Dysuria resident survival guide: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
Shown below is two algorithms summarizing the diagnosis of Dysuria | *Shown below is two algorithms summarizing the diagnosis of Dysuria | ||
Algorithm showing diagnosis of dysuria in woman | *Algorithm showing diagnosis of dysuria in woman | ||
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{{Family tree |C03| | | | | | |C04|C03= Yes|C04=No| }} | {{Family tree |C03| | | | | | |C04|C03= Yes|C04=No| }} | ||
{{Family tree | |!| | | | | | | | |!| }} | {{Family tree | |!| | | | | | | | |!| }} | ||
{{Family tree |D04| | | | | | | |R08|D04=Refer to ER|R08=Urine Dipstick for Nitrites and Leukocytes| }} | {{Family tree |D04| | | | | | | |R08|D04=Refer the patient to ER|R08=Urine Dipstick for Nitrites and Leukocytes| }} | ||
{{Family tree | | | | | | | | | | |!| }} | {{Family tree | | | | | | | | | | |!| }} | ||
{{Family tree | | | | | | | | | | |!| | | | | | | | | | | | |}} | {{Family tree | | | | | | | | | | |!| | | | | | | | | | | | |}} | ||
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{{Family tree | | | | | | | |!| | | | |!| | | | | | | | | |!| | |}} | {{Family tree | | | | | | | |!| | | | |!| | | | | | | | | |!| | |}} | ||
{{Family tree | | | | | | | |!| | | | |!| | | | | | | | | |!| | |}} | {{Family tree | | | | | | | |!| | | | |!| | | | | | | | | |!| | |}} | ||
{{Family tree | | | | | | | |R09| | |!| | | | | | | | | |!|R09=Specific Antibiotic}} | {{Family tree | | | | | | | |R09| | |!| | | | | | | | | |!|R09=Treat with Specific Antibiotic}} | ||
{{Family tree | | | | | | | | | | | | |!| | | | | | | |,|-|^|-|-|-|.| | |}} | {{Family tree | | | | | | | | | | | | |!| | | | | | | |,|-|^|-|-|-|.| | |}} | ||
{{Family tree | | | | | | | | | | | | |!| | | | | | | |o09| | | |p09| | | |o09=Postive|p09=Negative}} | {{Family tree | | | | | | | | | | | | |!| | | | | | | |o09| | | |p09| | | |o09=Postive|p09=Negative}} | ||
{{Family tree | | | | | | | |,|-|-|-|-|^|-|-|-|.| | | | |!| | | | | |!}} | {{Family tree | | | | | | | |,|-|-|-|-|^|-|-|-|.| | | | |!| | | | | |!}} | ||
{{Family tree | | | | | | | |P08| | | | | | |O08| | |p09| | | |!|P08=Urethral discharge/Itching|O08=Acid urine pH/history of | {{Family tree | | | | | | | |P08| | | | | | |O08| | |p09| | | |!|P08= Presence of any Urethral discharge/Itching|O08=Acid urine pH/history of Tuberculosis|p09= Treat with Specific antibiotic}} | ||
{{Family tree | | | | | | | |!| | | | | | | | |!| | | | | | | | | | |!|}} | {{Family tree | | | | | | | |!| | | | | | | | |!| | | | | | | | | | |!|}} | ||
{{Family tree | | | | | | | |!| | | | | | | | |!| | | | | | | | | | |!|}} | {{Family tree | | | | | | | |!| | | | | | | | |!| | | | | | | | | | |!|}} | ||
{{Family tree | | | | | | | |R09| | | | |P09| | | | | | | | | | |i09|i09=Think of non-infectious urogenital disease or vulvo-vaginal disease|R09=Swab|P09=Urine speicific test for Tuberculosis}} | {{Family tree | | | | | | | |R09| | | | |P09| | | | | | | | | | |i09|i09=Think of any other non-infectious urogenital disease or vulvo-vaginal disease|R09=Do Swab test|P09=Urine speicific test for Tuberculosis}} | ||
{{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | |!| | |}} | {{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | |!| | |}} | ||
{{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | |p09| | |p09=Refer to urologist/gynaecologist}} | {{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | |p09| | |p09=Refer the patient to urologist/gynaecologist}} | ||
{{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | |}} | {{Family tree | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | |}} | ||
{{Family tree | | | | | | | |p09| | | | | | | | | | | | | | | | | | | | | |p09=Urethritis(Chlamydia trachomatis,Neisseria gonorrhoeae or HErpes simplex virus)}} | {{Family tree | | | | | | | |p09| | | | | | | | | | | | | | | | | | | | | |p09=Urethritis(Chlamydia trachomatis,Neisseria gonorrhoeae or HErpes simplex virus)}} | ||
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Yellowish green colour|E06=Thin,mucoid/mucopurulent discharge| }} | Yellowish green colour|E06=Thin,mucoid/mucopurulent discharge| }} | ||
{{Family tree |!| | | | |!| | | | |!| | | | | | | | | | | |!}} | {{Family tree |!| | | | |!| | | | |!| | | | | | | | | | | |!}} | ||
{{Family tree |F05| |F06| | | |!| | | | | | | | | | | |!|F05= | {{Family tree |F05| |F06| | | |!| | | | | | | | | | | |!|F05=Swab test |F06=Swab test }} | ||
{{Family tree | |!| | | | |!| | | |!| | | | | | | | | | | |!}} | {{Family tree | |!| | | | |!| | | |!| | | | | | | | | | | |!}} | ||
{{Family tree | |G07| |G08| | |!| | | | | | | | | | | |!|G07= | {{Family tree | |G07| |G08| | |!| | | | | | | | | | | |!|G07=Gram negative Diplococci|G08=NAAT/PCR test }} | ||
{{Family tree | |!| | | | |!| | | |!| | | | | | | | | | | |!|}} | {{Family tree | |!| | | | |!| | | |!| | | | | | | | | | | |!|}} | ||
{{Family tree | |H08| | |H09| |!| | | | | | | | | | | |!|H08= | {{Family tree | |H08| | |H09| |!| | | | | | | | | | | |!|H08=Gonorrhoea|H09=Chlamydia}} | ||
{{Family tree | | | | | | | | | | |!| | | | | | | | | | | |!|}} | {{Family tree | | | | | | | | | | |!| | | | | | | | | | | |!|}} | ||
{{Family tree | | | | | | | | | | |!| | | | | | | | | | | |!|}} | {{Family tree | | | | | | | | | | |!| | | | | | | | | | | |!|}} | ||
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{{Family tree | | | |!| | | | | | |!| | | | | | | |!| | | |!| | | | | | |}} | {{Family tree | | | |!| | | | | | |!| | | | | | | |!| | | |!| | | | | | |}} | ||
{{Family tree | | | |!| | | | | | |!| | | | | | | |!| | | |!| | | | | | |}} | {{Family tree | | | |!| | | | | | |!| | | | | | | |!| | | |!| | | | | | |}} | ||
{{Family tree | | | |R09| | | |T09| | | | | |P09| | |!| | | | | | | |R09=Inflammation of the glans|T09=Ulcer|P09=Painful Vesicles| }} | {{Family tree | | | |R09| | | |T09| | | | | |P09| | |!| | | | | | | |R09=Inflammation of the glans penis|T09=Ulcer|P09=Painful Vesicles| }} | ||
{{Family tree | | | | |!| | | | | |!| | | | | | | | |!| | |!| | | | | | | | | | | | |}} | {{Family tree | | | | |!| | | | | |!| | | | | | | | |!| | |!| | | | | | | | | | | | |}} | ||
{{Family tree | | | | |!| | | | | |!| | | | | | | | |!| | |!| | | | | | | | | | | | | |}} | {{Family tree | | | | |!| | | | | |!| | | | | | | | |!| | |!| | | | | | | | | | | | | |}} | ||
{{Family tree | | | |R09| | |,|-|^|-|-|.| | | | |U09| |!| | |R09=Balanitis|U09=Herpes| | | | | | | | | |}} | {{Family tree | | | |R09| | |,|-|^|-|-|.| | | | |U09| |!| | |R09=Balanitis|U09=Herpes| | | | | | | | | |}} | ||
{{Family tree | | | | | | | |P08| | |O08| | | | | | | |!|P08= | {{Family tree | | | | | | | |P08| | |O08| | | | | | | |!|P08=a firm, painless, non-itchy skin ulceration with multiple sores OR a diffuse rash involving the palms of the hands and soles of the feet OR presence of gummas|O08= Painless genital ulcer,anorectal pain, tenesmus, and rectal discharge,inguinal lymphadenopathy| | | | | | | | | |}} | ||
{{Family tree | | | | | | | |!| | | | | |!| | | | | | | | |!| | |}} | {{Family tree | | | | | | | |!| | | | | |!| | | | | | | | |!| | |}} | ||
{{Family tree | | | | | | | |!| | | | | |!| | | | | | | | |!| | |}} | {{Family tree | | | | | | | |!| | | | | |!| | | | | | | | |!| | |}} | ||
{{Family tree | | | | | | | |R09| | | |P09| | | | | | |!|R09=Syphilis|P09=LGV}} | {{Family tree | | | | | | | |R09| | | |P09| | | | | | |!|R09=Syphilis|P09=Lymphogranuloma venereum (LGV) }} | ||
{{Family tree | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | }} | {{Family tree | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | }} | ||
{{Family tree | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | |}} | {{Family tree | | | | | | | | | | | | | | | | | | | | | | |!| | | | | | | | | |}} |
Revision as of 11:19, 13 August 2020
Dysuria Resident Survival Guide |
---|
Overview |
Causes |
Diagnosis |
Treatment |
Do's |
Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Iqra Qamar M.D.[2] Rinky Agnes Botleroo, M.B.B.S.
Overview
This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.
Causes
Life Threatening Causes
Life-threatening causes of dysuria include
These conditions may result in death or permanent disability within 24 hours if left untreated
Common Causes
- Acute Cystitis
- Urethritis from sexually transmitted infections
- Female genital structure related
- Male genital Structure related
- Foreign Body in urinary tract
- Indwelling Foley catheter
- Stone
- Urethral or ureteral stent
- Pyelonephritis
- Urethral Stricture
- Dermatological
- Local trauma
- Medication use
- Neoplasia
Diagnosis
- Shown below is two algorithms summarizing the diagnosis of Dysuria
- Algorithm showing diagnosis of dysuria in woman
Woman with dysuria | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Take complete history | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Presence of Comcomitant fever,flank pain, abnormal vital signs(Tachycardia,Tachypnea,Hypotension),nausea,vomiting | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Refer the patient to ER | Urine Dipstick for Nitrites and Leukocytes | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nitrite Postitive | Leukocytes positive,Nitrite negative | Both Nitrite and Leukocyte negative | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Urine culture | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Empirical Antibiotic Therapy | Urine Culture | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Positive | Negative | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treat with Specific Antibiotic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Postive | Negative | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Presence of any Urethral discharge/Itching | Acid urine pH/history of Tuberculosis | Treat with Specific antibiotic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Do Swab test | Urine speicific test for Tuberculosis | Think of any other non-infectious urogenital disease or vulvo-vaginal disease | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Refer the patient to urologist/gynaecologist | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Urethritis(Chlamydia trachomatis,Neisseria gonorrhoeae or HErpes simplex virus) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Male patient with dysuria | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Take complete history | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Presence of urethral discharge | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Ask about the discharge | Presence Of Genital Lesion | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
YES | NO | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Profuse,purulent discharge Yellowish green colour | Thin,mucoid/mucopurulent discharge | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Swab test | Swab test | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gram negative Diplococci | NAAT/PCR test | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Gonorrhoea | Chlamydia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Inflammation of the glans penis | Ulcer | Painful Vesicles | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Balanitis | Herpes | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
a firm, painless, non-itchy skin ulceration with multiple sores OR a diffuse rash involving the palms of the hands and soles of the feet OR presence of gummas | Painless genital ulcer,anorectal pain, tenesmus, and rectal discharge,inguinal lymphadenopathy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Syphilis | Lymphogranuloma venereum (LGV) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Any Localized Pain | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
YES | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Suprapubic pain | Flank pain Costovertebral angle tenderness Fever | Joint pain | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Urine Analysis | USG | Dx test | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cystitis | Spondyloarthropathy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.