You have a patient that might have a urinary tract infection (UTI). Which statement by the patient suggests that a UTI is likely?
A. “I pee a lot.”
B. “It burns when I pee.”
C. “I go hours without the urge to pee.”
D. “My pee smells sweet.”
Correct Answer: B. “It burns when I pee.”
A common symptom of a UTI is dysuria. A patient with a UTI often reports frequent voiding of small amounts and the urgency to void. Symptoms of uncomplicated UTI are pain on urination (dysuria), frequent urination (frequency), inability to start the urine stream (hesitation), sudden onset of the need to urinate (urgency), and blood in the urine (hematuria). Usually, patients with uncomplicated UTI do not have fever, chills, nausea, vomiting, or back pain, which are signs of kidney involvement or upper tract disease/pyelonephritis.
Option A: High amounts of solutes within the renal tubules cause a passive osmotic diuresis (solute diuresis) and thus an increase in urine volume. The classic example of this process is the glucose-induced osmotic diuresis in uncontrolled diabetes mellitus, when high urinary glucose levels (> 250 mg/dL [13.88 mmol/L]) exceed tubular reabsorption capacity, leading to high glucose levels in the renal tubules; water follows passively, resulting in glucosuria and increased urine volume.
Option C: Oliguria can be the result of various causes that can be apparent or subclinical. Oliguria can arise as a result of the normal physiological response of the body or due to an underlying pathology affecting the kidney or urinary tract. The most common prerenal cause is reduced blood flow to the kidney secondary to intravascular volume depletion, heart failure, sepsis, or as a side effect of medication.
Option D: Urine that smells sweet is often associated with diabetic ketoacidosis. Commonly accepted criteria for diabetic ketoacidosis are blood glucose greater than 250 mg/dl, arterial pH less than 7.3, serum bicarbonate less than 15 mEq/l, and the presence of ketonemia or ketonuria.
No comments:
Post a Comment