Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Senior - Urology > 2 - Infections Of The Urinary Tract > Flashcards

2 - Infections Of The Urinary Tract Flashcards

1
Q

Infections of the urinary tract (list)?

A

Acute cystitis
Acute pyelonephritis
Interstitial cystitis
Urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vesicoureteral reflux?

A

Consider in kid w UTI prior to toilet training (esp males)

Obtain VCUG and refer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kids w fever?

A

Consider UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Urinary tract anatomy?

A

Slide 8,9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Intrinsic defense mechanisms for UTI prevention?

A

Efficient bladder emptying w voiding
-> low bacterial colony counts

Glycosaminoglycan layer
- prevents bacterial adherence

Urine is antimicrobial

  • high osmolality
  • extremes of pH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Gender specific UTI defenses?

A

Females
- normal vag flora (pH and estrogen levels prevent)

Males
- prostatic fluid has zinc (antibacterial agent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

UTI risk factors by gender?

A

Females
- short urethra

Males
- foreskin + anal -> mucosal surface of foreskin being colonized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Risk factors for UIT?

A

Urinary retention, stasis, reflux

Anotomic or functional abnormalities of urinary tract

  • obstruction
  • neurologic disease
  • DM
  • pregnancy
  • FOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Anatomic or functional abnormalities make a UTI?

A

Complicated UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC Pathogenesis of UTI?

A

Ascending infection from urethra (MC route)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pyelonephrits MC’lly comes from?

A

Ascent of infection up the ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Other modes of UTI infection?

A

Hematogenous spread
Lymphatic spread
Direct extension from other organs (intraperitoneal abscess)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute UTIs are caused by?

A

Single pathogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chronic UTIs are caused by?

A

2+ pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Uncomplicated UTI is usually?

A

MC = E. Coli (the poops)

Can also be

  • klebsiella
  • proteus
  • enterobacter
  • enterococci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nosocomial UTIs are usually?

A

Pseudomonas

Staphylococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for asymptomatic bacteriuria?

A

No tx unless:

  • pregnant
  • invasive urologic procedure (catheter, imaging etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Acute cystitis is aka?

A

Bladder infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MC cause of acute cystitits?

A

Coliform bacteria

- e. Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Presentation of cystitis?

A 
Common
- irritative voiding symptoms 
- suprapubic discomfort
Gross hematuria
Symptoms often follow sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PE for cystitis?

A

Maybe suprapubic tenderness

- usually unremarkable though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cystitis ddx?

A

Females

  • vulvovaginitis
  • PID

Males

  • urethritis
  • prostatitis

Noninfectious

  • pelvic irradiation
  • chemotherapy
  • bladder ca
  • interstitial cystitis
  • voiding dysfunction d/o
  • psychosomatic d/o
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Workup for cystitis?

A

Labs

  • UA
  • urine culture

Imaging
- usually unnecessary (except males “were complicated”)

24
Q

Complicated vs uncomplicated acute cystitis?

A

Uncomplicated
- healthy women

Complicated
- everyone else

25
Uncomplicated acute cystitis tx?
Short term abx - septra (3 days) - nitrofuratonin (5 days) - fosfomycin (single dose) - fluoroquinolines (3-5 days) Analgesia - phenazopyridine (pyridium) Hot sitz baths
26
DOC for pregnant female cystitis?
Nitrofuratonin 100mg BID x 5 days
27
Male UTI needs?
A bunch of shit “its complicated” But also get a good sexual history
28
Women who get more than 3 UIT/yr?
Prophylactic abx - septra - nitrofuratonin - cephalexin Single dose at bedtime/sex time But send them to urology first to r/o weird anatomy
29
What is acute phyelonephritis?
Infection of renal parenchyma and renal pelvis
30
Acute pyelonephritis bacteria is usually?
Gram-neg - e.coli, proteus, klebsiella, enterobacteria And pseudomonas
31
Pyelonephritis is usually from?
Ascending lower UTI
32
Presentation of pyelonephritis?
``` Fever Shaking/chills Flank pain Irritative voiding ssx N/v Diarrhea ```
33
Pyelonephritis exam findings?
Fever Tachycardia CVA tenderness
34
Pyelonephritis ddx?
``` Acute cystitis Acute intra-abdominal disease Epididymitis Prostatitis PID ```
35
Labs for acute pyelonephritis?
``` UA - pyria - bacteriuria - hematuria - WBC CASTS CBC - Leukocytosis - L shift Blood/urine cultures - pathogen ```
36
Imaging for pyelonephritis?
Uncertain etiology | Complicated disease
37
Compications of acute pyelonephritis?
Sepsis w shock Inadequate therapy - abscess Diabetics
38
Why do DM pts have worse acute pyelonephritis?
Emphysematous pyelonephritis | - from gas-producing organisms
39
Pyelonephritis tx?
Outpatient (usually) - PO abx (quinolones) - pain control
40
Abx for pyelonephritis?
Fluoroquinolones usually - levofloxacin (5 days) - ciprofloxacin (7 days) Alternate - septra x 14 days - augmentin x 14 days
41
Pyelonephritis w fever 48hrs after tx?
Order imaging Mandatory urine cultures
42
Candidates for inpatient pyelonephritis tx | ?
``` Severe/complicated infection Obstructive uropathy DM Renal failure Multi-resistant pathogen Pregnant Uncontrolled ssx ```
43
Inpatient pyelo tx?
IV - amp and gent - ceftriaxone - levofloxacin - pip-tazo IV x 24hrs after fever then switch to PO x 2 weeks
44
Painful bladder syndrome?
Interstitial cystitis
45
Interstitial cystitis is?
Diagnosis of exclusion - neg UA, culture, cytology - no obvious cause
46
Who gets interstitial cystitis?
Women 40 y/o
47
Pathophysiology of interstitial cystitis?
Glycosaminoglycan (GAG) layer is disrupted - urinary irritants enter and bother the nerve/muscle tissue - progressive irritation and inflammation (further damage)
48
Primary complaint from interstitial cystitis?
``` Pain w bladder filling Relieved w urination Urgency Frequency Nocturia ```
49
Interstitial cystitis needs a good hx to include?
``` Exposure to pelvic radiation Tx w cyclophosphamide Genital herpes Vaginitis Urethral diverticulum ```
50
Labs for interstitial cystitis?
Infection and malignancy - UA - Culture - Cytology Urodynamic testing - bladder sensitation and compliance - excludes detrusor instability Cystoscopy w biopsy
51
Ddx for interstitial cystitis?
``` Cystitis Vaginitis Herpes Urethral diverticulum Carcinoma ```
52
Tx for interstitial cystitis?
No cure - symptomatic only - hydrodistention (20-30% improvment) - meds (amitriptyline, nifedipine) - intravesical dimethyl sulfoxide (DMSO) - TENS - acupuncture - surgery (last resort)
53
Urethritis is?
Infection of urethra - gonococcal - non-gonococcal STI
54
Urethritis presentation?
Drippy dick Cant pee Asymptomatic (40%)
55
Urethritis needs (eval)
NAAT - urine nucleic acid amplificaiton test Culture
56
Tx for urethritis
Chlamydia - azithromycin - doxy Gonorrhea - ceftriaxone - add on presumptive chlamydia tx
57
What is forrest gump’s password?
1forrest1

Senior - Urology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions