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2.1) My Cards > 7. MTB Step 3 - Urinary Tract Infection > Flashcards

7. MTB Step 3 - Urinary Tract Infection Flashcards

1
Q

CYSTITIS

What are (3) typical Clinical Manifestations of Cystitis?

A
  1. Dysuria
  2. WBC’s urine
  3. Suprapubic Tenderness
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2
Q

CYSTITIS

What is the typical Demographic of a patient with Cystitis?

A

Young, otherwise healthy Woman

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3
Q

CYSTITIS

  1. What is the Best INITIAL Test for Cystitis?
  2. What is the Most ACCURATE Test for Cystitis?
A

Best INITIAL Test = Urinalysis

Most ACCURATE Test = Urine Culture

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4
Q

CYSTITIS

What are (2) First-Line Antibiotics that may be used to treat Uncomplicated Cystitis?

A

Orally for 3 Days:

  1. Fosfomycin or
  2. Nitrofurantoin

BOTH are safe in pregnancy

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5
Q

CYSTITIS

What are (2) Antibiotics used to treat Uncomplicated Cystitis if E. coli resistance is > 20%?

A
  1. Ciprofloxacin
  2. Levofloxacin
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6
Q

CYSTITIS

What are (2) First-Line Antibiotics that may be used to treat Complicated Cystitis?

A

7 Days:

  1. TMP/SMX (Bactrim) or
  2. Ciprofloxacin
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7
Q

PYELONEPHRITIS

What are (4) typical Clinical Manifestations of Pyelonephritis?

A
  1. Dysuria
  2. WBC’s urine
  3. Flank/CV Tenderness
  4. Fever

Pyelonephritis (higher fever, more ill) is also more severe than Cystitis (lower fever, less ill)

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8
Q

PYELONEPHRITIS

  1. What is the Best INITIAL Test for Pyelonephritis?
  2. What is the Most ACCURATE Test for Pyelonephritis?
A

Best INITIAL Test = Urinalysis

Most ACCURATE Test = Urine Culture

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9
Q

PYELONEPHRITIS

  1. What is the Antibiotic Treatment for Outpatient Pyelonephritis?
  2. What are (4) Antibiotic Treatments for Inpatient Pyelonephritis?
A

Any Medication for Gram-Negative Bacilli:

Outpatient Pyelonephritis

  • Ciprofloxacin

Inpatient Pyelonephritis

  1. Ceftriaxone
  2. Ertapenem
  3. Ampicillin + Gentamicin
  4. Quinolones
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10
Q

CYSTITIS & PYELONEPHRITIS

When are Sonography and CT Scanning used for Cystitis & Pyelonephritis?

A

To determine Etiology of UTI (not to diagnose UTI)

  • Complicated
    • ​Stone
    • Stricture
    • Tumor
    • Obstruction
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11
Q

CYSTITIS & PYELONEPHRITIS

  1. On Urinalysis, what information does a Positive Leukocyte Esterase test give you?
  2. On Urinalysis, what information does a Positive Nitrite test give you?
A
  1. Leukocyte Esterase is derived from granulocytic WBCs and serves as Indirect evidence of the presence of Bacteriuria.
  2. Nitrites are indicative of Gram-Negative Bacteria. Protein is very nonspecific in a urinalysis. Protein can be from both infection and glomerular disorders. Red cells are nonspecific as well.
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12
Q

PERINEPHRIC ABSCESS

This is a Rare Complication of which UTI?

A

Pyelonephritis

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13
Q

PERINEPHRIC ABSCESS

What is the typical Clinical Manifestation of a patient with a Perinephric Abscess?

A

A patient with Pyelonephritis (dysuria+wbc+flank pain+fever) who does NOT respond to treatment after 5 - 7 days.

Patient remains Febrile and still shows WBCs on Urinalysis.

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14
Q

PERINEPHRIC ABSCESS

  1. What are (2) Best INITIAL Tests for Perinephric Abscess?
  2. What is the ONLY way to determine a precise Microbiologic Diagnosis to guide therapy for Perinephric Abscess?
A
  1. Best INITIAL Test = Sonogram or CT Scan
  2. _Microbiologic D_x = Biopsy
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15
Q

PERINEPHRIC ABSCESS

What is the Treatment for Perinephric Abscess?

A

Quinolone + Staphylococcal coverage (eg, oxacillin, nafcillin, vancomycin)

because treatment with antibiotics for gram-negative organisms preferentially selects out for staphylococci

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16
Q

PROSTATITIS

What are (3) Clinical Manifestations of Prostatitis?

A
  1. Dysuria
    • Frequency
    • Urgency
    • Burning
  2. Perineal or Sacral pain
  3. Tender & “Boggy” Prostate on DRE
17
Q

PROSTATITIS

  1. What is the Best INITIAL Test for Prostatitis?
  2. What is the Most ACCURATE Test for Prostatitis?
A
  1. Best INITIAL Test = Urinalysis
  2. Most ACCURATE Test = Urine WBCs AFTER Prostate Massage
18
Q

PROSTATITIS

What are (3) Antibiotics used to treat Prostatitis?

A
  1. Ciprofloxacin
  2. TMP/SMX (Bactrim)
  3. Fosfomycin

Just like treating an abscess; use the same drugs as for cystitis and pyelonephritis but extend the length of therapy.

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