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Repro/GU by Minnie (she/her) > 240 - UTI > Flashcards

240 - UTI Flashcards

1
Q

What is the serious adverse effect associated with beta-lactams?

A

Allergy

Collateral damage to natural flora

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2
Q

What are the drug of choice for uncomplicated cystitis? (2)

A

TMP-SMX or Nitrofuantoin

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3
Q

Why might a patient have UTI symptoms but no bacteria on urinalysis or culture?

A

Bacteria can form a nidus in the bladder and live there without getting into the urine

Pts are considered infected with a UTI if they have consistent symptoms

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4
Q

List the indications for imaging in patients with UTI

A
  • Complicated UTI
  • Failure to respond after 3 days of therapy

NOTE: image after no response to therapy after 72h of therapy in UTI, or 5-6 days in pyelonephritis

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5
Q

List 3 symptoms commonly associated with acute pyelonephritis

A

Chills

Fever

Flank pain

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6
Q

What virulence factor is most important for bacterial adherence?

A

Pili

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7
Q

List 4 host factors that promote colonization of bacteria in the urinary tract

A
  • Sexual activity
    • Increases inoculation
  • Spermicide
    • Allows bacteria to bind
  • Estrogen binding
    • Allows bacteria to bind
  • Antimicrobials
    • Decrease indiginous flora, which exposes more receptors
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8
Q

What is the next step in management when a patient presents with symptoms of a UTI?

A

Urinalysis

(Can treat emperically before results come back, do not need to culture)

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9
Q

List 3 symptoms of cystitis

A

Dysuria

Urgency

Frequency

Cystitis = bladder infection; common type of UTI

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10
Q

Which bacteria is the most common cause of UTI?

A

E. coli

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11
Q

What is the difference between complicated and uncomplicated UTI?

A
  • Uncomplicated
    • Normal urinary tract
    • Usually people with female genitalia
    • People with normal male genitalia usually do not get UTIs
  • Complicated
    • Anormal urinary tract (in structure or function)
    • Any child and anybody with male genitalia who gets a UTI probably has a complicated UTI
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12
Q

How does the treatment of uncomplicated cystitis differ in reinfection vs. persistent infection?

A
  • Re-infection
    • Usually a longer interval, different bacteria
    • Manage medically with antibiotics
  • Persistent infection
    • Short interval, same bacteria
    • Image and treat surgically (remove potential nidus that is seeding infection)
    • If no imaging fingings, try low-dose prophylaxis for a long tiem
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13
Q

Which class of antibiotics is best for treating acute pyelonephritis in young women?

A

Fluroquinolone

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14
Q

Which patient group requires treatment for asymptomatic bacteruria?

A

Pregnant women

Do not treat asymptomatic bacteruria in anyone else!

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15
Q

Which of these drugs would you select for treatment in this situation?

A

Drug A - has the highest margin of error

(Want a drug that has urinary levels way above required MIC to kill the bug)

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16
Q

Describe the pathogenesis (Key early events) in UTI pathogenesis

A
  • Pathogenic bacteria stick to epithelial cells
  • Cells phagocytosed, immune system activated (cytokines), WBCs recruited
  • Bacteria work to try to block the cytokines so they can get some traction
17
Q

What is the difference between complicated and uncomplicated pyelonephritis?

A

Obstruction = complicated

No obstruction = uncomplicated

18
Q

What is the serious adverse effect associated with fluoroquinolones?

A

Tendonitis, allergy

Collateral damage to natural flora

19
Q

What is the serious adverse effect associated with nitrofurantoin?

A

Pulmonary fibrosis

20
Q

What is the adverse effect associated with Fosfomycin?

A

GI distress (Nausea, diarrhea)

21
Q

Which drug used to treat UTI is safest during any phase of pregnancy?

A

Beta lactams

(Penicillins and cephalosporins)

22
Q

Which antibiotic agents used to treat UTI are most likely to cause “collateral damage” by dirupting the normal urinary flora? (2)

A

Fluoroquinolones

Beta-lactams

23
Q

What is the serious adverse effect associated with TMP-SMX?

A

Rash

(And Stevens-Johnson syndrome)

24
Q

What is the most common cause of acute pyelonephritis in young women?

(Which pathogen)

A

P-piliated E. coli

25
Q

Why does cranberry juice work to prevent UTI?

A

Contains mannose

Mannose prevents fimbriae and pili from sticking to cells of the urinary tract

In E. coli, Type 1 sticks to bladder, Type P sticks to urinary ract

26
Q

In addition to antibiotics, what treatment should be considered for the management of a small perirenal abscess in a functioning kidney?

A

Percutaneous drainage

27
Q

What is the appropriate managment of a complicated UTI?

A

Do imaging

Manage medically and/or surgically depending on findings

Repro/GU by Minnie (she/her) (31 decks)

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