Body Sites (Urine) Flashcards

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1
Q

A microorganism responsible for causing infection or infectious disease

A

Etiologic agent

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2
Q

A person who harbors the etiologic agent but shows no apparent signs or symptoms of infection or disease

A

Carrier

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3
Q

The origin of the etiologic agent or location from which it disseminates (e.g., water, food, insects, animals, other humans)

A

Reservoir

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4
Q

Infections acquired as a result of a medical procedure

A

Health care–associated infection (HAI)

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5
Q

Infection for which the etiologic agent was acquired in a hospital or long-term health care center or facility

A

Nosocomial infection

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6
Q

Microorganisms that cause infections or disease

A

Pathogen

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7
Q

Organism’s ability to cause disease

A

Pathogenicity

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8
Q

Measure or degree of pathogenicity of an organism

A

Virulence

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9
Q

Characteristics that enable pathogens cause disease

A

Virulence factors

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10
Q

Organisms which cause infection when one or more of the host’s defense mechanisms are disrupted or malfunction

A

Opportunistic pathogens

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11
Q

Microorganisms that inhabit many surfaces of the human body

  • Colonizers, Normal flora, and Transient microbiota
  • Are collectively known as the….
A

Human microbiome

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12
Q

The persistent survival of microorganisms on a surface of the human body (with no clinical expression, no immune response)

A

Colonization

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13
Q

______ are able to survive, but do not multiply, on the surface and are frequently shed with the host cells.

A

Transient colonizers

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14
Q

______ not only survive but also thrive and multiply; their presence is more persistent.

A

Resident microbiota

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15
Q

The establishment of a long-lasting, mutually beneficial or harmless relationship between a colonizer and the human host

A

Possible role of colonizing organisms

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16
Q

The first step in the process for the development of infection and disease.

A

Possible role of colonizing organisms

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17
Q

Balance between the normal human microbiome and the appearance of a potentially infectious agent.

A

Host-pathogen relationship

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18
Q

Host factors + Environment + Virulence factor

A

Host-pathogen relationship

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19
Q

Among the most common bacterial infections that lead patients to seek medical care.

A

UTI

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20
Q

Who has a higher incidence of UTI?

A

Women

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21
Q

What factors make women more susceptible to UTIs?

A
  • Short urethra in close proximity to perirectal region,
  • Sexual intercourse ↑ contamination of the female urethra.
  • Anatomic + hormonal changes favor the development of UTIs
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22
Q

What makes older men more susceptible to UTIs?

A

Enlarged prostate prevents bladder from emptying.

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23
Q

What are the routes of transmission for UTI?

A

Ascending, hematogenous, and lymphatic

24
Q

Does urine north of the urethra contain natural flora?

A

No; urine is sterile

25
Q

What do we call normal flora that we see in voided urine? Where does it actually reside in the body?

A

Urogenital flora; comes from the epithelium at the distal end if the urethra

26
Q

What percentage of patients with catheters will develop a UTI?

A

Up to 20% of patients with catheters will develop a UTI

27
Q

What are three physical properties that act as a defense against UTIs?

A
  • Normal voiding of urine
  • Valve-like mechanism that prevents backward flow
  • Uroendothelial cells that initiate an immune response
28
Q

What are three chemical properties of urine that act as defense against UTIs?

A
  • High osmolality, Low pH
  • High urea content
  • High organic acid content
29
Q

Isolation of bacteria without signs of infection

Increases with age!

A

Asymptomatic bacteriuria

30
Q

Cystitis

A

Infection of the bladder

31
Q
  • Primarily in young, sexually active women

- Symptomatic; few isolated organisms (<105 CFU/mL)

A

Acute urethral syndrome

32
Q

Inflammation of kidney parenchyma, calices, & pelvis

A

Pyelonephritis

33
Q

What percentage of sepsis originates from the urinary tract?

A

25% - called urosepsis

34
Q

What is urethritis usually caused by?

A

An STD - specifically GC

35
Q
The following conditions are what?
Underlying disease 
Sickle Cell anemia
Diabetes
Kidney stones
Structural abnormalities of Urinary tract
Indwelling catheters
Neurogenic bladder
A

Risk factors for complicated UTIs

36
Q

Which common UTI pathogen uses adhesins to facilitate bacterial adhesion?

A

Uropathogenic E. coli (UPEC)

37
Q

Which common UTI pathogen hydrolyzes urea, which then increases pH and creates an environment favoring the formation of kidney stones?

A

Proteus spp.

38
Q

Which common UTI pathogen adheres to the uroepithelial cells?

A

S. saprophyticus

39
Q

In what time frame should a urine culture be delivered to the lab?

A

Within two hours

40
Q

Name the urine sample type described. Least invasive/ Periurethral area is cleansed before collecting a midstream urine

A

Clean-catch midstream urine (CCMS)

41
Q

Name the urine sample type described. Urine considered uncontaminated

A

Straight catheterized urine (“In and Out.”)

42
Q

Name the urine sample type described. Specimen collected from a catheter port, not the collection bag!

A

Indwelling catheter collection

43
Q

Name the urine sample type described. Most Sterile;
A syringe is used to obtain urine from the bladder.
Only acceptable urine specimen for Anaerobic culture!

A

Suprapubic bladder aspiration

44
Q

Name the urine sample type described. When the patient doesn’t have a bladder, they have an nephrostomy.

A

Nephrostomy and Illeal Conduit

45
Q

May include exam of centrifuged sediment of urine for enumeration of PMNs

A

Microscopic Urinalysis

46
Q

What specific UTI organism is a nitrate reductase test good for detecting?

A

Enterobacterales

47
Q

What is a leukocyte esterase test good for detecting?

A

Inflammatory cells - correlates with hemocytometer counts for pyuria

48
Q

Is a gram stain best for detecting microbes in low or high numbers?

A

Higher numbers (> or = to 10^5 cfu/mL)

49
Q

T or F. You centrifuge urine before making a gram stain.

A

False

50
Q

How do we gram stain urine?

A

Using a 0.01 mL loop, transfer well-mixed urine onto a slide and let air dry without spreading.

51
Q

When is doing a gram stain from a urine sample most useful for the clinician?

A

When a patient may have acute pyelonephritis, an invasive UTI, or other patients for whom immediate information is necessary for appropriate clinical management.

52
Q

When should you add a CNA or PEA plate for a urinary culture?

A

Include CNA or PEA when the culture has two types of infections and you need to make sure the gram pos isn’t being masked by gram neg - also used when there’s a straight cath sample.

53
Q

For plating urine, how much does the calibrated loop deliver? How much growth does 1 colony represent?

A

0.001 mL or 1 uL; 1,000 CFU/per mL

54
Q

For plating urine from a suprapubic aspirate, how much does the calibrated loop deliver? How much growth does 1 colony represent?

A

0.01 mL or 10 uL; 100 CFU/per mL

55
Q

What 5 organisms (or groups of organisms) require susceptibility testing?

A
  • Enterobacterales
  • Pseudomonas and other NonFermementers
  • S.aureus
  • CNS, not S. saprophyticus
  • Enterococcus sp. from inpatients or surgical urology