Block 5: UTI Phys. Flashcards
What is a UTI and what are the types?
Infection of lower urinary tract of the bladder, upper urinary tract, or the kidney
- Cystitis
- Pyelonephritis
What is the most common uncomplicated UTI?
Cystitis
When would you see a complication in cystitis?
- Pregnant, immunocompromised, male
- Invasive procedures performed on the urethra
- UTI is likely to result in failure of therapy
What are the risk facotrs of cystitis?
- DM
- Familial predisposition
- Obstruction
- Neurogenic bladder
- Use of spermicides and diaphragms
- Advanced age
What is urethritis?
Infection and inflammation of the urethra
What are the causes of cystitis?
Ascension of bacteria through the urethra to the bladder by E coli obstructing urine flow and presence of residual urine
What are the sx of cystitis?
- Asymptomatic
- Painful bladder syndrome (interstitial)
What is painful bladder sydrome?
Mimics sx of UTI in the absence of infection or pathology
What is pyelonephritis?
Infection of the renal pelvis and parenchyma of the kidney usually from E coli
How is pyelonephritis classified?
Uncomplicated or complicated:
1. Anatomic or functional abnormalities
2. Pregnancy
3. Recurrence
4. Pathogen
What is the RF for pyelonephritis?
- Femal
- Abnormal genitourinary tract
What is the cause of pyelonephritis?
Pathogen ascends from the bladder through the ureter to the kidney resulting from bactermia (obstructive processes or instrumentation)
What are the causes of pyelonephritis?
Acute or chronic:
1. Chronic pyelonephritis
2. Vesicoureteral reflux (VUR): Abnormal backflow of urine from the bladder to the kidney
3. Lead to sepsis and septic shock
What are the sx of pyelonephritis?
- Costovertebral angle pain
- Chills
- Fever
- Lower UTI sx
Olders:
1. Confusion
2. Decreased appetite
3. Unsteady gait
WHat is is vaginitis?
Inflammation of the vagina that causes discharge, itching, and pain
What is the most common gynecologic condition in adult women?
Vaginitis
What are the causes of vaginitis?
- Change in normal balance of bacteria (normal 3.9-4.2)
- Reduced estrogen levels after menopause
What factors change to flora in the vagina?
- Age
- Sexual activity
- Hygiene
- Immune status
- Underling skin dx
- Medication
- STI
- Stress
What are the sx of vaginitis?
Bacterial is asymptomatic in 50% of women
1. Discharge is thin, malodorous, gray, yellow
2. Pruritis
3. Pain
What is urinary incontinence?
Involuntary leakage of urine
What is stress incontinence?
Involuntary loss of urine with physical activity or sneezing/coughing.
What is nocturnal incontinence?
Involuntary loss of urine during sleep.
What is insensible incontinence?
Complaint of incontinence but person is unaware that it happened or how it occurred because it was not felt.
What is urgency incontincen?
Involuntary loss of urine with feeling of urgency
What is coital incontinence?
Involuntary loss of urine with coitus
What is mixed incontinence?
Involuntary loss of urine with physical activity or sneezing/coughing, postural changes, and feelings of urgency.
What is postural incontinence?
Involuntary loss of urine with position change
What is continuous incontinence?
Complaint of continuous loss of urine
How do you assess urinary incontinence?
- History and physical examination
- Urinalysis
- Pelvic exam
- 3-day voiding diary
What is cervitis?
Inflammation of the cervix:
1. Caused by infection or other vaginal issues
2. Noninfectious cervicitis may result from trauma, radiation, or malignancy
What is a natural host environement for inflammation?
Cervix
What are the common sx of cervicitis?
- Vaginal discharge
- Vaginal bleeding
What is PID?
Pelvic inflammatory disease: Infection caaused by bacteria that orginates in the vagina or cervix and is carried to the uterus, fallopian tubes, and ovaries
What is the cause of PID?
- Multiple sex partners
- Early sexual activity
- Young age for first intercourse
- Use of an IUD for contraception
- Surgery
What are the sx of PID?
Pain and tenderness in lower abdomen
What is prostatisis?
Inflammation and enlargement of the prostate gland
What are the types of prostatitis?
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic prostatitis/chronic pelvic pain syndrome
- Asymptomatic inflammatory prostatitis
What is the cause of acute bacterial prostitis?
- Usually caused by gram-negative bacterial
- Causes severe prostatitis symptoms, systemic infection, and acute bacterial UTI.
Least common but easy to diagnose
What is chronic bacterial prostatis?
- Often occurs with recurrent UTIs from same strain
- Common infecting bacteria include E. coli, Enterobacter, and Klebisella.
- With or without sx
What is the most common prostatitis?
Chronic prostatitis/chronic pelvic pain syndrome
What is the cause of Chronic prostatitis/chronic pelvic pain syndrome?
- UTI abnormalities
- Neurologic or psychiatric disorders
- Trauma
- Local irritation
What is the cause of Asymptomatic inflammatory prostatitis?
- Prostate inflammation without GU symptoms
- Usually found during examination for other conditions when semen samples or prostate biopsy produce inflammatory cells or leukocytes with no associated discomfort
Sx of Acute bacterial prostatitis?
- Fever
- Chills
- Arthralgia
- Low back pain
- Pelvic pain
- Abdominal pain
Sx of Chronic prostatitis/chronic pelvic pain syndrome?
- Painful ejaculation
- Dysuria
- Blood-tinged urine or semen
- Pain
What is Epididymitis?
Inflammation of epididymis (tube that collects and transports sperm)
What is orchitis?
Inflammation of one or both testicles
What is the causes of epididymitis?
Frequently an infectious process, but cultures often fail to show an identifiable infectious agent
Acute epididymo-orchitis: Severe epididymitis that extends to testicle
What are the types of orchitis?
- Bacterial
- VIral
What are the sx of acute epididymitis?
Pain and swelling over several days
What are the sx of chronic epididymus?
Pain and swelling lasting more that 6 weeks:
Scrotal induration: Hardening of scrotum.
What are the sx of orchitis?
- Swelling in one or both testicles
- Mild to severe pain
- Tenderness
- Fever
- Nausea
- Vomiting
- Infertility
