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Host and Defense 2020 > 4/3/17 Infections of the Urinary Tract SPIVAK TEST #3 > Flashcards

4/3/17 Infections of the Urinary Tract SPIVAK TEST #3 Flashcards

1
Q

What is the term for bacteria in urine?

A

-Bacteriuria

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2
Q

What is it called when you have a bacterial infection of lower or upper urinary tract?

A

-Urinary tract infection

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3
Q

What is bacterial infection of the bladder?

A

-Acute cystitis

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4
Q

If someone has bacteriuria does that mean that someone has an infection?

A

-No just that bacteria are colonized

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5
Q

T/F Acute cystitis is a lower urinary tract infection and the symptoms are confined in the lower urinary tract.

A

True

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6
Q

T/F Acute pyelonephritis is a bacterial infection of upper urinary tract (ureters, renal pelvis, kidney parenchyma)

A

True

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7
Q

If you are pregnant and have a UTI is it uncomplicated or complicated?

A

-Complicated

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8
Q

What type of UTI involves the upper urinary tract?

A

-Acute pyelonephritis

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9
Q

What type of UTI involves the lower urinary tract?

A

-Acute cystitis

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10
Q

If you have diabetes and have a UTI is it complicated or uncomplicated?

A

-Complicated

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11
Q

To be deemed uncomplicated with a UTI you should meet what three criteria?

A
  • Not pregnant
  • Normal urinary anatomy
  • No co-morbities
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12
Q

UTIs develop in how many patients with indwelling urinary catheters?

A
  • > 10%
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13
Q

T/F Pyelonephritis is more common than cysitis

A

False

-Cysitis is more common

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14
Q 
In healthy individual in the absence of infection, which bacteria typically colonizes the lower urinary tract?
A) Staph. aureus
B) Proteus species
C) E. coli
D) None of the above
A

D) None of the above

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15
Q

What is the most common bacterial cause of UTIs?

A

-E. coli

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16
Q

Besides E. coli what are the three other bacteria you find in UTIs?

A
  • Proteus mirabilis
  • Klebsiella pneumoniae
  • Staph. saprophyticus
17
Q

T/F The urinary tract is normally sterile in young, healthy patients.

A

-True

18
Q

T/F GI pathogens colonize peri-urethral mucosa

A

True

19
Q

Which of the following symptoms is not included is cystitis?
A) Pain or burning with urnation (dysuria)
B) Suprapubic pain
C) Increased frequency of urination
D) Increased urgency of urination
E) Nausea/vomiting
F) All the above are included

A

E) Nausea/vomiting

20
Q

What is the gold standard of UTI diagnosis?

A

Symptoms + urine culture

21
Q

If a patient has a positive culture without symptoms what do you diagnose?

A

-Bacteriuria

22
Q

Should you use antibiotics for asymptomatic bacteriuria?

A

No

23
Q

If a person with a suspected UTI has a fever and flank or costo-veterbral angle pain what type of UTI do they have?

A

-Pyelonephritis

24
Q

The urinalysis is important why?

A

-To rule out a UTI

25
Q

T/F Obtaining a Urinalysis (UA) is not necessary for UTI diagnosis when specific signs and symptoms are clearly present or absent.

A

True

26
Q

T/F Pyuria is common in patients with asymptomatic bacteriuria

A

True

27
Q

You are evaluating the urinalysis and culture on the previous slides. Has > 100,000 cfu/mL of E. coli but no symptoms are included in the report Do they meet criteria for a UTI?
A) Yes- Time to prescribe an antibiotic
B) No - not enough abnormal findings on UA
C) Maybe I need more info
D) I dont know

A

C) Need to know if there are symptoms or not

28
Q

Does cystitis resolve without antibiotics?

A

Yes generally

29
Q

What three drugs do you use for uncomplicated cystitis?

A
  • Nitrofurantoin
  • TMP/SMX
  • Fosfomycin
30
Q

What three drugs do you use for uncomplicated pyelonephritis?

A
  • Fluoroquinolones
  • TMP/SMX
  • B-lactams
31
Q

E. coli resistance to amoxicillin is now what percent world wide?

A
  • > 20%
32
Q

What percent of E. coli is resistant to fluoroquinolone?

A
  • 20%
33
Q

If you have a bacteriuria in what instances would you need an antibiotic?

A
  • Pregnant
  • Preurology procedure
  • Renal transplant
  • Neutropenic
34
Q

What population of people have the highest prevalence of asymptomatic bacteriuria?

A

-Female long term care residents

35
Q

A patient is admitted with an indwelling bladder catheter. Urine culture reveals > 100,000 CFU E. coli. There are no urinary symptoms and the patient feels well. what is the best management?
A) Remove catheter if possible, no other treatment
B) Initial broad spectrum antibiotic
C) Change the catheter and re-culture
D) Start a low-dose long-term antibiotic while catheter is in place

A

A) remove catheter if possible, no other treatment

Host and Defense 2020 (61 decks)

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