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Med Screening > Screening for GU Disease > Flashcards

Screening for GU Disease Flashcards

1
Q

what organs are involved in the GU system

A

renal/kidneys
ureters
bladder
urethra

females - ovaries, uterus
males - prostate, testicles

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2
Q

where is pain referred to from kidneys

A

low back
low abdomen
outer hips/outer upper thighs
inner upper thighs

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3
Q

where is pain referred to from ureter

A

makes a small U between AIIS levels

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4
Q

where is pain referred to from urinary bladder

A

oval centered b/w ASIS levels on abdomen

small circle below oval, AIIS level, above ureter “U”

circle below PSIS

ovals from inner gluteal folds to posterior upper inner thighs (angled in)

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5
Q

what are common GU sx (9)

A

back pain
groin pain
dysuria
nocturia
unable to empty bladder
hematuria
incontinence
polyuria
proteinuria

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6
Q

what do GU constitutional sx look like

A

like flu sx

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7
Q

what are male specific GU sx (4)

A

difficulty w start/stop of urine flow
testicular pain
swelling or mass in groin
sexual dysfunction

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8
Q

what are female specific GU sx (3)

A

dysmenorrhea
pain w intercourse
abnormal bleeding or discharge

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9
Q

what usually causes polyuria

A

diuresis

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10
Q

how might proteinuria present

A

foamy, if lot of protein

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11
Q

what are screening Qs

A

urinary/renal specific sx
- changes in bowel and/or bladder function?
- recent infections?

GU specific dx or family hx
- DM I / II
- kidney dz
- gout

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12
Q

what are follow up questions if someone says there has been some bladder changes (5)

A

incontinence/retention
urine color
frequency/urgency
pain
sexual dysfunction

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13
Q

what followup question should you ask if someone has had a recent infection

A

UTI

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14
Q

what is a consideration if there was an infection w the bladder

A

could impact the kidneys also

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15
Q

what are risk factors for renal and urinary problems

A

> 65yo
African, Hispanic, pacific island, native american descent

hx:
- DM, HTN
- kidney dz, cardiac issues, stroke
- kidney stones, UTI, lower tract obstruction, autoimmune dz

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16
Q

what is a primary risk factor for end stage renal dz

A

DM

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17
Q

who should be screened (6)

A

men over 45 (prostate)
hematuria
change in urinary flow
constitutional sx
pain unchanged by mechanical changes
pseudorenal pain is neg

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18
Q

what sx shoul make you suspicious of prostate involvement when doing a preliminary screen of a man >45yo

A

back pain w dysuria

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19
Q

what are red flag and urgent sx

A

back pain w urinating
hematuria
constitutional sx

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20
Q

what could cause pseudorenal pain

A

T10 and T12 distribution pain related to irritation of costal nerves

may look like renal colic (associated w kidney stone)

trauma related

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21
Q

how do you r/o pseudorenal pain

A

fist percussion over kidneys
GU screen

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22
Q

how could you r/i pseudorenal pain

A

A/P joint mob over costo-vertebral angle reproduces sx

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23
Q

upper UTI vs lower UTI

A

upper - kidney, ureteral
lower - bladder, urethra

upper presents w more constitutional sx and will be a more urgent referral

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24
Q

what are sx of upper UTI (6)

A

flank pain
fever/chills
hematuria
pyuria
nocturia

ill/constitutional sx

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25
Q

what are sx of lower UTI (7)

A

polyuria
inc urgency
LBP, pelvic pain
dysuria
hematuria
pyuria

more localized than systemic effect

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26
Q

upper vs lower GU obstructions

A

upper - kidney tumor, kidney stones
lower - bladder tumor, BPH, prostate CA

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27
Q

what are sx of upper GU obstruction (5)

A

renal colic - pain comes and goes
n/v
hematuria
fever/chills
inc urge

tends to be sicker, more constitutional sx

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28
Q

why do you see n/v w upper GU obstructions

A

d/t significant, inc high pain

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29
Q

what are signs of upper GU obstruction

A

urinalysis
- RBC, WBC present (urgent referral)

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30
Q

what are lower GU obstruction sx

A

can’t empty bladder
incontinence (overflow)

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31
Q

inc pt population at risk for BPH

A

men >50yo

50% of men in 60s
80% of men in 70s and 80s

32
Q

sx of BPH (4)

A

same as prostate cancer

bladder never empties
frequent urination (q2hours)
straining causes less elasticity of bladder
inc risk of UTI

33
Q

incidence of prostate cancer

A

2nd most common type of cancer
1/3 of all CA dx for men
very slow growing

34
Q

what are risk factors of prostate cancer

A

men who are:
>65yo
family hx
diet
African American inc risk

35
Q

sx of prostate cancer

A

same as BPH

bladder never empties
frequent urination (q2hours)
straining causes less elasticity of bladder
inc risk of UTI

36
Q

r/o prostate cancer

A

blood screening marker (PSA)
- prostate screening antigen

lot of false positives, but only quick screening tool

37
Q

what are 4 types of urinary incontinence

A

stress
urge
overflow
mixed

38
Q

what is a common misnomer of urinary incontinence

A

not a normal part of aging
not a normal part of post partum

ms dysfunction ^^

39
Q

what population has an inc prevalence of urinary incontinence

A

elite female athletes
- strong cores inc abdominal pressure
- can override pelvic floor

40
Q

what should you think if you see urinary incontinence w C-spine pain

A

could have cord compression
- cauda equina compression
- conus medullary compression

41
Q

what is stress incontinence

A

support of bladder or urethra is damaged, normal bladder

42
Q

how common is stress incontinence

A

75% of women have this

43
Q

what can cause stress incontinence

A

weak pelvic floor
ligamentous and fascia laxity
lot can happen post partum

44
Q

what is urge incontinence

A

overactive bladder

45
Q

what can cause urge incontinence

A

involuntary contraction of detrusor mm
neurological in nature

46
Q

what is overflow incontinence

A

over distention of bladder
bladder can’t fully empty

47
Q

who do you see overflow incontinence in

A

SCI - UMN problem causing bladder retention
prostate - blocked
cauda equina

48
Q

what is mixed incontinence

A

combination of any of the stress, urge, overflow

49
Q

acute vs chronic renal failure

A

acute = reversible
chronic = non reversible
- can lead to end stage renal dz

50
Q

what is acute renal failure often related to

A

major medical event
critical illness

51
Q

what is a common sx of acute renal failure

A

severe dehydration
- important education point

52
Q

what is 40% of ESRD associated w

A

diabetic neuropathy

53
Q

risk factors for chronic renal failure (5)

A

DM
HTN
chronic UTI
kidney transplant

chronic use of OTC (tylenol, NSAIDS) w caffeine and/or codeine use

54
Q

what are general skin manifestations of ESRD (8)

A

fatigue
weakness
dec alertness
inability to concentrate
pallor
ecchymosis
pruritus
dry skin and mucus membranes

55
Q

what are hematological/body fluid manifestations of ESRD (9)

A

anemia
tendency to bleed easily
polyuria
nocturia
dehydration
hyperkalemia
metabolic acidosis
hypocalcemia
hyperphosphatemia

56
Q

what are EENT manifestations of ESRD (2)

A

metallic taste in mouth
pale conjunctiva

57
Q

what are pulmonary manifestations of ESRD (3)

A

dyspnea
rales
pleural effusion

58
Q

what are CV manifestations of ESRD (2)

A

DOE
HTN

59
Q

what are GI manifestations of ESRD (3)

A

anorexia
n/v
GI bleed

60
Q

what are GU manifestations of ESRD (3)

A

impotence
amenorrhea
loss of libido

61
Q

what are skeletal manifestations of ESRD (4)

A

osteomalacia
osteoporosis
bone pain
edema

62
Q

what are neurologic manifestations of ESRD (7)

A

memory loss
sz
ms tremors
paresthesias
ms weakness
restless leg
cramping

63
Q

renal vs bladder cancers

A

similar but bladder is worse

64
Q

what are risk factors for bladder cancer (3)

A

smoking
men>women
occupational exposure to carcinogens

65
Q

what are sx of bladder cancer (3)

A

hematuria
dysuria
urgency

66
Q

what are risk factors for renal cancer (5)

A

smoking
obesity
HTN
men > women
long term dialysis

67
Q

what are sx of renal cancer (7)

A

same as bladder
- hematuria
- dysuria
- urgency

flank pain
wt loss
fever
fatigue

68
Q

pt population you typically see testicular cancer in

A

males 15-35yo

69
Q

what is key w testicular cancer

A

early dx

70
Q

what are risk factors for testicular cancer (4)

A

family hx
occupational exposure to carcinogens
HIV
ethnicity - caucasians 5-10xs > African americans

71
Q

what are sx of testicular cancer (3)

A

lump in either testicle
fatigue
LBP

72
Q

what sx make you think conus medullaris compression

A

UI w saddle anesthesia

73
Q

what sx make you think cauda equina compression

A

UI w LE paraparesis, radicular pain, numbness

74
Q

what are 3 immediate referrals

A

hematuria
sx of conus medullaris compression
sx of cauda equina compression

75
Q

what are soon referrals (2)

A

fist percussion is positive
back pain w change in urine

Med Screening (17 decks)

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