Urinary System

Question 1

Most Common cause of UTI

Answer 1

E.Coli, 2nd is Staphy. saprophyticus

Question 2

What’s important when assessing UTI?

Answer 2

CVA Tenderness

Question 3

U/A results for lower UTI

Answer 3

Elevated nitrates, increased leukocyte esterase, urine sediments, hematuria, alkalotic urine. NO CASTS

Question 4

How can urethritis and vaginitis be differentiated from UTI?

Answer 4

By absences of hematuria

Question 5

Two 1st choice drugs for uncomplicated UTI

Answer 5

Bactim- 1 tab bid x 3 days (ex. sulfa/pregnancy)

Nitrofuritonin- 100 mg bid x 7 days (pregnancy)

Question 6

Treatment for Complicated UTI

Answer 6

Ciprofloxacin 250 mg BID x 3 days (no pregnancy)

Question 7

Drugs for UTI during pregnancy

Answer 7

Ampicillin/Clavulanate: 500 mg PO QuadD x 7 days
Cephalexin: 500 mg PO Quad d x 7 days
Get U/A at end to confirm eradication for all!

Question 8

Diagnosis of upper UTI

Answer 8

Chills, fever, CVA tenderness, WBC casts

Question 9

Differential diagnosis for upper UTI

Answer 9

Nephrolithiasis, lower UTI

Question 10

Treatment for Upper UTI, 1st Choice

Answer 10

Ciprofloxacin 500 mg BID x 7 days

Question 11

Alternative Treatment for Upper UTI (x2)

Answer 11

Amoxicillin/ Clavonic acid x 14 days

TMP/SMZ BID x 14 days.

Question 12

What else will pyelonephritis need to order?

Answer 12

If male, urinary tract anatomy imaging. If recurrent for females, the same.

Question 13

What do you do for gross hematuria?

Answer 13

Refer to urologist

Question 14

Defining hematuria

Answer 14

Gross or microscopic, or transient or persistent

Question 15

Most common causes of hematuria?

Answer 15

Calculi, infection, cancer, obstruction, bleeding diathesis

Question 16

When do you refer to a urologist for hematuria?

Answer 16

Gross or >50 RBC/hpf on single UA

Question 17

S&S of interstitial cystitis or painful bladder syndrome?

Answer 17

Frequency, nocturia, urgency, urethral pain, lower abdominal pain, incomplete emptying,

Question 18

Pathology of IC?

Answer 18

Believed that potassium or uric acid infiltrate the bladder wall because of a poor production of mucus that coats the wall

Question 19

What different diseases are associated with IC?

Answer 19

IBS, SLE, fibromyalgia, migraines, sensitive skin, allergies

Question 20

How is it diagnosed?

Answer 20

Diagnosis of exclusion, with potassium sensitivity test

Question 21

Treatment for IC?

Answer 21

TENS unit, acupuncture, smoking cessation, exercise, stress reduction, bladder training, legal exercises, bladder diary, bland diet

Question 22

Prostatitis incidence?

Answer 22

Most common male GU disease

25% will have prostatitis.

Question 23

4 Types of prostatitis

Answer 23

I- Acute Bacterial
2- Chronic bacterial
3- Chronic Non-Bacterial- Chronic pelvic pain syndrome
4- Asymptomatic inflammatory prostatitis

Question 24

S&S of prostatitis?

Answer 24

Abrupt, low back pain, suprapubic pain, dyschezia, fever, chills, nausea, malaise, arthralgia, meager, urinary frequency, weak stream, terminal dribbling

Question 25

S&S of physical exam?

Answer 25

I- very tender, warm, swollen, boggy II- not that tender, boggy Chronic Non Bacterial- just tender

Question 26

Treatment for Prostatitis?

Answer 26

Mild to moderate- Bactrim or cipro x 6 weeks | Severe- in patient care

Question 27

Labs for prostatitis?

Answer 27

U/a, C&S

Question 28

BPH S&S

Answer 28

Strain, heistance, weak stream, incomplete emptying, dribbling, nocturia

Question 29

Treatment for BPH

Answer 29

Alpha adrenergic blocker- bedtime, 2-4 weeks for response | Finasteride

Question 30

Etiology of Epididymitis?

Answer 30

G&C, e. coli, staph aureus, lifting and straining

Question 31

Physical exam for epididymitis?

Answer 31

Testicular pain with vas deferent modularity Edema of scrotum and epidiymus Positive Prehn's sign Hydrocele, prostate may be tender

Question 32

Treatment of epididymitis?

Answer 32

Treat like gonorrhea or chlamydia If it's an enteric organism, treat with levaquin 500 mg PO x 10 days If there's no improvement after 3 days, reevaluate

Question 33

Etiology of Testicular torsion?

Answer 33

Occurs during sleep, trauma, sex, with L testicle mor often being affected Most in males 10-20

Question 34

S&S of testicular torsion

Answer 34

Abdominal pain, scrotal edema and erythema NO FEVERS Absent cremasteric reflex and Prehn's sign

Question 35

Treatment of testicular torsion?

Answer 35

Emergency, surgical intervention

Question 36

Four etiologies of erectile dysfunction?

Answer 36

Neurologic, vascular, hormonal (hypogonadism and hyperprolacinemia), and psychological

Question 37

What type of bacteria makes the urine alcolotic in UTI?

Answer 37

Proteus Mirabilis

Question 38

What lab result on UA is not likely in pyeloneprhitis?

Answer 38

Proteinuria

Question 39

How are most bladder cancers treated?

Answer 39

Transurethral resection as well as intrathecal chemotherapy.