Week 6 – Genitourinary (GU)
The provider is counseling a patient who has stress incontinence about ways to minimize accidents.
What will the provider suggest initially?
Voiding every 2 hours during the day
A pregnant woman at 30 weeks gestation has proteinuria. What will the provider do next?
Evaluate her blood pressure
The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid
residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result?
This is a normal result.
A patient's recent blood work indicates acute kidney injury. You know that acute kidney injury can be
caused from:
Heart failure exacerbation
GERD
Increase in metoprolol dose
atrial fibrillation
Heart failure exacerbation and cause decreased perfusion to the kidneys, leading to acute
kidney injury. Changes in medications or nephrotoxic can cause acute kidney injury,
metoprolol is not one of them. While patients with atrial fibrillation can have decreased
cardiac output, it is often compensated to preserve renal perfusion
A male patient complaints of dysuria. His urinalysis is positive for nitrates, leukocytes, and bacteria.
What medication should be given and for how many days?
Trimethoprim-sulfamethoxazole for 7-10 days
First line treatment is similar to females which include TMP/SMX, nitrofurantoin, fosfomycin.
The correct length of treatment is only in TMP/SMX in the possible answer choices.
A patient who has diabetes has symptoms consistent with renal stones. Which type of stone is most
likely in this patient?
Uric acid
, A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick
during a well patient exam. What type of urinary tract infection does this represent?
Uncomplicated
Unresoved
Complicated
Isolation
An older male patient reports gross hematuria but denies flank pain and fever. What will the
provider do to manage this patient?
Perform a 24-hour urine collection
Refer for cystoscopy and imaging
Monitor blood pressure closely
Obtain a urine culture
A 16-year-old female patient is being treated for her first UTI. She had an allergic reaction with
hives after taking sulfa as a child. Which of the following antibiotics would be contraindicated?
Trimethoprim-sulfamethoxazole
A female patient with the complaint of dysuria has a urine specimen that is positive for leukocytes and
nitrates. There is blood in the specimen. The most appropriate diagnosis is:
UTI with hematuria
The presence of leukocytes and nitrates in the urine indicates likely infection in the bladder,
and more likely from a gram-negative pathogen such as Escherichia coli. The presence of
blood is common when patient's has a UTI. A diagnosis of chlamydia cannot be made based
on the symptoms and urinalysis results.
An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of
the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric
reflex. What is the most important intervention?
Immediate referral to the emergency department
Transillumination to assess for a “blue dot” sign
Prescribing anti-infective agents to treat the infection
Doppler ultrasound to assess testicular blood flow
A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract
infection. After treatment for the UTI, what testing is indicated for this patient?
The provider is counseling a patient who has stress incontinence about ways to minimize accidents.
What will the provider suggest initially?
Voiding every 2 hours during the day
A pregnant woman at 30 weeks gestation has proteinuria. What will the provider do next?
Evaluate her blood pressure
The provider is evaluating a patient for potential causes of urinary incontinence and performs a postvoid
residual (PVR) test which yields 30 mL of urine. What is the interpretation of this result?
This is a normal result.
A patient's recent blood work indicates acute kidney injury. You know that acute kidney injury can be
caused from:
Heart failure exacerbation
GERD
Increase in metoprolol dose
atrial fibrillation
Heart failure exacerbation and cause decreased perfusion to the kidneys, leading to acute
kidney injury. Changes in medications or nephrotoxic can cause acute kidney injury,
metoprolol is not one of them. While patients with atrial fibrillation can have decreased
cardiac output, it is often compensated to preserve renal perfusion
A male patient complaints of dysuria. His urinalysis is positive for nitrates, leukocytes, and bacteria.
What medication should be given and for how many days?
Trimethoprim-sulfamethoxazole for 7-10 days
First line treatment is similar to females which include TMP/SMX, nitrofurantoin, fosfomycin.
The correct length of treatment is only in TMP/SMX in the possible answer choices.
A patient who has diabetes has symptoms consistent with renal stones. Which type of stone is most
likely in this patient?
Uric acid
, A 30-year-old male patient has a positive leukocyte esterase and nitrites on a random urine dipstick
during a well patient exam. What type of urinary tract infection does this represent?
Uncomplicated
Unresoved
Complicated
Isolation
An older male patient reports gross hematuria but denies flank pain and fever. What will the
provider do to manage this patient?
Perform a 24-hour urine collection
Refer for cystoscopy and imaging
Monitor blood pressure closely
Obtain a urine culture
A 16-year-old female patient is being treated for her first UTI. She had an allergic reaction with
hives after taking sulfa as a child. Which of the following antibiotics would be contraindicated?
Trimethoprim-sulfamethoxazole
A female patient with the complaint of dysuria has a urine specimen that is positive for leukocytes and
nitrates. There is blood in the specimen. The most appropriate diagnosis is:
UTI with hematuria
The presence of leukocytes and nitrates in the urine indicates likely infection in the bladder,
and more likely from a gram-negative pathogen such as Escherichia coli. The presence of
blood is common when patient's has a UTI. A diagnosis of chlamydia cannot be made based
on the symptoms and urinalysis results.
An adolescent male reports severe pain in one testicle. The examiner notes edema and erythema of
the scrotum on that side with a swollen, tender spermatic cord and absence of the cremasteric
reflex. What is the most important intervention?
Immediate referral to the emergency department
Transillumination to assess for a “blue dot” sign
Prescribing anti-infective agents to treat the infection
Doppler ultrasound to assess testicular blood flow
A female patient reports hematuria and a urine dipstick and culture indicate a urinary tract
infection. After treatment for the UTI, what testing is indicated for this patient?
