack of concentration (Earliest)
60
Symptoms of Metastasis
61
GIT Symptoms Related to Urology
- Examples
62
Etiology of GIT Symptoms Related to Urology
1. Reno-intestinal reflexes.
2. Organ relationship.
3. Peritoneal irritation.
63
GIT Symptoms Related to Urology
- In Females
63
**Sexual/Genital Problems Related to Urology**
- In Males
64
Other Objective Symptoms Related to Urology
65
Urological Physical Examination
1) General.
2) Abdominal and DRE.
3) Targeted neurologic examination.
66
Finding in **Scrotal Skin**
Edema, infection, cyst, ulcer, sinus, tumor.
66
Scrotal Examination
- Scrotal Skin
- Testis
- Tunica Vaginalis
- Epidydimis
- Spermatic Cord
67
Reflexes in **Scrotal Skin**
Cremasteric reflex: L1,2.
68
Normal Testes
69
Abnormalities in Testes
70
Characters of Hydrocele (in Tunica Vaginalis)
71
Types of Hydrocele
Congenital or Acquired (idiopathic or secondary).
72
**Normal Epidydymis**
73
**Abnormal Epidydymis**
74
Abnormal Spermatic Cord
75
Patient Position in **DRE**
1) Dorsal position.
2) Lithotomy position.
3) Left lateral position.
4) Elbow chest position.
5) Standing and leaning forward.
76
Insperction in **DRE**
77
Anal Canal Examination in **DRE**
77
Finger introduction in **DRE**
78
Prostate Zone Examination in **DRE**
79
Supra-Prostatic Zone Examination in **DRE**
80
Bi-manual Examination in **DRE**
- Best under anaesthesia
- For: bladder tumor staging.
81
Bi-Digital Examination in **DRE**
- Index in anus and thumb in perineum.
- For:
Cowper's gland infection (acute, chronic).
Fistula: whip-cord induration.
82
Final Steps in **DRE**
- Finger inspection: Mucous, blood.
- Cleaning,
- Say thanks to patient.
