142 Chapter 7 ■ PRACTICAL APPLICATIONS
Chapter Seven
PRACTICAL APPLICATIONS
Name: ______________________________
A. Patient History
The patient is a 75-year-old male with a history of hematuria, dysuria, chronic UTIs, and benign
prostatic hyperplasia. At present, he has nocturia three times per night with slow urinary stream.
A CT scan showed a distended urinary bladder with large postvoid residual. In the kidney there is
evidence of cortical renal cysts. Cystoscopy was performed, revealing a diverticulum of the bladder
with a neoplastic lesion within the diverticulum. A biopsy was performed, and it showed ulceration
and chronic cystitis, but no malignancy.
1. The patient has a history of: …………….
A. Bladder cancer
B. Prostate cancer
C. Painful urination
D. Protein in his urine
2. What x-ray test showed an
abnormality of the bladder? ………………
A. Cystoscopy
B. Pelvic ultrasound
C. Cystourethrogram
D. Computed tomography
3. What is a diverticulum? …………………..
A. Neoplastic lesion
B. Outpouching of a wall of an organ
C. Inflammatory region of an organ
D. Sac of fluid in an organ
4. The biopsy revealed: ……………………….
A. Inflammation and defect in the bladder
lining
B. Carcinoma of the bladder
C. Distended urinary bladder
D. Hernia of the ureter
B. UTI in Children
The symptoms of urinary tract infections in older children are similar to those seen in adults.
Cystitis manifests by suprapubic discomfort, burning, urgency, and polyuria. An upper UTI such
as pyelonephritis manifests by chills, fever, and flank (the sides of the body, between the ribs and
the ilium) pain. Any child previously toilet-trained who suddenly develops enuresis or daytime
wetting should be evaluated. However, many UTIs in children are asymptomatic, and the younger
the child, the more obscure the signs and symptoms. An infant with a UTI may present only with
fever, lethargy, irritability, and/or failure to thrive.
1. A symptom of cystitis is: …………………
A. Inability to urinate
B. Frequent urination
C. Chest pain
D. Jaundice and itching
2. An example of an upper UTI is: …………
A. Nephrosclerosis
B. Flank pain
C. Lithotripsy
D. Inflammation of the renal pelvis
3. Enuresis is: …………………………………..
A. Bedwetting
B. Nocturia
C. Anuria
D. Strong sensation of having to urinate
throughout the day
4. What type of symptoms do young
children with UTIs frequently
manifest? ……………………………………..
A. Blood in the urine
B. Protein in the urine
C. Often no symptoms
D. Elevated BUN