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Is it acute or chronic? Acute onset of a cough would suggest an acute URI, viral pneumonia, or bronchopneumonia. A chronic cough is more suggestive of pneumoconiosis, chronic bronchitis, emphysema, bronchiectasis, tuberculosis, carcinoma of the lung ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Is there fever? A significant fever would suggest either pyelonephritis, particularly in females, or acute prostatitis in males.
Is the urine grossly bloody or are there a significant number of red cells on microscopic examination? ... DIAGNOSTIC WORKUP
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...
Is it transient? Migraine, asthma, and drugs such as diuretics may produce transient polyuria.
Is it massive? Massive polyuria is usually due to pituitary or nephrogenic diabetes insipidus and ... DIAGNOSTIC WORKUP
... READ EXCERPTS »
...
Are there significant numbers of white blood cells (WBCs) in the urine? This would suggest a UTI. If there are white cell casts or clumps, the infection may be a pyelonephritis. A urine culture and colony count should be ordered. ... DIAGNOSTIC WORKUP
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...
Are there significant RBCs in the urine? If so, one should consider glomerulonephritis, collagen disease, tuberculosis, neoplasm, trauma, renal calculus, and polycystic kidney disease. If not, the most likely etiology is a UTI. ... DIAGNOSTIC WORKUP
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...
Has the patient been on any drugs? Sulfonamides are notorious for causing renal failure, but one must also consider amphotericin B, gold compounds that might be administered in arthritis, and lead and other ... DIAGNOSTIC WORKUP
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...
Dysuria is a painful or burning sensation during or immediately after urination. This is a common symptom in primary care; nearly 20% of women aged 20–55 will have one episode of dysuria per year. Women have episodes of acute dysuria much more frequently than... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Polyuria is defined as urine output greater than 3 L per day. The output of a large volume of dilute urine leads to extracellular dehydration, which stimulates the thirst centers to influence the patient to increase fluid intake; thus, this condition may also lead to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Initial history of cough should include an assessment of the production of sputum. Additionally, associated history and physical findings, with particular attention to the quantity, quality, and circumstances surrounding coughing episodes and social details (such as history of... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Initial history of cough should include an assessment of the production of sputum, and the quantity, quality, and circumstances of the sputum production and coughing episodes. Additionally, associated history and physical findings, with particular attention to inciting factors... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
Dysuria is defined as pain with urination and is a very common complaint in female children. It is commonly due to either urinary tract infection or perineal irritation from a variety of causes.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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...
Proteinuria in children is defined as a quantitative 24-hour urine collection with >4 mg/m2/hour (>100 mg/m2/day) of protein. Semiquantitative definitions include urine dipstick ≥1+ (30 mg/dL) for specific gravity (SG) ≤1.015, or 2+ ... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Pyuria is defined as the presence of white blood cells in the urine. This condition is commonly caused by urinary tract infection, asymptomatic bacteriuria, or vaginal contamination of the urine specimen.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
...
A cough occurs by increased intrathoracic pressure against a closed glottis (Valsalva maneuver), followed by the abrupt opening of the glottis and a sudden expulsion of air. Increased intrathoracic pressure leads to dynamic compression of the airways. The effect of air flow at... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
In adults, “chronic” is often defined as more than 3 months of coughing in 2 years, but chronic cough is not as well defined in children. In general, for children, cough of more than 3–4 weeks’ duration will be brought to the attention of caregivers... Differential Diagnosis ... Workup and Diagnosis ... Treatment
... READ EXCERPTS »
... The differential diagnosis of cough is best developed with the use of anatomy. Cough may arise from an irritative focus anywhere along the respiratory tract. The irritation may be intrinsic, in which case it is usually inflammatory,
... READ EXCERPTS »
... Dysuria is difficult or painful micturition. One could cover most of the causes simply by considering the inflammatory lesions of the genitourinary tract in ascending order. Thus, there may be a urethritis or urethral carbuncle, a trigonitis
... READ EXCERPTS »
... Polyuria is an absolute increase in the urine output in a 24-hour period. The average individual excretes 1,500 mL of urine a day. Many physiologic conditions increase the output of urine (stress, exercise, and warm weather associated with copious drinking). From a
... READ EXCERPTS »
... There are many causes of proteinuria. The mnemonic VINDICATE is a helpful way of developing a list of possibilities.
PROTEINURIA
V—Vascular category should call to mind CHF,
... READ EXCERPTS »
... Pyuria is included here although it is not a symptom or a definitive finding on physical examination. Examination of the urine, however, is so frequently a part of every physical examination that the causes of pyuria should be available for immediate
... READ EXCERPTS »
...
ANURIA AND OLIGURIA
ANURIA AND OLIGURIA
Diminished output of urine (oliguria with less than 500 mL output in 24 hours) and no
... READ EXCERPTS »
... Incontinence may be due to loss of voluntary control of urination, in which case neurologic disorders are usually the cause, or it may result from overflow of a distended bladder (overflow incontinence), in which case the cause may be bladder neck obstruction or a flaccid neurogenic bladder.
... READ EXCERPTS »
... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious — possibly life-threatening — hemodynamic instability. Its... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or alcohol, and... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, frequency is a cardinal sign of urinary tract infection. However,... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
... READ EXCERPTS »
... Hesitancy — difficulty starting a urine stream generally followed by a decrease in the force of the stream — can result from a urinary tract infection, a partial lower urinary tract obstruction, a neuromuscular disorder, or use of certain drugs. Occurring at all ages... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of urine or scant... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate, accompanied by bladder pain, is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated, frequent voiding in an effort to... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI) but can also result from prolonged storage of a... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. It's most prevalent in the fall and may recur... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn't yield sputum or blood. It's one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Productive coughing is the body's mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn't remove. It's a sudden, forceful, noisy expulsion of air from the lungs that contains sputum, blood, or both. The sputum's color, consistency, and odor... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Acute
Viral upper respiratory infection
Pharyngitis
Rhinitis
Tracheobronchitis
... READ EXCERPTS »
... Central diabetes insipidus
Renal disease
Nephrogenic diabetes insipidus, congenital
Chronic renal insufficiency (especially
... READ EXCERPTS »
... Benign/Physiologic
Fever
Exercise
Orthostatic
Contrast dye
Usually Nonnephritic
Chronic pyelonephritis
Arteriolar
... READ EXCERPTS »
... Urethral
Congenital urethral stenosis, web, atresia
Posterior urethral valves
Inflammation or stricture
Trauma
... READ EXCERPTS »
... Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in females than in males and affect approximately 10% to 20% of all females at least once. Lower UTI is also a prevalent bacterial disease in children, with females again most... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Whooping cough, also known as pertussis, is a highly contagious respiratory infection usually caused by the nonmotile, gram-negative coccobacillus Bordetella pertussis and, occasionally, by the related similar bacteria B. parapertussis and ... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Dysuria—painful or difficult urination—is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI)—a common disorder, especially in women. (See ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious—possibly life-threatening—hemodynamic instability. Its causes can be... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Urinary frequency refers to an increased urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, urinary frequency is a cardinal sign of urinary tract infection (UTI). However, it can also... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
... READ EXCERPTS »
... Urinary hesitancy—difficulty starting a urine stream generally followed by a decrease in the force of the stream—can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder, or use... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of urine or... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate accompanied by bladder pain is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Frequent... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It’s characteristic of urinary tract infection (UTI), but it can also result from... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys and most prevalent in the fall;... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn’t yield sputum or blood. It’s one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that clears airway... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains sputum or blood (or both). The... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Désirée A. Lie
Cough is among the top 10 reasons for visits to family physicians in the United States. It accounts for 200 to 400 million episodes of illness per year. Three causal conditions increasing in frequency over the past... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... David M. Quillen
Approach Dysuria is defined as “painful urination.” Acute dysuria is a frequent problem seen in ambulatory practices, accounting for more than three million office visits a year. The most common diagnosis given for patients... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Irene M. Hamrick
The prevalence of proteinuria in the general population is 3%, and 5% in healthy adolescents (1). Heavy and persistent proteinuria is associated with the development of end-stage renal disease in patients with glomerular
... READ EXCERPTS »
... Richard Rathe
Urinary incontinence (UI) in adults is one of the most prevalent and underdiagnosed afflictions in the United States (>25 million effected individuals, >50% of nursing home residents). The economic impact is estimated to be more than16... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Marcia W. Funderburk
Oliguria and anuria are important clinical signs that should be recognized quickly so that the cause can be identified and treatment initiated promptly to preserve renal function and prevent life-threatening... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
... READ EXCERPTS »
... Differential Overview
❑ Lower urinary tract infection
❑ Acute pyelonephritis
❑ Urethritis
❑ Vaginitis
❑ Acute... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Differential Overview
❑ Urinary tract infection
❑ Diabetes mellitus
❑ Diuretic therapy
❑ Bladder outlet obstruction ... Diagnostic Approach ... Clinical Findings
... READ EXCERPTS »
... Differential Overview
❑ Diabetes
❑ Drugs/toxins
❑ Acute tubular necrosis
❑ Glomerulonephritis
&... Diagnostic Approach ... Clinical Findings
... READ EXCERPTS »
... Differential Overview
❑ Cystitis
❑ Benign prostatic hypertrophy
❑ Pelvic floor relaxation
❑ Drugs
❑ Prostatitis ... Diagnostic Approach ... Clinical Findings
... READ EXCERPTS »
... Differential Overview
❑ Acute tubular necrosis
❑ Prerenal azotemia
❑ Tubular toxins
❑ Bladder outlet obstruction
❑... Diagnostic Approach ... Clinical Findings
... READ EXCERPTS »
... Differential Overview
❑ Viral upper respiratory infection
❑ Asthma
❑ Sinusitis
❑ Mycoplasma bronchitis
❑ Pneumonia ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Differential Overview
❑ Upper respiratory infection
❑ Allergy
❑ Asthma
❑ Chronic bronchitis
❑ Chronic... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Cystitis and urethritis, the two forms of lower urinary tract infection (UTI), are nearly 10 times more common in women than in men and affect approximately 10% to 20% of all women at least once. Lower UTI is also a prevalent bacterial disease in children, with girls also... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys. It’s most... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains sputum, blood, or both. The sputum’s... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Dysuria (painful or difficult urination) is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI) — a common disorder, especially in women.
Dysuria... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious — possibly life-threatening — hemodynamic instability. Its causes can be... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It’s usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, urinary frequency is a cardinal sign of urinary tract infection (UTI). (See... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Urinary hesitancy — difficulty starting a urine stream generally followed by a decrease in the force of the stream — can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder, or use... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may involve large volumes of... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate, accompanied by bladder pain, is a classic symptom of urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small amounts of urine. Repeated, frequent voiding in an effort to... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. Croup syndrome is most common in boys and most prevalent in the fall; it may... History ... Physical assessment ... Medical causes ... Special considerations ... Patient counseling ... Pictures
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn’t yield sputum. It’s one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Productive coughing is the body’s mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn’t remove. It’s a sudden, forceful, noisy expulsion of air (from the lungs) that contains sputum or blood (or both).... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Definedas sound that occurs on sudden release of air under high pressure,which is generated by forceful contraction of expiratory musclesagainst a closed glottis. Clinical dilemma is to determine whethercoughing is associated with mild illness or more serious problem.... Principal Causes of Cough ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
...Dysuria (pain on urination) is usually producedby inflammation of urethra or bladder or both. Principal Causes of Dysuria Urinarytract infection Urethritis Cystitis Pyelonephritis Chemical irritation Diaper ... Clinical Features and Diagnosis ... Diagnostic Approach ... Table 15.1. Criteria for Diagnosis of Urinary Tract Infections ... References
... READ EXCERPTS »
... Proteinuriais a common finding in childhood and adolescence. Usual pathogenesis involves increasein permeability of glomerular basement membrane. Less common isdecreased absorption or increased secretion of protein by renaltubules, which may occur... Principal Causes of Proteinuria ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
... Urinaryincontinence or enuresis refers to the involuntary passage of urine. Most children have achieved urine continenceduring the day by 4 yrs of age, and during the night by 6 yrs ofage. Primary incontinence exists when achild has never... Principal Causes of Urinary Incontinence ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
...Polyuria (excessive urine volume) is usuallyassociated with polydipsia (excessive thirst). Principal Causes of Polyuria and Polydipsia Diabetesmellitus Diabetes insipidus Antidiuretichormone deficiency (central diabetes insipidus ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
... Dysuria—painful or difficult urination—is commonly accompanied by urinary frequency, urgency, or hesitancy. This symptom usually reflects lower urinary tract infection (UTI)—a common disorder, especially in women.
Dysuria results from... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A cardinal sign of renal and urinary tract disorders, oliguria is clinically defined as urine output of less than 400 ml/24 hours. Typically, this sign occurs abruptly and may herald serious—possibly life-threatening—hemodynamic... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A relatively common sign, polyuria is the daily production and excretion of more than 3 L of urine. It's usually reported by the patient as increased urination, especially when it occurs at night. Polyuria is aggravated by overhydration, consumption of caffeine or alcohol, and... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Urinary frequency refers to increased incidence of the urge to void without an increase in the total volume of urine produced. Usually resulting from decreased bladder capacity, frequency is a cardinal sign of urinary tract infection. However,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Hesitancy—difficulty starting a urine stream generally followed by a decrease in the force of the stream—can result from a urinary tract infection (UTI), a partial lower urinary tract obstruction, a neuromuscular disorder, or use of certain drugs.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Urinary incontinence, the uncontrollable passage of urine, can result from a bladder abnormality, a neurologic disorder, or an alteration in pelvic muscle strength. A common urologic sign, incontinence may be transient or permanent and may... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A sudden compelling urge to urinate (urinary urgency), accompanied by bladder pain, is a classic symptom of a urinary tract infection (UTI). As inflammation decreases bladder capacity, discomfort results from the accumulation of even small... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Cloudy, murky, or turbid urine reflects the presence of bacteria, mucus, leukocytes or erythrocytes, epithelial cells, fat, or phosphates (in alkaline urine). It's characteristic of urinary tract infection (UTI) but can also result from prolonged storage of a urine specimen... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Resonant, brassy, and harsh, a barking cough is part of a complex of signs and symptoms that characterize croup syndrome, a group of pediatric disorders marked by varying degrees of respiratory distress. It's most prevalent in the fall and may recur... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A nonproductive cough is a noisy, forceful expulsion of air from the lungs that doesn't yield sputum or blood. It's one of the most common complaints of patients with respiratory disorders.
Coughing is a necessary protective mechanism that... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Productive coughing is the body's mechanism for clearing airway passages of accumulated secretions that normal mucociliary action doesn't remove. It's a sudden, forceful, noisy expulsion of air from the lungs that contains sputum, blood, or both. The... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
The differential diagnosis of cough is best developed with the use of
anatomy. Cough may arise from an irritative focus anywhere along the
respiratory tract. The irritation may be intrinsic, in which case it
is usually inflammatory, neoplastic,... Pictures
... READ EXCERPTS »
...
Dysuria is difficult or painful micturition. One could cover most of
the causes simply by considering the inflammatory lesions of the
genitourinary tract in ascending order. Thus, there may be a urethritis or
urethral carbuncle, a trigonitis or... Pictures
... READ EXCERPTS »
...
Polyuria is an absolute increase in the urine output in a 24-hour
period. The average individual excretes 1,500 mL of urine a day. Many
physiologic conditions increase the output of urine (stress, exercise, and
warm weather associated with... Pictures
... READ EXCERPTS »
...
There are many causes of proteinuria. The mnemonic VINDICATE is a
helpful way of developing a list of possibilities.
V—Vascular category should call to mind CHF, hypertension, and
renal vein thrombosis.
I—... Pictures
... READ EXCERPTS »
...
Pyuria is included here although it is not a symptom or a definitive
finding on physical examination. Examination of the urine, however, is so
frequently a part of every physical examination that the causes of pyuria
should be available for immediate recall for all... Pictures
... READ EXCERPTS »
...
Diminished output of urine (oliguria with less than 500 mL of output in
24 hours) and no output of urine (anuria) are best understood using
pathophysiology. The causes may be divided into prerenal (where less fluid
is delivered to the kidney for... Pictures
... READ EXCERPTS »
...
Incontinence may be due to loss of voluntary control of urination, in
which case neurologic disorders are usually the cause, or it may result from
overflow of a distended bladder (overflow incontinence), in which case the
cause may be bladder neck
... READ EXCERPTS »
...Michael Clemmens, MD
What to Do - Interpret the Data
Intussusception is the most common cause of bowel obstruction in children
afterthenewbornperiod.Theincidencepeaksinlateinfancybutmaybeseen
at any age. Intussusception occurs when a part of the bowel collapses into
the... Suggested Readings
... READ EXCERPTS »
... Author:
Renée Roberts, MD
What to Do - Interpret the Data
It is generally agreed upon that a difficult airway is a situation when problems exist in establishing adequate ventilation via mask or artificial airway.
This situation can... Suggested Readings
... READ EXCERPTS »
... Author:
Elizabeth Wells, MD
What to Do - Take Action
The term anticipatory guidance refers to the practice in which pediatricians
provide information and counsel parents about child development and behavior. It helps... Infants (Birth to 1 Year) ... Toddlers and Preschool Age (1–5 Years) ... School Age (6–11 Years) ... Younger Adolescents (11–15 Years) ... Older Adolescents (16–21 Years) ... Suggested Readings
... READ EXCERPTS »
... Matthew Fogg, MD
Allergic Child - BASICS
Allergic Child - description
The allergic child tends toward IgE-mediated reactions in response to pollens, molds, environmental allergens, drugs, insect stings, and foods. ... Allergic Child - DIAGNOSIS ... Allergic Child - TREATMENT ... Allergic Child - FOLLOW UP ... Allergic Child - bibliography ... Allergic Child - CODES
... READ EXCERPTS »
... Mercedes M. Blackstone, MDKathy N. Shaw, MD, MSCE Urinary Tract Infection - BASICS Urinary Tract Infection - description UTI is growth of bacterial urinary tract pathogen(s):... Urinary Tract Infection - DIAGNOSIS ... Urinary Tract Infection - TREATMENT ... Urinary Tract Infection - FOLLOW UP ... Urinary Tract Infection - bibliography ... Urinary Tract Infection - CODES ... Urinary Tract Infection - FAQ
... READ EXCERPTS »
... Etiology
Pediatric urinary tract infection begins with colonization of the periurethral
area with gastrointestinal bacteria. These bacteria may then ascend into the
bladder, kidneys, or both. A variety of virulence factors may promote infection
with certain bacterial isolates... Presentation ... Diagnosis ... Management of Urinary Tract Infection ... Radiographic Evaluation after Urinary Tract Infection
... Management of Vesicoureteral Reflux ... Selected Readings ... Pictures
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Frequent and sudden urges to urinate may be more than a nuisance. They may be symptoms of a urinary condition. Listen to experts describe a condition...
Medicines can help people with overactive bladder. But so can a wide variety of lifestyle changes. Listen as experts describe everyday things you can...
Having the urge to go can be distressing, but there are several medicines that can help. Listen to experts describe how the different medicines for...
She blamed it on her aging body until she learned that you don't have to live with it. See how a little trial and error helped one woman regain...