CMN 568 Unit 4 Exam Questions and Answers | Verified & Updated 2024

CMN 568 Unit 4 Exam Questions and Answers | Verified & Updated 2024 Acute Cystitis - Definition - Answer ️️ -Infection of the bladder commonly due to coliform bacteria (e coli) and gram positive (enterococci) Acute cystitis symtoms - Answer ️️ -irritative voiding suprapubic discomfort hematuria Acute cystitis signs - Answer ️️ -UA - pyuria, bacteriuria, hematuria Acute cystitis treatment - Answer ️️ -Uncomplicated in women: cephalexin, nitrofurantoin, trimethoprim-sulfamethaxazole Restrictive use of fluoroquinolone Refer if - radiographic abnormality evidence of urolithiasis or recurrent cystitis due to bacterial persistence. Acute pyelonephritis - definition - Answer ️️ -Infectious inflammatory disease of the kidney parenchyma and renal pelvis. Gram negative bacterial most causative agents - e coli, proteus, klebsiella, enterobacter, pseudomonas Acute pyelonephritis - symptoms - Answer ️️ -fever, flank pain, shaking chills, irritative voiding symptoms Acute pyelonephritis - signs - Answer ️️ -CBC- leukocytosis and a left shift UA - pyuria, bacteriuria, hematuria White cell casts Renal ultrasound may show hydronephrosis differentials include acute cystitis or a lower urinary source Acute pyelonephritis - treatment - Answer ️️ -Outpatient setting empiric therapy - ampcilillin, ciprofloxacin, levofloxacin, trimethoprim-sulfamethaxazole CT or Ultrasound Catheter or nephrostomy drain refer - complications, urolithiasis, obstruction Admit for parenteral antibiotics, complicating factors, sepsis Urinary stone disease- patients - Answer ️️ -Exceeded in frequency as a urinary tract disorder by infections and prostatic disease White men more frequently affected Urinary stone disease - types - Answer ️️ -Five major types of urinary stones: calcium oxalate, calcium phosphate, struvite, uric acid, and cyctine Most common types are composed of calcium Geographic factors contribute to the development of stones Areas of high humidity and elevated temps are contributing factors Urinary stone disease - risk factors - Answer ️️ -Sedentary lifestyles have higher incidence Higher rates of hypertension, carotid calcification, and CV disease High protein, salt intake, inadequate hydration appear most important factors Sodium intake should be restricted to keep urinary sodium levels less than 150 meq/day Urinary stone disease-signs and symptoms - Answer ️️ -Pain may occur episodically and radiate anteriorly over the abdomen Nausea and vomiting ID on non contrast CT or ultrasound Obstructing urinary stone are usually present with acute or severe colic severe flank pain Urinary pH is valuable clue to the cause Dietary counseling Urinary incontinence - Types - Answer ️️ -urge, stress, transient, overflow, functional Urge incontinence - Answer ️️ -Most common cause of persistent incontinence in the elderly, involuntary leakage Stress incontinence - Answer ️️ -Present when involuntary leakage occur from effort or exertion or from sneezing or coughing Transient incontinence - Answer ️️ -Incontinence less than 6 weeks spontaneously resolves when the underlying condition is treated Overflow incontinence - Answer ️️ -Prevalence of prostate disorders, incontinence in older men. Caused by obstruction of urinary outflow. Dribbling is a symptom Functional Incontinence - Answer ️️ -Inability or willingness to toilet because of physical, cognitive, psychological, or environmental factors. Common in hospital and nursing home patients. Abdominal pain - Answer ️️ -One of most frequent complaints in primary care Most patients have minor non-surgical causes History of ABD pain is Important - Answer ️️ -Onset: sudden, gradual Location: where, radiation? Duration: chronic >2 weeks Character: Sharp, well localized, dull, diffuse, burning, knawing, crampy, colicky. Aggravating factors: Makes pain worse, food, movement, position Relieving factors: makes pain better, position, antacids, food, defecation or urination Timing: Constant or intermittent, certain times of day, related to meals or school Associated symptoms: Fever, vomiting, diarrhea, anorexia, hematemesis or melena, constipation, amenorrhea, dysuria, jaundice ALWAYS document LMP! IBD - Answer ️️ -inflammatory bowel disease (Chron disease and ulcerative colitis) IBS - Answer ️️ -irritable bowel syndrome Past medical history related to ABD pain