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Repro/GU > 240 UTI > Flashcards

240 UTI Flashcards

1
Q

What factors suggest a complicated UTI?

A 
functional/anatomic abnormality of tract
male sex
pregnancy
elderly patients
diabetic or immunosuppressed patients
and more
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2
Q

What bacterial virulence factors aid in urinary tract colonization?

A

adhesins (ex. pili)

determine the extent of infection

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3
Q

What are the clinical features of cystitis?

A

frequency, urgency, dysuria

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4
Q

What are the clinical features of pyelonephritis?

A

chills, fever, flank pain + frequency/urgency/dysuria

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5
Q

What are the clinical features of prostatitis?

A

chills, fever, prostate pain + frequency/urgency/dysuria

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6
Q

When are imaging studies used for UTIs?

A

in men and compromised patients

also in patients who do not respond to therapy

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7
Q

What are indications for radiologic investigation in acute clinical pyelonephritis?

A

concern for obstruction or history of calculi
potential papillary necrosis
history of genitourinary surgery
poor response to treatment
underlying conditions (diabetes mellitus, polycystic kidney disease, neuropathic bladder)
infection with unusual organisms

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8
Q

What is the mechanism of beta-lactam drugs?

A

inhibition of cell wall synthesis

examples: penicillins, cephalosporins, aztreonam

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9
Q

What is the mechanism of aminoglycosides?

A

inhibition of ribosomal protein synthesis

examples: gentamicin, streptomycin

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10
Q

What is the mechanism of quinolone antibiotics?

A

inhibition of bacterial DNA gyrase

examples: ciprofloxacin, levofloxacin

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11
Q

What is the mechanism of fosfomycin antibiotics?

A

inhibition of bacterial cell wall synthesis

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12
Q

What is the mechanism of nitrofurantoin?

A

inhibition of several bacterial enzyme systems

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13
Q

What is the mechanism of trimethoprim-sulfamethoxazole?

A

antagonism of bacterial folate metabolism

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14
Q

What is the mechanism of vancomycin?

A

inhibition of bacterial cell wall synthesis (at beta-lactams)

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15
Q

What class of antibiotics is associated with acute interstitial nephritis?

A

methicillin (and other antistaphylococcal penicillins)

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16
Q

What is the major side effect associated with antipseudomonal penicillins?

A

hypernatremia

17
Q

Which class of antibiotics is associated with ototoxicity and nephrotoxicity?

A

aminoglycosides

18
Q

What class of antibiotics is associated with photosensitivity and CNS effects?

A

fluoroquinolones

19
Q

Which patients have contraindications to fluoroquinolones?

A

children and pregnant patients

20
Q

Which antibiotic is associated with red man syndrome?

A

vancomycin

also associated with nephrotoxicity and ototoxicity when combined with other drugs

21
Q

How long should uncomplicated bladder infections be treated?

A

treated for 3 days with most drugs

treat for 5 days with nitrofurantoin

22
Q

When should asymptomatic bacteriuria be treated?

A

pregnant woman

prior to urologic intervention

23
Q

What is the treatment for acute prostatitis?

A

fluoroquinolone therapy for 7-10 days initiated immediately

modify drug after urine culture

24
Q

What is the treatment for chronic prostatitis?

A

TMP-SMX or FQ (depending on culture) for 3 months

25
Q

What radiologic findings are associated with emphysematous pyelonephritis?

A

gas in parenchyma or collecting system

managed surgically, life threatening

26
Q

How are renal abscesses managed?

A

IV antimicrobials and abscess drainage for large abscesses

27
Q

What is the microscopic hallmark of malacoplakia?

A

michaelis-gutman bodies

28
Q

When should pregnant women be screened for bacteruria?

A

first trimester

29
Q

When should bacteriuria be treated in the elderly?

A

never if asymptomatic

very common and not related to UTI or renal function

30
Q

When should catheter-associated UTIs be treated?

A

only if symptomatic

31
Q

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

A

p-pillated e coli

32
Q

Excluding history of previous allergy, what drug is safe during any phase of pregnancy?

A

penicillin

33
Q

What is the optimal antimicrobial agent for treatment of acute pyelonephritis in young women?

A

fluoroquinolone

34
Q

What are the drugs of choice for the treatment of uncomplicated cystitis in most young women?

A

TMP-SMX; nitrofurantoin

Repro/GU (30 decks)

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