B5-076 Dysuria

Question 1

common cause of delirium in older hospitalized patients

Answer 1

UTI

Question 2

most common bacteria causing acute cystitis

Answer 2

e. coli

Question 3

risk factors for acute cystitis

Answer 3

• cis female gender (short urethra, sexual activity)
• indwelling catheter
• diabetes mellitus
• urinary retention

Question 4

• suprapubic pain
• dysuria
• urinary frequency
• urgency

Answer 4

acute cystitis

Question 5

congenital condition where urine can reflux from the bladder to the kidney

Answer 5

vesicoureteral reflux

Question 6

bacterial infection of the kidney

Answer 6

bacterial pyelonephritis

Question 7

2 mechanisms of bacterial pyelonephritis

Answer 7

• ascending infection (most common)
• hematogenous spread

Question 8

flank pain + systemic systems

fevers, chills, malaise, nausea, vomiting

Answer 8

bacterial pyelonephritis

Question 9

[…] more readily causes bacteremia compared to cystitis

Answer 9

bacterial pyelonephritis

bacteremia -> cytokine release -> sepsis

Question 10

Answer 10

bladder diverticula

Question 11

Answer 11

VUR

Question 12

which STIs cause urethritis?

2

Answer 12

gonorrhea
chlamydia

related to recent sexual contact

Question 13

an unpleasant sensation perceived to be related to the urinary bladder associated with lower UT symptoms of more than 6 weeks duration

absence of infection or other identifiable causes

Answer 13

interstitial cystitis/bladder pain syndrome

Question 14

things that can cause chemical irritation leading to cystitis

3

Answer 14

caffeine
spicy foods
acidic foods

Question 15

dysuria with negative culture in a patient with previous radiation

Answer 15

radiation cystitis

Question 16

common condition in post menopausal women due to decreased estrogen in vaginal tissues

Answer 16

atrophic vaginitis

Question 17

• thin, pale, tan tissues
• friable, inflamed, red tissues
• associated with dysuria and dyspareunia

Answer 17

atrophic vaginitis

Question 18

loss of […] causes vaginal fluid to become more alkaline

Answer 18

lactobacillicus

Question 19

treatment of atrophic vaginitis

Answer 19

topical estrogen

avoid if hx. of breast or uterine cancer

Question 20

leading cause of bladder cancer in US

Answer 20

smoking

Question 21

• bacteria in urine but no clinical symptoms
• episodic
• does not require antibiotics

Answer 21

asymptomatic bacteriuria

Question 22

urinalysis tests for

3

Answer 22

RBCs
WBCs
bacteria (nitrates)

Question 23

urinalysis is not diagnostic of UTI. you have to get a

Answer 23

URINE CULTURE!!!!!!

Question 24

• empiric antibiotic with good urinary concentration and effective against common uropathogens
• DNA gyrase inhibitor

Answer 24

levofloxacin

Question 25

• acts as topical analgesic in urinary system
• turns urine orange

Answer 25

pyridium

will make subsequent dipsticks inaccurate

Question 26

antibiotic with very high concentration in urine but poor tissue penetration

Answer 26

nitrofurantoin

Question 27

poor choice for pyelonephritis but good for sexual UTI ppx

antibiotic

Answer 27

nitrofuratoin

Question 28

symptoms of interstitial cystitis worsen around

Answer 28

ovulation

Question 29

• multiple negative cultures
• symptoms worse with menstrual cycle, spicy food, stress

Answer 29

interstitial cystitis

Question 30

treatment for asymptomatic bacteriuria

Answer 30

none needed

Question 31

limiting fluids in dysuria causes

Answer 31

mucosal irritation

should actually hydrate despite symptoms