Thread by @TrishVini

Urinary History Taking for #MedStudents #TrishasTweetorial

Struggle to take an effective, comprehensive #UH in a 5 min #OSCE?

#sdocs @MedicsAcademy @MedTweetorials #TrishasTopTips 👇👇
[1/19]

When did you last take a urinary history?
#OSCE
[2/19]

Before we start #FristThingsFirst I’m a Realist

Urinary History is not ≠ to Urogynae History #PelvicFloorDisorders

For ☝️ use:
#Urinary dysfunction
#Sexual dysfunction
#Bowel dysfunction
#Vaginal dysfunction
[3/19]

#WeCanDoThis #OSCE

Wash Hands – Introduction
#SameTime #SaveTime
Patient Details – Ask age and DOB
#NoMathsToday
[4/19]

Consent #ForAHistory? #Always
& “I understand you have been having trouble with your waterworks?”
[5/19]

PC
“You mentioned X can you tell me a little bit more about that?”
“How long have you been experiencing these problems for and when did the problems start?”
[6/19]

#TheBIGbit #TopMarks #HowIFitItALLin
BEFORE
DURING
AFTER
OTHER
[7/19]

BEFORE
How many times would you go to the toilet in 1 day?
Is this normal for you or has the number of times changed? #TrueFrequency VS. #Urge
Have you like you were unable to hold it in and had to rush to the bathroom? 👉Urge
[8/19]

BEFORE 2.0
Have you ever not made it to the bathroom in time? 👉 Incontinence
When you go to the toilet do you find it difficult to start urinating? 👉Hesitancy
[9/19]

DURING
How would you describe your flow of urine?
When you urinate is there any pain down below? #Dysuria #TerminalDysuria
Or any pain in any other part of your body? #Loin #Back
[10/19]

AFTER
When you have finished urinating is there any dribbling? #Prostate
When you finish, does it feel like you still need to urinate as if you haven’t fully emptied your bladder? 👉Incomplete emptying #Detrusor #Prostate
[11/19]

OTHER
Toilet at night #Nocturia
Coughed or sneeze #Stress
No urine (Anuria) #UTI?
Less (Oliguria), more (Polyuria), normal amount of urine
Fever
Have you had a chance to look at your urine? 👉 Blood?
⛔️#FrankHaematuria ⛔️ Cloudy? Colour?
[12/19]

PMHx
Current medically diagnosed problems #GENERAL
Hospital or had any operations
Diagnosis of high blood pressure, diabetes, multiple sclerosis #TARGETED
Children & Deliveries
Sexually Active
[13/19]

FHx
Conditions in the family #GENERAL
Kidney disease or PKD #TARGETED
[14/19]

DHx
Prescribed – yes, dose? #GENERAL
Any form of prescribed steroids #TARGETED
Over the counter
Herbal
Allergies
[15/19]

SHx
Smoking 👉Ex, Straights or Rolling, Amount, Years
Alcohol 👉Units per week
Exercise 👉 ‘Able to keep active?’
Occupation #IndustrialCarcinogens
Foreign Travel #Schistosomiasis
Impact on life
[16/19]

Thank patient
Wash hands
Leave station – or stay for a baptism of 🔥 🔥 🔥
[17/19]

Summarise
Impressions and Differentials – have 5 top COMMON ones #NotZebras
A FEW 👇
MORE oscestop.com/Urinary_histor…
[18/19]

Investigations and Plan
Examine
#Start Bed side tests 👉 #End Invasive tests
Conservative 👉Biological 👉Surgical
[19/19]