NR 601 wk 6 Genitourinary problems
Genitourinary problems Dysuria Subjective experience of pain or burning on urination Hematuria - Blood in urine; more than 3 RBC= direct relationship to quantity of blood and the probability of pathology - Two types (Transient: sometimes, Persistent: more often) - Differentials: trauma, cancer, coffee, chocoholic, alcohol, citrus, antibiotics, anticoagulation, - glomerulonephritis, urolithiasis, menses - Pathophysiology-depends on the cause Diagnostic tests - UA: Blood - Urine culture with sensitivities - Microscopic urine exam: if more than 3 RBC 3- explore hemoglobinuria 3- test for cause ANA, immunoglobulins, CMP Causes are varying Proteinuria - renal pathology, most often glomerular in origin - Due to illness, stress, exercise or benign - Can develop from overproduction of filterable plasma proteins, may be associated with multiple myeloma - If continues associated with pathology - Best test for this is 24 hour urine; 165mg is abnormal, 3.5 grams is nephrotic disease Differentials Benign or functional causes: orthostatic proteninuria, Bence jones protein- multiple myeloma Diagnostic tests - 24 hr urine; measure protein and Cr (if excretion rate 3-3.5g/d, pt has nephrotic syndrome) - Full Chemistry panel-FBS - LIPID PROFILE - Un/uc with ID and sensitivity - CBC WITH DIFF
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