12: GIGU Cases Flashcards
Four infections that are considered UTI
- Asymptomatic bacteriuria
- Cystitis
- Prostatitis
- Pyelonephritis
Cystitis
Symptomatic bladder infection
Three things that can make a UTI a complicated UTI
- Systemic symptoms (fever, flank pain, CVA tenderness)
- Hx abnormal voiding
- Foreign body (catheter, stone, stent)
Five symptoms of cystitis
Dysuria, frequency, urgency, suprapubic pain, hematuria
Four symptoms of pyelonephritis that are present along with the symptoms of cystitis
Fever, flank pain, CVA tenderness, N/V
What is considered a severe case of pyelonephritis?
Sepsis, concern for obstruction, or no improvement after 48hrs of Abx
Plan for mild vs severe case of pyelonephritis
Mild: no imaging, treat with Abx
Severe cases: CT scan abdomen and pelvis
Two somatic findings commonly associated with pyelonephritis
- SD at T12-L2
2. Iliopsoas spasms
Three ways to determine antibiotic for pyelonephritis
- Suspected bacteria (usually E. coli)
- Abx resistance patterns at your institution
- Pt allergies
Duration of treatment for complicated vs uncomplicated pyelonephritis
Uncomplicated: 3-5 days
Complicated: 10-14 days
Three categories of mechanical bowel obstructions and examples of those
- Intrinsic: congenital disease, IBS, primary intestinal malignancy, volvulus
- Extrinsic: adhesion, neoplasm
- Intraluminal: feces, bezoars, foreign bodies
Functional bowel obstruction
Intestinal dysmotility; no actual mechanical blockage
Strangulated mechanical obstruction
Indicates vascular insufficiency -> high risk for ischemia
Main cause for small bowel obstruction vs large bowel obstruction
Small: adhesions
Large: carcinoma
Symptoms of small vs large bowel obstruction
Small: vomiting, cramping pain, distention
Large: distention, post-prandial cramping, bowel habit change
Ileus
Pseudo-obstruction; dysmotility that prevents intestinal content from moving distally
When does ileus commonly occur + other causes
Typically after a surgery; can also be due to opiates, intestinal ischemia, sepsis, electrolyte imbalance
Treatment for ileus
Is transient and usually resolves on its own
How to examine for volume status in a pt
JVD, oral mucosa, capillary refill, skin tenting, ascites, LE pitting edema, sacral edema
What BUN:Cr suggests prerenal AKI?
> 20:1
What urinalysis test is very useful in AKI diagnosis
Albumin/creatinine ratio
