Acute Urologic Concerns

A comprehensive set of flashcards covering key concepts related to acute urologic conditions, their definitions, symptoms, diagnostics, and management approaches.

What is the main cause of Urinary Tract Infections (UTIs)?

Bacteria.

What is cystitis?

A lower urinary tract infection confined to the urethra and bladder.

What is pyelonephritis?

An upper urinary tract infection that includes infections in the kidneys and ureters.

What are the typical symptoms of acute simple cystitis?

Dysuria, urinary frequency, urinary urgency, and suprapubic pain.

What indicates a complicated UTI?

Signs suggesting extension beyond the bladder, such as fever, chills, flank pain, and pelvic pain in males.

Which organisms are most commonly responsible for UTIs?

E. coli (75-95% of cases), Klebsiella pneumoniae, and Proteus mirabilis.

What demographic is at increased risk for UTI?

Women, especially during pregnancy and as they age.

What are common clinical manifestations of acute uncomplicated cystitis in adults?

Dysuria, urinary frequency, urgency, hematuria, and suprapubic pain.

What might older adults experience instead of classic UTI symptoms?

Changes in mental status, new incontinence, dizziness, and anorexia.

What is the purpose of urinalysis in diagnosing UTI?

To evaluate symptoms and check for the presence of bacteria, leukocyte esterase, and nitrites.

What does the presence of leukocyte esterase on a dipstick indicate?

Pyuria (presence of white blood cells in urine), suggestive of infection.

When should a urine culture be requested?

If a UTI is suspected and symptoms persist or if the patient has risk factors for multidrug-resistant organisms.

What is the first-line treatment for uncomplicated UTI?

Nitrofurantoin, trimethoprim-sulfamethoxazole, or fosfomycin.

What is the recommended management for cystitis in pregnant women?

Cefpodoxime or amoxicillin-clavulanate may be used; trimethoprim-sulfamethoxazole should be avoided in certain trimesters.

What symptoms indicate a potential diagnosis of pyelonephritis?

Fever, chills, flank pain, costovertebral angle tenderness, and abdominal guarding.

What is the usual pathogen for pyelonephritis?

E. coli (75-90% of cases).

What is the primary management for patients suspected of pyelonephritis?

Obtain a urine culture and sensitivities before starting antibiotics.

What are some risk factors for developing kidney stones?

High calcium, high oxalate levels, low urine volume, family history, and certain medications.

What is hematuria?

Blood in urine, either microscopic or visible to the naked eye.

What kind of imaging tests may be used for kidney stones?

CT abdomen/pelvis, ultrasound, or radiography.

What are common types of kidney stones?

Calcium oxalate, calcium phosphate, uric acid, cystine, and struvite.

What should be done if hematuria is detected?

Perform a thorough history and physical exam, including potential imaging.

What is the risk factor for hematuria associated with renal issues?

Hematuria can be a sign of conditions like renal malignancies or infection.

How is acute bacterial prostatitis diagnosed?

By examining the prostate for firmness, tenderness, and in conjunction with urinalysis findings.

What treatment options are available for acute bacterial prostatitis?

Ciprofloxacin, levofloxacin, or trimethoprim-sulfamethoxazole, depending on STI risk.

What is the recommended approach for managing recurrent uncomplicated cystitis?

Change behaviors, increase fluid intake, and consider non-antibiotic options.

What might indicate the need for urology referral in managing cystitis?

Persistent symptoms despite antibiotic treatment.

When is it appropriate to treat asymptomatic bacteriuria?

In pregnant individuals or before certain urologic procedures.

What are some dietary recommendations to prevent UTIs?

Increase fluid intake, avoid bladder irritants, and do not postpone urination.

What are potential complications of untreated pyelonephritis in pregnancy?

Septic shock and acute respiratory distress syndrome.

What are the symptoms of interstitial cystitis?

Chronic bladder pain that is relieved by urination, with urinary frequency and urgency.

What is the main treatment goal for interstitial cystitis?

Symptomatic relief to improve quality of life.

What indications suggest further evaluation of hematuria?

Persistent hematuria or the presence of risk factors for cancer.

What urine pH level could indicate certain types of kidney stones?

A low urine pH (acidic) is commonly associated with uric acid stones.

In what situations should urine cultures be repeated?

If symptoms return after treatment or if hematuria persists.

What might cause a false positive for hematuria on a urine dipstick?

Menstruation, vigorous exercise, or contamination.

What might management look like for patients with recurrent acute prostatitis?

Close follow-up and possibly referral to urology for further evaluation.

What might leukocyturia indicate on a urinalysis?

Possible urinary tract infection or related condition.

What are some behavioral factors that can increase UTI risk?

Sexual activity without post-intercourse urination, use of spermicides, and diaphragms.

What drugs may affect urinary color and indicate potential infection or pathology?

Phenazopyridine can turn urine red or orange.

What is the recommended action when a gross hematuria is present with signs of obstruction?

Immediate evaluation and imaging to identify potential causes.

What types of urinary symptoms might accompany acute bacterial prostatitis?

Dysuria, urgency, frequency, and pelvic or perineal pain.

What differentiates gross from microscopic hematuria?

Gross hematuria is visible to the naked eye; microscopic requires examination.

What should be considered in differential diagnoses of hematuria?

UTI, glomerular disease, nephrolithiasis, and malignancy.

What urine test confirms the presence of WBCs in urine?

A urinalysis showing positivity for leukocyte esterase.

What substances can be found in urine crystals?

Small ions and molecules precipitate to form organized structures.

What can the presence of dysmorphic red blood cells suggest?

Possible underlying glomerular disease.

Which types of bacteria are less common in causing urinary tract infections?

Gram-positive bacteria such as Staphylococcus saprophyticus.

What is the recommended follow-up for patients treated for UTIs?

Re-evaluate if symptoms persist, especially within 2 weeks after treatment.