B8-046 Female UTI Flashcards
cystitis, urethritis, and prostatitis are [upper/lower] UTI
lower
pyelonephritis, intra-renal abscess, perinephric abscess is [upper/lower] UTI
upper
UTI in healthy patient with functionally normal urinary tract
uncomplicated UTI
infection associated with anatomic/functional abnormality of the urinary tract, immunocompromised host, or multi-drug resistant bacteria
complicated UTI
pyelonephritis tends to arise from […] UTI
ascending
2 consecutive clean catch urine sample growing bacteria in the absence of symptoms
asymptomatic bacteriuria
does asymptomatic bateriuria need to be treated?
no
only in pregnancy or prior to GU surgery
UTIs in males are [complicated/uncomplicated]
complicated
UTIs in pregnancy are [complicated/uncomplicated]
complicated
UTIs in children are [complicated/uncomplicated]
complicated
UTIs in patients with DM are [complicated/uncomplicated]
complicated
genetic factor that provides risk factor for recurrent UTI
lewis blood group non-secretor
80% of outpatient UTIs are caused by
E coli
major virulence factor of UPEC
P pili
(prevents phagocytosis, upregulated in strains that cause pyelonephritis)
fever, chills, flank pain
CVA tenderness
pyelonephritis
treatment options for uncomplicated cystitis [3]
nitrofurantoin 100 mg BID x5
TMP/SMX BID x 3
fosfomycin 3g x 1
why is nitrofurantoin not recommend in pyelonephritis?
poor tissue penetration
treatment for pyelonephritis [3]
floroquinolone x 7 days
TMP/SMX BID x 14 days
oral b lactam x 14 days
definition of recurrent UTI
3 within 12 months OR
2 in 6 months
what diagnostic tool is mandatory for evaluation of recurrent UTI?
urine cultures
treatment for recurrent UTI in postmenopausal women
vaginal estrogen
treatment options for UTI in pregnancy [4]
penicillins
cephalosporin
nitrofurantoin (hemolytic anemia)
fosfomycin
what type of kidney stones are caused by urease producing bacteria?
struvite
(Proteus, Klebsiella, S. sapro)
intensely pink on MacConkey agar
E coli
viscous colonies
Klebsiella
swarming motility pattern
proteus mirabilis
Leukocyte casts in urine sample may indicate
pyelonephritis
Alkaline urine (pH > 8) may indicate
urease producing organisms
(Proteus, Klebsiella, S. sapro)
Positive urinary nitrites indicate
bacteria that convert nitrates to nitrites
(most commonly E.coli)
(lack of nitrites does not mean no infection)
antibiotic prophylaxis may be considered in all women with
recurrent uncomplicated UTIs
(can be continuous or postcoital)
first line medications for treatment of UTI [2]
nitrofurantoin
Trimethoprim/sulfamethoxazole (TMP/SMX)
staghorn calculus is composed of
struvite (magnesium ammonium)
struvite stones are produced by […] producing bacteria
urease
(proteaus mirabilis)
symptoms of upper UTI
fever
CVA tenderness
chills, malaise (ill appearing)
treatment options for uncomplicated pyelonephritis [3]
fluoroquinolone x 7 day
TMP-SMX x 14 days
beta-lactam x 14 days
not recommended for treatment of pyelonephritis due to poor tissue penetration
nitrofuratoin
treatment of asymptomatic bacteriuria in pregnancy
culture –> appropriate antibiotics
(no cipro or trimethoprim)
