Acute Urologic Concerns

A set of flashcards covering key concepts and definitions related to acute urologic concerns from the lecture notes.

What is the definition of cystitis?

Cystitis is a lower urinary tract infection confined to the urethra and bladder.

What defines pyelonephritis?

Pyelonephritis is an upper urinary tract infection affecting the kidneys and ureters.

What is nephrolithiasis?

Nephrolithiasis refers to the formation of kidney stones.

What is the clinical manifestation of acute cystitis in adults?

Adults typically experience dysuria, urinary frequency, urgency, hematuria, and suprapubic pain.

What are common symptoms in older adults presenting with cystitis?

May include new incontinence, confusion, dizziness, and increased falls.

What is hematuria?

Hematuria is defined as the presence of blood in the urine.

What is the prevalence of urinary tract infections in females by age 30?

By 30 years of age, approximately 50% of women will have experienced symptoms of a UTI.

What bacteria is most commonly associated with urinary tract infections?

Escherichia coli (E. coli) is present in 75-95% of UTI cases.

What are some risk factors for urinary tract infections?

Having a vagina, pregnancy, recent sexual intercourse, diabetes, and structural urinary abnormalities.

What are typical symptoms of an uncomplicated cystitis?

Symptoms include dysuria, urinary frequency, urgency, and possibly hematuria.

How is a UTI diagnosed?

A UTI can be diagnosed based on symptoms, urinalysis, and urine culture.

What is the significance of nitrites in urinalysis?

Nitrites indicate a gram-negative bacterial infection, typically E. coli.

What should be avoided in treating cystitis if concerns for pyelonephritis exist?

Nitrofurantoin should be avoided if pyelonephritis is suspected.

What is the first-line treatment for uncomplicated cystitis in females?

Nitrofurantoin monohydrate/macro-crystals or trimethoprim-sulfamethoxazole.

What does a high number of squamous epithelial cells in urine suggest?

It suggests contamination of the urine sample.

What is the recommended follow-up for patients with hematuria?

Repeat urinalysis should be conducted several weeks after treatment to evaluate for persistent hematuria.

What is the clinical presentation of acute bacterial prostatitis?

Fever, chills, malaise, dysuria, urgency, perineal pain, and cloudy urine.

What is the recommended treatment for acute bacterial prostatitis suspected as a sexually transmitted infection?

Ceftriaxone and doxycycline.

In cases of pyelonephritis, what percentage of untreated cystitis can progress to this condition during pregnancy?

20-30% of cases.

What type of medications are commonly used for pain management in cystitis?

Urinary analgesics, such as phenazopyridine HCl.

What is the management approach for complicated UTIs?

Urine culture and susceptibility testing with targeted antibiotic therapy.

What dietary advice can help prevent urinary tract infections?

Increased fluid intake, avoiding bladder irritants such as caffeine and alcohol.

What are common pathogens in pyelonephritis?

E. coli, Proteus mirabilis, and Klebsiella pneumoniae.

What should be monitored in pregnant patients with pyelonephritis?

Frequent follow-up cultures and evaluation for any complications.

What are the common clinical manifestations of nephrolithiasis?

Renal colic, hematuria, nausea, and dysuria.

What diagnostic tests are used for suspected nephrolithiasis?

CT abdomen/pelvis without contrast and urine analysis.

What is the general prevalence of hematuria in the population?

1 to 20% of the general population may have asymptomatic hematuria.

What does hematuria with dysuria suggest?

It likely indicates a urinary tract infection.

When is it appropriate to treat for asymptomatic bacteriuria?

In pregnant individuals or those undergoing procedures with anticipated mucosal bleeding.

What is considered recurrent cystitis in females?

Another UTI less than 2 weeks after completing appropriate treatment.

What is interstitial cystitis?

A chronic bladder pain condition without identifiable etiology, also called painful bladder syndrome.

What is the management goal of interstitial cystitis?

Provide symptomatic relief to improve the quality of life.

What are the common treatment options for interstitial cystitis?

Pentosan polysulfate sodium, amitriptyline, and lifestyle modifications.

What are some laboratory findings that support a diagnosis of pyelonephritis?

Pyuria, flank pain, fever, and CVA tenderness.

What does a UA show in the presence of significant hematuria?

Typically more than 3 red blood cells per high-power field on microscopic evaluation.

What condition is indicated by a positive leukocyte esterase on a UA dipstick?

The presence of white blood cells in the urine indicating a potential infection.

What is the relationship between urinary obstruction and pyelonephritis?

Obstruction increases the risk of urinary infections and pyelonephritis.

What is a common treatment approach for nephrolithiasis based on stone size?

Smaller stones may be managed conservatively with hydration; larger stones may require procedures.

How long should patients with symptomatic cystitis be followed after treatment?

RTC if symptoms do not resolve by the end of treatment or recur.

What role does cranberry juice play in UTI prevention?

Conflicting evidence exists; may help reduce the incidence of UTIs.

What is the suggested follow-up after antimicrobial treatment for bacterial prostatitis?

Monitor for symptoms and consider further evaluation if symptoms persist.

What are the clinical findings of acute prostatitis?

Tender, firm prostate on examination, fever, and urinary symptoms.

What demographic is at increased risk for kidney stones?

Males have a higher incidence than females, with risk increasing with age.

In urinalysis, what does the presence of bacteria indicate?

It is consistent with a urinary tract infection.

What is the role of lifestyle modification in managing cystitis?

Encourages fluid intake, proper hygiene, and regular urination habits.

What is the definition of urolithiasis?

The presence of stones anywhere in the urinary tract.

What color change indicates the presence of hematuria?

Pink or red urine.

What laboratory test is crucial for confirming hematuria?

Microscopic urinalysis.

What is the most common type of kidney stone?

Calcium oxalate stones, accounting for 70-80% of stone cases.

What should be suspected with fever and flank pain in a patient?

Potential pyelonephritis.

What complications can arise from untreated pyelonephritis during pregnancy?

Septic shock syndrome and respiratory distress syndrome.

In older adults, what atypical presentations might occur with UTI?

Altered mental status or confusion instead of classic symptoms.

What is a significant concern regarding the recurrence of UTIs in patients with diabetes?

Diabetes can predispose individuals to multiple recurrent infections.

What is a differential diagnosis for hematuria in males?

Prostatic hyperplasia, prostate cancer, or urinary stones.

What is the typical follow-up protocol for patients with a diagnosis of hematuria?

UA should be repeated after initial evaluation; further investigations may be needed.