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Chapter Reviews - CWWU 12th ed Review > 055 Infections of the Urinary Tract > Flashcards

055 Infections of the Urinary Tract Flashcards

1
Q

Bacteriuria and pyuria ARE/ARE NOT synonymous with a UTI.

A

Bacteriuria and pyuria ARE NOT synonymous with a UTI.

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2
Q

UTIs are classified based on their __.

A

UTIs are classified based on their PRESUMED SITE OF ORIGIN.

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3
Q

UTIs can be __ (occurring in healthy patients withnormal urinary tracts) or __ (associated with factors that increase the likelihood of bacteriuria and decrease the efficacy of therapy).

A

UTIs can be UNCOMPLICATED (occurring in healthy patients withnormal urinary tracts) or COMPLICATED (associated with factors that increase the likelihood of bacteriuria and decrease the efficacy of therapy).

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4
Q

__ are the most common bacterial infection, and, as such, make a significant impact on healthcare costs.

A

UTIs are the most common bacterial infection, and, as such, make a significant impact on healthcare costs.

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5
Q

The incidence of bacteriuria increases with

__ as well as with __ and certain __ that alter lower urinary tract function or cause immunosuppression.

A

The incidence of bacteriuria increases with
INSTITUTIONALIZATION/HOSPITALIZATION as well as with PREGNANCY and certain COMORBIDITIES that alter lower urinary tract function or cause immunosuppression.

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6
Q

To date, THERE IS/THERE IS NO clear association has been described between recurrent uncomplicated UTIs and renal sequelae such as scarring, hypertension, or progressive renal insufficiency.

A

To date, THERE IS NO clear association has been described between recurrent uncomplicated UTIs and renal sequelae such as scarring, hypertension, or progressive renal insufficiency.

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7
Q

Most UTIs are caused by bacteria, usually originating from the __ flora.

A

Most UTIs are caused by bacteria, usually originating from the BOWEL flora.

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8
Q

__, including adhesin, play a role in determining which bacteria invade and the extent of infection.

A

BACTERIAL VIRULENCE FACTORS, including adhesin, play a role in determining which bacteria invade and the extent of infection.

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9
Q

__ predisposes patients to recurrent UTIs and is a genotypic trait.

A

INCREASED EPITHELIAL CELL RECEPTIVITY predisposes patients to recurrent UTIs and is a genotypic trait.

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10
Q

__ is a key factor in increasing host susceptibility to UTIs.

A

OBSTRUCTION TO URINE FLOW is a key factor in increasing host susceptibility to UTIs.

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11
Q

__ is critically important in considering diagnosis; results of urine testing cannot be analyzed without knowledge of signs and symptoms.

A

CLINICAL PRESENTATION is critically important in considering diagnosis; results of urine testing cannot be analyzed without knowledge of signs and symptoms.

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12
Q

Urine must be collected in a manner that minimizes __.

A

Urine must be collected in a manner that minimizes CONTAMINATION.

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13
Q

Formal urinalysis is preferred over __.

A

Formal urinalysis is preferred over DIPSTICK TESTING.

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14
Q

Urine culture results provide __.

A

Urine culture results provide BACTERIAL SENSITIVITES.

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15
Q

Urine IS/IS NOT sterile.

A

Urine IS NOT sterile.

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16
Q

The female urinary microbiome has been identified using __, and knowledge of these microbiota should inform UTI management and interpretation of novel culture techniques such as the expanded quantitative urine culture (EQUC) protocol.

A

The female urinary microbiome has been identified using RNA SEQUENCING TECHNIQUES, and knowledge of these microbiota should inform UTI management and interpretation of novel culture techniques such as the expanded quantitative urine culture (EQUC) protocol.

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17
Q

The prevalence of asymptomatic bacteriuria varies with __, __, and __.

A

The prevalence of asymptomatic bacteriuria varies with AGE, SEX, and COMORBID CONDITIONS.

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18
Q

Untreated asymptomatic bacteriuria IS/IS NOT associated with hypertension or renal insufficiency.

A

Untreated asymptomatic bacteriuria IS NOT associated with hypertension or renal insufficiency.

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19
Q

Several guidelines recommend SCREENING/NOT SCREENING for or treating asymptomatic bacteriuria except in specific patient populations.

A

Several guidelines recommend NOT SCREENING for or treating asymptomatic bacteriuria except in specific patient populations.

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20
Q

__ contributes to development of multi-drug resistant symptomatic UTIs.

A

TREATMENT OF ASYMPTOMATIC BACTERIURIA contributes to development of multi-drug resistant symptomatic UTIs.

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21
Q

Antimicrobial resistance is increasing because of __.

A

Antimicrobial resistance is increasing because of EXCESSIVE UTILIZATION.

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22
Q

Antimicrobial selection should be influenced by __, __, __, and __.

A

Antimicrobial selection should be influenced by EFFICACY, SAFETY, COST, and COMPLIANCE.

23
Q

Both the __ as well as the __ are critical in preventing the perpetuation of antimicrobial resistance as well as adverse events related to treatment.

A

Both the CHOICE OF THE AGENT as well as the DURATION OF THERAPY are critical in preventing the perpetuation of antimicrobial resistance as well as adverse events related to treatment.

24
Q

Obtaining a thorough history, with emphasis on __, __, __, and __, is critical.

A

Obtaining a thorough history, with emphasis on PRIOR SYMPTOMS, URINALYSIS, CULTURE RESULTS, and TRIGGERS FOR INFECTIONS, is critical.

25
Q

Sources of possible bacterial persistence must be identified and __.

A

Sources of possible bacterial persistence must be identified and ERADICATED.

26
Q

Imaging and cystoscopy ARE/ARE NOT recommended for recurrent uncomplicated UTIs.

A

Imaging and cystoscopy ARE NOT recommended for recurrent uncomplicated UTIs.

27
Q

Prevention of recurrence should focus on __.

A

Prevention of recurrence should focus on NON-ANTIBIOTIC INTERVENTIONS.

28
Q

Acute pyelonephritis classically presents as the abrupt onset of __, __, and __ but can present as symptoms as mild as cystitis or as severe as sepsis.

A

Acute pyelonephritis classically presents as the abrupt onset of CHILLS, FEVER, and FLANK OR COSTOVERTEBRAL ANGLE TENDERNESS but can present as symptoms as mild as cystitis or as severe as sepsis.

29
Q

__ is a life-threatening infection diagnosed radiographically by the presence of gas in the parenchyma or collecting system and can be managed via percutaneous drainage or surgically.

A

EMPHYSEMATOUS PYELONEPHRITIS is a life-threatening infection diagnosed radiographically by the presence of gas in the parenchyma or collecting system and can be managed via percutaneous drainage or surgically.

30
Q

Renal abscesses are well delineated by CT and are classically managed with __ and __. Smaller abscesses may be amenable to conservative treatment with medical management.

A

Renal abscesses are well delineated by CT and are classically managed with IV ANTIMICROBIAL AGENTS and DRAINAGE. Smaller abscesses may be amenable to conservative treatment with medical management.

31
Q

__ is a bacterial infection in a hydronephrotic kidney. Prompt diagnosis is critical; treatment entails intravenous antimicrobial agents and drainage of the obstructed renal unit.

A

PYONEPHROSIS is a bacterial infection in a hydronephrotic kidney. Prompt diagnosis is critical; treatment entails intravenous antimicrobial agents and drainage of the obstructed renal unit.

32
Q

__ is a chronic renal infection that is often found in poorly functioning renal units obstructed secondary to nephrolithiasis. It can be mistaken for renal tumors.

A

XGP is a chronic renal infection that is often found in poorly functioning renal units obstructed secondary to nephrolithiasis. It can be mistaken for renal tumors.

33
Q

__ is an unusual inflammatory disease thought to result from abnormal macrophage function. Michaelis-Gutmann bodies are lysosomal inclusion bodies that characterize this disease microscopically.

A

MALACOPLAKIA is an unusual inflammatory disease thought to result from abnormal macrophage function. Michaelis-Gutmann bodies are lysosomal inclusion bodies that characterize this disease microscopically.

34
Q

__ is necrotizing fasciitis arising from the perineal skin, scrotum, urethra, or rectum.

A

FOURNIER GANGRENE is necrotizing fasciitis arising from the perineal skin, scrotum, urethra, or rectum.

35
Q

__ and __ are the essentials of treatment of Fournier gangrene.

A

EMERGENT SURGICAL DEBRIDEMENT and BROAD-SPECTRUM ANTIMICROBIAL AGENTS are the essentials of treatment of Fournier gangrene.

36
Q

Periurethral abscess can occur secondarily to __ or __; treatment entails surgical debridement, suprapubic urinary drainage, and antimicrobial agents.

A

Periurethral abscess can occur secondarily to URETHRAL STRICTURE or CATHETERIZATION; treatment entails surgical debridement, suprapubic urinary drainage, and antimicrobial agents.

37
Q

__ is a clinical syndrome characterized by extremes of body temperature, heart rate, respiratory rate, and WBC count that occurs in response to an infection.

A

SEPSIS is a clinical syndrome characterized by extremes of body temperature, heart rate, respiratory rate, and WBC count that occurs in response to an infection.

38
Q

The principles of management of sepsis include __, __, __, __, and __.

A

The principles of management of sepsis include RESUSCITATION, SUPPORTIVE CARE, MONITORING, ADMINISTRATION OF BROAD-SPECTRUM ANTIMICROBIAL AGENTS, and DRAINAGE OR ELIMINATION OF INFECTION.

39
Q

The surviving sepsis campaign and early __ has been shown to improve outcomes in critically ill patients.

A

The surviving sepsis campaign and early GOAL-DIRECT THERAPY has been shown to improve outcomes in critically ill patients.

40
Q

Screening for bacteriuria via __ should be performed in all pregnant women during the first trimester.

A

Screening for bacteriuria via URINE CULTURE should be performed in all pregnant women during the first trimester.

41
Q

The prevalence of bacteriuria does not change with the occurrence of pregnancy; however, unlike in non-pregnant women, spontaneous resolution of bacteriuria in pregnant women is __.

A

The prevalence of bacteriuria does not change with the occurrence of pregnancy; however, unlike in non-pregnant women, spontaneous resolution of bacteriuria in pregnant women is UNLIKELY.

42
Q

All pregnant women with bacteriuria SHOULD/SHOULD NOT be treated.

A

All pregnant women with bacteriuria SHOULD be treated.

43
Q

Bacteriuria more commonly progresses to __ during pregnancy.

A

Bacteriuria more commonly progresses to ACUTE PYELONEPHRITIS during pregnancy.

44
Q

Screening for bacteriuria is not recommended in elderly patients because there is no relationship between asymptomatic bacteriuria and uncomplicated UTIs and __; asymptomatic bacteriuria should not be treated.

A

Screening for bacteriuria is not recommended in elderly patients because there is no relationship between asymptomatic bacteriuria and uncomplicated UTIs and DETERIORATING RENAL FUNCTION; asymptomatic bacteriuria should not be treated.

45
Q

Infections of the urinary tract may present as subtle signs, and a __ is often required for diagnosis.

A

. Infections of the urinary tract may present as subtle signs, and a HIGH INDEX OF SUSPICION is often required for diagnosis.

46
Q

__ and __ are essential to minimize development of bacteriuria.

A

CAREFUL ASEPTIC INSERTION OF THE CATHETER and MAINTENANCE OF A CLOSED, DEPENDENT DRAINAGE SYSTEM are essential to minimize development of bacteriuria.

47
Q

The development of catheter-associated bacteriuria is __. Only symptomatic catheter-associated UTIs require treatment.

A

The development of catheter-associated bacteriuria is INEVITABLE. Only symptomatic catheter-associated UTIs require treatment.

48
Q

The majority of spinal cord–injured patients with bacteriuria are __. Only symptomatic patients require therapy.

A

The majority of spinal cord–injured patients with bacteriuria are ASYMPTOMATIC. Only symptomatic patients require therapy.

49
Q

UTI in patients with spinal cord injury commonly presents as __, __, __, __, __, __, and/or __.

A

UTI in patients with spinal cord injury commonly presents as FEVER, FLANK, BACK OR ABDOMINAL DISCOMFORT, LEAKAGE BETWEEN CATHETERIZATIONS, INCREASED SPASTICITY, MALAISE, LETHARGY, and/or CLOUDY, MALODOROUS URINE.

50
Q

__ before the initiation of empirical therapy is essential because spinal cord–injured patients often culture diverse flora with a high probability of bacterial resistance.

A

URINE CULTURE before the initiation of empirical therapy is essential because spinal cord–injured patients often culture diverse flora with a high probability of bacterial resistance.

51
Q

__ places patients with spinal cord injury at the lowest risk for significant long-term urinary tract complications.

A

CLEAN INTERMITTENT CATHETERIZATION places patients with spinal cord injury at the lowest risk for significant long-term urinary tract complications.

52
Q

__ entails treatment with an antimicrobial agent before and for a limited time after a procedure to prevent local or systemic postprocedural infections.

A

ANTIMICROBIAL PROPHYLAXIS entails treatment with an antimicrobial agent before and for a limited time after a procedure to prevent local or systemic postprocedural infections.

53
Q

The __ and __ determine the need for antimicrobial prophylaxis.

A

The TYPE OF PROCEDURE and COMPETENCY OF THE HOST DEFENSES determine the need for antimicrobial prophylaxis.

54
Q

Special considerations for antimicrobial prophylaxis include patients undergoing __, those with __, and patients with __,

A

Special considerations for antimicrobial prophylaxis include patients undergoing TRUS-BIOPSY, those with RISK OF ENDOCARDITIS AND BACTERIURIA, and patients with INDWELLING ORTHOPEDIC HARDWARE.

Chapter Reviews - CWWU 12th ed Review (22 decks)

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