B5-076 Dysuria Flashcards
common cause of delirium in older hospitalized patients
UTI
most common bacteria causing acute cystitis
e. coli
risk factors for acute cystitis
- cis female gender (short urethra, sexual activity)
- indwelling catheter
- diabetes mellitus
- urinary retention
- suprapubic pain
- dysuria
- urinary frequency
- urgency
acute cystitis
congenital condition where urine can reflux from the bladder to the kidney
vesicoureteral reflux
bacterial infection of the kidney
bacterial pyelonephritis
2 mechanisms of bacterial pyelonephritis
- ascending infection (most common)
- hematogenous spread
flank pain + systemic systems
fevers, chills, malaise, nausea, vomiting
bacterial pyelonephritis
[…] more readily causes bacteremia compared to cystitis
bacterial pyelonephritis
bacteremia -> cytokine release -> sepsis
bladder diverticula
VUR
which STIs cause urethritis?
2
gonorrhea
chlamydia
related to recent sexual contact
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
interstitial cystitis/bladder pain syndrome
things that can cause chemical irritation leading to cystitis
3
caffeine
spicy foods
acidic foods
dysuria with negative culture in a patient with previous radiation
radiation cystitis
common condition in post menopausal women due to decreased estrogen in vaginal tissues
atrophic vaginitis
- thin, pale, tan tissues
- friable, inflamed, red tissues
- associated with dysuria and dyspareunia
atrophic vaginitis
loss of […] causes vaginal fluid to become more alkaline
lactobacillicus
treatment of atrophic vaginitis
topical estrogen
avoid if hx. of breast or uterine cancer
leading cause of bladder cancer in US
smoking
- bacteria in urine but no clinical symptoms
- episodic
- does not require antibiotics
asymptomatic bacteriuria
urinalysis tests for
3
RBCs
WBCs
bacteria (nitrates)
urinalysis is not diagnostic of UTI. you have to get a
URINE CULTURE!!!!!!
- empiric antibiotic with good urinary concentration and effective against common uropathogens
- DNA gyrase inhibitor
levofloxacin
- acts as topical analgesic in urinary system
- turns urine orange
pyridium
will make subsequent dipsticks inaccurate
antibiotic with very high concentration in urine but poor tissue penetration
nitrofurantoin
poor choice for pyelonephritis but good for sexual UTI ppx
antibiotic
nitrofuratoin
symptoms of interstitial cystitis worsen around
ovulation
- multiple negative cultures
- symptoms worse with menstrual cycle, spicy food, stress
interstitial cystitis
treatment for asymptomatic bacteriuria
none needed
limiting fluids in dysuria causes
mucosal irritation
should actually hydrate despite symptoms
