Symptomatology of genito urinary system
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This document discusses symptoms related to diseases of the genitourinary system. It describes various types of pain that can occur due to conditions like obstruction, infection, or tumors in the kidneys, ureters, bladder, or urethra. It also discusses micturition abnormalities, hematuria, discharge from the genitals, and general symptoms seen in nephrology. Several case studies are presented to demonstrate how symptoms can localize diseases.
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Symptomatology of genito urinary system
- 1. Symptomatology of Genitourinary System Dept. of Medicine Introductory Lecture Series III Term
- 2. Learning Objectives • Learn definitions of some specific terms associated with genitourinary system • Learn to localize disease from symptoms related to genitourinary disease
- 4. Symptoms- 1. Pain • Obstruction- stricture, calculus • Infection • Tumour
- 5. Symptoms- 1. Pain • Obstruction- stricture, calculus • Infection • Tumour • Immunological injury • Trauma
- 6. Symptoms- 1. Pain Organ Site Upper UT Renal Flank/ Loin Ureter Loin to Groin
- 7. Symptoms- 1. Pain Organ Site Upper UT Renal Flank/ Loin Ureter Loin to Groin Lower UT Bladder Supra-Pubic Urethra Urethral
- 10. Pain related terms with localisation • Loin Pain: Acute and Chronic
- 11. Pain related terms with localisation • Loin Pain: Acute and Chronic • Colics: Renal, Ureteral, Urethral
- 12. Ureteric Colic
- 13. Loin to Groin
- 14. Pain related terms with localisation • Loin Pain: Acute and Chronic • Colics: Renal, Ureteral, Urethral • Dysuria: Burning pain before, during or after
- 15. Dysuria
- 16. Suprapubic Pain
- 17. Pain related terms with localisation • Loin Pain: Acute and Chronic • Colics: Renal, Ureteral, Urethral • Dysuria: Burning pain before, during or after • Strangury: Extreme pain when bladder is empty
- 18. Strangury
- 19. 2. Micturition Abnormalities • Urgency: Inability to postpone
- 20. 2. Micturition Abnormalities • Urgency: Inability to postpone • Frequency: Increased number of times
- 21. 2. Micturition Abnormalities • Urgency: Inability to postpone • Frequency: Increased number of times • Polyuria: Above + increased volume
- 22. 2. Micturition Abnormalities • Urgency: Inability to postpone • Frequency: Increased number of times • Polyuria: Above + increased volume • Oliguria: Reduced volume (<500 ml)
- 23. 2. Micturition Abnormalities • Urgency: Inability to postpone • Frequency: Increased number of times • Polyuria: Above + increased volume • Oliguria: Reduced volume (<500 ml) • Anuria: No urine production
- 24. Urgency
- 25. Frequency
- 26. Men too!
- 27. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow
- 28. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow • Slow Stream: Decreased flow
- 29. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow • Slow Stream: Decreased flow • Hesitancy: Difficulty in initiating
- 30. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow • Slow Stream: Decreased flow • Hesitancy: Difficulty in initiating • Precipitancy: Inability to stop midway
- 31. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow • Slow Stream: Decreased flow • Hesitancy: Difficulty in initiating • Precipitancy: Inability to stop midway • Dribbling : Leak of small amounts after
- 32. 2. …Micturition Abnormalities • Retention: Inability to pass/ No urine flow • Slow Stream: Decreased flow • Hesitancy: Difficulty in initiating • Precipitancy: Inability to stop midway • Dribbling : Leak of small amounts after • Incontinence: Involuntary passage of urine – Stress Incontinence – Urge Incontinence
- 33. Precipitancy
- 34. Dribbling
- 37. 2. …Micturition Abnormalities • Nocturia -During the night • Enuresis –During sleep
- 38. Enuresis
- 39. 3. Urethral Discharge, Blistering and Ulceration • In Males • Infection (Urethritis, genital Herpes, Syphilis, Gonorrhea) • Females?
- 41. 4. Hematuria Definition: More than three RBCs in centrifuged urine per high-power field on microscopy ( > 3 RBC/HPF) Normal urine: No red blood cell or less than 3RBCs/ HPF
- 42. 4. Hematuria
- 43. Types of Hematuria • Microscopic Hematuria: normal colour on naked- eye examination • Gross Hematuria: tea/ cola-colored, pink/red
- 44. Hematuria
- 45. Types of Hematuria • Continuous • Intermittent
- 46. Types of Hematuria • Painful • Painless
- 47. Hematuria with Associated Symptoms • Hematuria with renal colic: renal calculus or ureteric calculus
- 48. Hematuria with Associated Symptoms • Hematuria with renal colic: renal calculus or ureteric calculus • With dysuria, straining to void and strangury: bladder or urethra stone
- 49. Hematuria with Associated Symptoms • Hematuria with renal colic: renal calculus or ureteric calculus • With dysuria, straining to void and strangury: bladder or urethra stone • Hematuria with urinary frequency, urgency and dysuria bladder or lower urinary tract infection or (tuberculosis or tumor)
- 50. Hematuria with Associated Symptoms • Hematuria with renal colic: renal calculus or ureteric calculus • With dysuria, straining to void and strangury: bladder or urethra stone • Hematuria with urinary frequency, urgency and dysuria bladder or lower urinary tract infection or (tuberculosis or tumor) • If accompanied by high fever, chills and loin pain: pyelonephritis
- 51. Hematuria Associations • Hematuria with edema and hypertension glomerulonephritis hypertensive nephropathy
- 52. Hematuria Associations • Hematuria with edema and hypertension glomerulonephritis hypertensive nephropathy • Hematuria with mass in the kidney neoplasm hereditary polycystic kidney
- 53. Hematuria Associations • Hematuria with edema and hypertension glomerulonephritis hypertensive nephropathy • Hematuria with mass in the kidney neoplasm hereditary polycystic kidney • Hematuria with hemorrhage in skin and mucosa hematological disorders infectious diseases
- 54. Hematuria Associations • Hematuria with edema and hypertension glomerulonephritis hypertensive nephropathy • Hematuria with mass in the kidney neoplasm hereditary polycystic kidney • Hematuria with hemorrhage in skin and mucosa hematological disorders infectious diseases • Hematuria with chyluria filariasis
- 55. Microscopy
- 56. Microscopy
- 57. Gross Hematuria
- 58. Sediment/ Clot
- 59. Mild & Uniform Hematuria
- 60. Smoky Urine
- 61. Normal Urine
- 62. Other Genitourinary Symptoms • Females: –Menstrual abnormalities –Vaginal Discharge –Fertility disturbances
- 63. Other Genitourinary Symptoms • Females: – Menstrual abnormalities – Vaginal Discharge – Fertility disturbances • Males – Impotence (erectile dysfunction) – Loss of libido (decreased interest) – Premature ejaculation (early seminal emission) – Retrograde ejaculation (reverse into bladder) – Fertility disturbances
- 64. General Symptoms in Nephrology • Fatigue and breathlessness
- 65. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting
- 66. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling
- 67. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling • Itching
- 68. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling • Itching • Easy bruising and bleeding
- 69. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling • Itching • Easy bruising and bleeding • Bone pains, fractures and tetany
- 70. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling • Itching • Easy bruising and bleeding • Bone pains, fractures and tetany • Headache sleep disturbances, altered consciousness and seizures
- 71. General Symptoms in Nephrology • Fatigue and breathlessness • Nausea & Vomiting • Peri- orbital and leg swelling • Itching • Easy bruising and bleeding • Bone pains, fractures and tetany • Headache sleep disturbances, altered consciousness and seizures • Chest pain (HT, Pericarditis, Lipid abnormalities)
- 72. Case 1: 24 year female, Newly Married • Fever and Pain lower abdomen • Burning while passing urine • Needing to go frequently to the toilet • Cannot wait once she feels like passing urine
- 73. Case 2: 22 year old soldier 2 days after unprotected sex • Pus like discharge from urethra • Burning pain while passing urine • Frequent visits to the toilet • Intense pain lower abdomen and in the urinary passage after urination
- 74. Case 3: 50 year old multipara
- 75. Case 3: 50 year old multipara • Distressed by the smell of urine accompanying her all the time • Does not go outdoors; Depressed • Passage of small amounts of urine during coughing, sneezing or lifting weights
- 76. 65 year old retired manager
- 77. 65 year old retired manager • Reduced stream of urine X 1 year • Difficulty in initial passing of urine once bladder is full • If he has to stop while passing, he cannot stop- ‘it all comes out’ • Had an episode of inability to pass urine requiring catheterization -1 month ago
- 78. 19 year old student • Pain in the right loin radiating to groin since last night • Blood in urine
- 79. 40 year old male • Backache & continuous pain left loin X 1 M • Painless, red colored urine last week- stopped on its own • Painless passage of blood today
- 80. 55 yr old male; After lifting a heavy weight • Backache since • weakness of lower limbs X 2 days • Pain lower abdomen and Inability to pass urine X 1 day • Leaking of urine almost all the time X 1 day • Fever with chills right now
- 81. 40 Y old executive, too much stress
- 83. Had a happy marriage until 6 months
- 84. No interest in physical relationship
- 85. Behind closed doors too..
- 86. 5 Y old child; sore throat 3 weeks ago • Swelling whole body, started around eyes X 4 • Reduced urine X 3 days • Pinkish opaque urine X 2 Days • No urine X 1 day • Drowsy • Breathless
- 87. 35 year old housewife • 6 months earlier had night time urination 3 to 4 times for few weeks • Reduced urine output X 2 months • Progressive breathlessness and fatigue X 1 month • Swelling of face and feet X 2 months • Cramps in hands and feet X 1 month