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ClinSci IV > 26. Urinary Tract Infections > Flashcards

26. Urinary Tract Infections Flashcards

1
Q

above the vesicleurerteral vvalves

A

upper tract

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2
Q

below the vesicoureteral valves

A

lower tract

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3
Q

involvement of tissue structures with instruments or comorbidities, usually male

A

complicated

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4
Q

pus in the kidney causing inflammed kidney, calyces, pelvis

A

pylenonephritis

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5
Q

bladder inflammation

A

cystitis

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6
Q

3 or more UTI/yearas

A

recurrence

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7
Q

recurrence in a month with the same organism

A

relapse

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8
Q

relapse but <1 month usually a different orgnanism

A

reinfection

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9
Q

in this group, males predominate with urogenital malformations more common

A

neonates

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10
Q

at this time, females predominate for UTI frequency at 80%

A

childbearing years

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11
Q

prior history, uncircumcised, sexual intercourse especially with frequency, inherited factors like IgA deficiency, structural abnormalities associated with reflux like vesico-ureteral reflux and duplicated collection system, obstruction like prostate enlargement and ureteral stones, foreign body especially foley chronic indwelling catheter

A

risk factors for UTI

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12
Q

10^5 CFU/mL sungle species in clean catch urine, e coli 80%, staph saprophyticus 15% particularly in sexually active females, other gram -

A

symptomatic UTI definition

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13
Q

> 10^5 CFU/mL single species in clean catch urine, treat in pregnany, renal transplant, and before urogenital surgery, common in nursing home residents, don’t treat, do not treat or check with foley in place, UTI with/from foley can lead to sepsis, therefore is symptomatic*** UTI

A

asymptomatic UTI definition

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14
Q

gram positive cocci catalase positive coagulase negative novobiocin resistant

A

staphylococcus saprophyticus

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15
Q

gram negative rod lactose fermenting fast

A

escherichia coli

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16
Q

random, first void, clean catch, catheter, will show pH specific gravity, protein, glucose, ketones, bilirubin, leukocyte esterase, results will show WBC, RBC, epithelial cells, bacteria, casts, crystals, squamous epithelial cells (epis) represent a urethral or labial wash but doesn’t tell you anything about the bladder thus is unimportant

A

urinalysis types

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17
Q

gram positive cocci catalase negative alpha hemolytic optochin sensitive bile soluble

A

streptococcus pneumoniae

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18
Q

gram positive cocci, catalase negative, alpha hemolytic, optochin and bile solubility negative,

A

streptococcus mutans and mitits

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19
Q

gram positive cocci, catalase negative, gamma hemolytic, grows in 6.5% NaCl

A

enterococcus faecium/faecalis

20
Q

gram positive cocci, catalase negative, gamma hemolytic, doesn’t grow in 6.5% NaCl

A

streptococcus bovis

21
Q

gram positive cocci, catalase negative, beta hemolytic, bacitracin sensitive

A

streptococcus pyogenes

22
Q

pH 4.5-8 hints at potential genus, specific gravity 1.005-1.025 which identifies SIADH and solutes, glucose is usually negative unless diabetic patients, ketones are usually negative but can be elevaetd in dehydration and toxins, blood is negative specifically in hemoglobin (perioxidase cross reacts), bilirubin is usually negative (direct/conjugated) hepatic disease, protein is negative usually unless nephrotic syndrome or renal failure, urobilinogen is negative or small (Ehrlich U) identifies hemolysis ***

A

UTI UA dipstick

23
Q

gram positive cocci, catalase negative, beta hemolytic, not bacitracin sensitive

A

streptotoccus agalactiae

24
Q

gram positive rod, spore forming, anaerobic

A

clostridium/clostridiodies

25
Q

RBC between 0-5 is normal, need to be physical/intact, compare to dipstick, WBC between 0-5 is normal, correlated it with leukocyte esterase, few bacteria but is not a gram stain so not specific enough ***

A

UTI UA microbiology

26
Q

27 year old male presents with pain and burning on urination, differential cystitis and urethritis, work up with split urine first void then clean catch, on first void pH 6.5, specific grabity 1.015, negative glucose, ketones, bilirubin, urobilinogen, nitrite, protein, leukocyte esterase, moderate red blood cells, moderate white blood cells, ***, result I was pyuria, result II was clean, interpreted as urethritis with no cystitis, differential of sexually transmitted disease, mechanical, irritative, gonorrhea/chlamydia DNA by polymerase chain reaction

A

case I

27
Q

for urethritis, differentiate infection from irritation ***

A

UTIs by geography

28
Q

46 year old female with abdominal pain, initial UTI was pH 6.5, specific grabity of 1.005, negative glucose, ketones, bilirubin, urobilinogen, nitrites, protein, leukocyte esterase, trace RBC and WBC, 0-3 RBC, 5-10 WBC, 20-50 epithelial cells, no better after 3 days of TMP/SMX,

A
29
Q

18 year old female with pain and burning on urination, no other symptoms, negative past history, normal physicla exam, differential of cytitis and urethritis of various types including infectious, first UA, clean catch, *** caution on fluoroquinolones

A
30
Q

gram positive rod, spore forming, aerobic, motile, gelatin hydrolytic, hemolytic

A

bacillus cereus

31
Q

gram positive rods, spore forming, aerobic, non-motile, no gelatin hydrolysis, non-hemolytic

A

bacillus anthracis

32
Q

gram positive rods, not spore forming

A

corynebacterium/listera monocytogenes

33
Q

gram negative rod, slow lactose fermenting

A

citrobacter/serratia

34
Q

gram negative rod, non-lactose fermenting, oxidase positive

A

pseudomonas aeruginosa

35
Q

gram negative rod, non-lactose fermenting, oxidase negative, H2S positive

A

salmonella/proteus

36
Q

gram negative rod, oxidase negative, H2S negative

A

shigella/yersinia

37
Q

gram negative, curved rod, oxidase positive, urease positive

A

helicobacter pylori

38
Q

gram negative, curved rod, oxidase positive, growth at alkaline pH

A

vibrio

39
Q

gram negative, curved rods, oxidase positive, growth at 42C

A

campylobacter

40
Q

gram negative coccobacilli

A

haemophilus influenzae, pasturella, brucella, bordatella, franciscella, acinetobacter

41
Q

gram negative diplococci, aerobic, maltose positive

A

neisseria meningitidis

42
Q

gram negative diplococci, aerobic, maltose negative, uses glucose

A

neisseria gonorrhoeae

43
Q

gram negative, diplococci, aerobic, maltose negative, glucose negative

A

moraxella catarrhalis

44
Q

bacteria not usually gram stained, recticulate body and elementary body formation

A

chlamydia trachomatis/pneumoniae

45
Q

bacteria not usually gram negative, spirochete

A

borellia, treponema pallidum, leptospira

46
Q

bacteria not usually gram stained, no cell wall

A

mycoplasma

47
Q

bacteria not usually gram stained, unique cell wall

A

myobacterium

ClinSci IV (43 decks)

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