Author Question: A 77-year-old female patient with heart failure complains of frequency and urgency of urination ... (Read 147 times)

dmcintosh

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A 77-year-old female patient with heart failure complains of frequency and urgency of urination during the day and nocturia of 2 to 3 times a night. Which of the following medications can cause these symptoms?
 
  A. Beta adrenergic blocker
  B. Diuretic
  C. ACE inhibitor
  D. Digitalis

Question 2

Your 24-year-old female patient complains of dysuria as well as frequency and urgency of urination that develops the day after she uses her diaphragm. Urine culture reveals a bacterial count of 100 CFU/mL. These signs and symptoms indicate:
 
  A. Upper urinary tract infection
  B. Lower urinary tract infection
  C. Normal bacteriuria
  D. Urethritis



harveenkau8139

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Answer to Question 1

ANS: B
A patient may complain of frequency that she or he associates with a particular medication. Alternatively, this association may not be clear until a complete list of the patient's medications is available. Signs and symptoms are primarily frequency and urgency, both of which may be complicated by coexisting GU conditions, such as BPH, some type of incontinence, or mobility issues. A review of a patient's medications and administration schedule should be sufficient to determine that a diuretic is a contributing cause. Consider urinalysis to rule out a UTI.

Answer to Question 2

ANS: B
In women whose symptoms suggest uncomplicated UTI, a culture of greater than 102 CFU/mL of a specific bacterium is indicative of cystitis. However, this CFU number is controversial. Infectious disease specialists recommend use of 103 CFU / mL as diagnostic of UTI. In the past, a bacterial count of 105 CFU/mL was regarded as significant for UTI. UTI diagnosis relies on the patient's subjective report of symptoms of UTI, not only the number of bacteria. Patients with asymptomatic bacteriuria can have bacterial counts as high as 10 5 CFU/mL. Asymptomatic bacteriuria is not treated. Risk factors for the development of a UTI include increasing age, recent sexual intercourse, a history of UTI, use of a diaphragm or cervical cap, and anatomic abnormalities.



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