Signs and Symptoms

Question 1

What are the symptoms of acute urinary retention?

Answer 1

• Long history of gradually worsening voiding symptoms
• Hesitancy
• Poor stream
• Incomplete emptying
• Post micturition dribble

Question 2

What are the symptoms indicating a recent infection?

Answer 2

• Burning dysuria
• Smelly urine
• Haematuria

Question 3

What is a classic history for acute urinary retention?

Answer 3

• Back pain - cauda equina syndrome
• Woman
• Commencement of any new medications - opiates, anti-cholinergics
• Bowel habits

Question 4

What might you find on an examination for acute urinary retention?

Answer 4

• Tachycardia, non pyrexial

- Palpable bladder

Question 5

What are the clinical features of renal cell carcinoma?

Answer 5

• Haematuria
• Pain
• Mass

Question 6

What are the clinical features of transitional cell carcinoma?

Answer 6

• Haematuria
• Pain
• LUTS

Question 7

What are the signs and symptoms of renal colic?

Answer 7

• Loin to groin pain, very severe and colicky
• Nausea and vomiting
• Occasionally LUT symptoms (frequency, urgency) if stone in lower ureter
• Microscopic haematuria
• Tachycardia
• Dehydration

Question 8

What are common differential diagnoses for renal colic?

Answer 8

• Pyelonephritis
• Ectopic pregnancy, torted ovarian cyst
• Gastro: appendicitis, diverticulitis
• HPB: pancreatitis, cholecystitis
• Vascular: ruptured AAA
• Misc: musculo-skeletal pain

Question 9

What are the signs and symptoms of a UTI?

Answer 9

• Increased urinary frequency and urgency
• Dysuria
• Frank haematuria
• Systemically unwell
• Sometimes can cause pyelonephritis

Question 10

What patient factors might suggest complicated UTIs?

Answer 10

• Not responding to antibiotics based on microbiological sensitivity
• Frank haematuria after infective symptoms have resolved
• Previous history of stone disease and recurrent episodes of pyelonephritis

Question 11

What is the international prostate symptom score (IPSS)?

Answer 11

Score each one from 0-5

1. incomplete emptying
2. frequency
3. intermittency (stopped/started while urinating)
4. urgency
5. weak stream
6. straining
7. nocturia

1-7 mild, 8-19 moderate, 20-35 severe

Question 12

What are the features of BPH?

Answer 12

• Nocturia
• Frequency
• Urgency
• Post-micturition dribbling
• Poor stream/flow
• Hesitancy
• Overflow incontinence
• Haematuria
• Bladder stones
• UTI