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Section 10: Renal and Genitourinary Disorders > Chapter 91: Urinary Tract Infection and Hematuria > Flashcards

Chapter 91: Urinary Tract Infection and Hematuria Flashcards

1
Q

asymptomatic bacteriuria

A
  1. The presence of >100,000 (>10x5) colony-forming units (CFU)/mL of a single pathogen on two successive clean-catch urine cultures in a woman without symptoms.
  2. The presence of >100,000 (>10x5) CFU/mL on one clean-catch urine culture in asymptomatic men.
  3. The presence of 100 CFU/mL of a single isolate in a catheterized urine specimen in a patient without symptoms.
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2
Q

prevalence of asymptomatic bacteriuria in patient with indwelling catheter for more than a month

A

100%

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3
Q

T or F: Treatment of asymptomatic bacteriuria is recommended only in pregnant women and patient to go on invasive urinary procedure

A

True

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4
Q

where does cystitis starts?

A

urethritis what colonized by pathogen form GI system

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5
Q

how cystitis diagnosed?

A

dysuria, urinary frequency, and hematuria

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6
Q

what is the difference in diagnosis of urethritis to cystitis?

A

in urethritis their is presence of discharge

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7
Q

patient presented with flank pain or costovertebral angle tenderness, with or without fever, in the setting of a positive urine culture of 105 CFU/mL what is your diagnosis?

A

pyelonephritis

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8
Q

3 pattern of renal infection as complication of pyelonephritis

A

acute bacterial nephritis
renal abscess
emphysematous pyelone- phritis

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9
Q

T or F:
The traditional diagnostic criterion dating from 1960 of uncomplicated UTI had been a positive urine culture of 105 CFU/mL; however, in symptomatic patients, low-colony-count infections with ≥102 to 103 CFU/mL are clinically valid

A

True

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10
Q

T or F:

recurrent infection alone is a criterion for complicated UTI.

A

False

recurrent infection alone is not a criterion for complicated UTI.

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11
Q

complicated UTI diagnostic criteria in terms of urine culture

A

isolation of 105 CFU/mL of urine culture

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12
Q

this refers to the clinical syndrome of fever and flank pain or tenderness with or without vomiting in a woman with an anatomically normal urinary tract without comorbidities

A

Uncomplicated pyelonephritis

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13
Q

Catheter-associated UTI (CAUTI) refers to a UTI occurring in a per- son whose urinary tract is currently catheterized, or has been within the previous ___

A

48 hours

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14
Q

how recurrent UTI diagnosed?

A

Recurrent UTI is defined as two uncomplicated UTIs in 6 months or three or more uncomplicated UTIs in the preceding 12 months

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15
Q

2 categories of recurrent UTI

A

relapse

reinfection

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16
Q

category of recurrent UTI that happen within 2 weeks of treatment completion caused by the same organism from a focus within the urinary system

A

relapse recurrent UTI

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17
Q

category of recurrent UTI that caused by a different bacterial isolate or by previously isolated bacteria after a negative intervening culture or a period of >2 weeks between infections

A

reinfection recurrent UTI (more common than relapse)

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18
Q

The strongest behavioral risk factors for recurrent UTI (in women) are the frequency of ___

A

sexual intercourse and the use of a diaphragm and spermicide

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19
Q

mechanism to get UTI?

A

ascending infection (most common)
hematogenous
lymphatic

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20
Q

37 year old male presents dysuria with a urethral discharge. what is the diagnosis?

A

urethritis

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21
Q

In women, Chlamydia infection should be suspected in the following settings

A

new sexual partners
partner with urethritis
examination findings of cervicitis
low grade pyuria (no bacteria in urinalysis)

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22
Q

T or F:
A history of vaginal discharge or irritation is more often associated with vaginitis, cervicitis, or pelvic inflammatory disease than with UTI

A

true

23
Q

Approximately ___ of patients treated for sepsis have an etiology from the genitourinary system

A

10% to 19%

24
Q

T or F:
Bacteria in urine double each hour at room temperature, so urine should be refrigerated if not sent directly to the laboratory

A

True

25
Q

urinalysis result that are uncentrifuged or dipstick test

A

leukocyte esterase

nitrate

26
Q

E. coli will convert nitrate to nitrites in urinalysis. what bacteria do not?

A

enterococcus
pseudomonas
acinetobacter species

27
Q

T or F:
A positive urinary dipstick nitrite or leukocyte esterase test result supports the diagnosis of UTI, but a negative test result does not exclude it in the correct clinical presentation

A

True

28
Q

A WBC count of ___ in a centrifuged specimen from a symptomatic patient is abnormal

A

> 5 cells/high-power field (HPF)

29
Q

T or F:

In men, >3 or 4 WBCs/HPF in a centrifuged specimen can be significant when bacteria are present

A

False

In men, >1 or 2 WBCs/HPF in a centrifuged specimen can be significant when bacteria are present

30
Q

T or F:
The presence of any bacteria on a Gram-stained specimen of uncentrifuged urine (>1 bacterium/HPF or 1000×) is significant and highly correlates with culture results of >105 CFU/mL

A

True

31
Q

accurate predictors of a UTI

A

dipstick test positive for nitrates
moderate pyuria
and/or bacteriuria

32
Q

Urine culture should be performed for the following patients

A

complicated UTI
pyelonephritis
sepsis
recent antimicrobial therapy

33
Q

The primary indication for blood cultures in patients with suspected UTI is clinical ___

A

clinical sepsis

34
Q

renal ultrasound is indicated with the following patient

A 
male
elderly
diabetic
Beverly ill
acute worsening of renal function (GFR <40mL/min)
35
Q

Plain film radiography and US have poor sensitivity for detection of intrarenal gas formation in ___

A

emphysematous pyelonephritis

36
Q

CT is the best imaging modality for the following diseases

A

kidney or ureteral stones

emphysematous pyelonephritis

37
Q

how many residual volume predisposes to bacteriuria?

A

> 180mL

38
Q

guidelines in treatment of UTI including pyelonephritis in divided into 3 groups which are

A
  1. uncomplicated lower tract disease
  2. complicated UTI or pyelonephritis
  3. women with UTI symptoms in whom coexistent urethritis cannot be excluded
39
Q

this drug continues to be recommended due to its limited adverse effects

A

Trimethoprim-sulfamethoxazole

40
Q

T or F:

A 5-day course of extended-release nitrofurantoin is as effective as 3 days of trimethoprim-sulfamethoxazole therapy

A

True

41
Q

first-line drug of choice for uncomplicated UTI

A

single 3 gram dose fosfomycin

42
Q

Both nitrofurantoin and fosfomycin are recommended oral agents in the event of ___

A

extended-spectrum β-lactamase– producing E. coli infection

43
Q

Third-generation cephalosporins are highly effective against ___, whereas first-generation cephalosporins are more effective against ___

A

enterobacteria

staphylococci

44
Q

why the CDC do not recommend Fluoroquinolones as treatment for both cystitis and urethritis?

A

because of N. gonorrhoeae infection

45
Q

antibiotic for adult female with lower (cystitis) uncomplicatied?

A
  1. Nitrofurantoin monohydrate/macrocrystals, 100 milligrams twice a day × 5 days
  2. TMP-SMX DS (160/800 milligrams), 1 tab twice a day × 3 days
  3. Fosfomycin, 3 grams in single dose or (where available)
  4. Pivmecillinam, 400 milligrams twice a day × 5 days
  • urine culture not required
46
Q

antibiotic for adult male with lower (cystitis) or adult female with upper (pyelonephritis), complicated?

A
  1. Ciprofloxacin, 500 milligrams twice a day × 5–7 days
  2. Levofloxacin, 750 milligrams once a day × 5–7 days

-urine culture required

47
Q

antibiotic for adult female with lower (urethritis)

A
  1. Ceftriaxone, 250 milligrams plus Azithromycin, 1-gram single dose or Doxycycline, 100 milligrams twice a day × 7 days
48
Q

Men with UTI without immunocompromise may have improved outcomes with therapy for ___, rather than 14 days

A

7 days

49
Q

treatment plan for CAUTI other than antibiotic?

A

replacement of catheter prior to start of antibiotic and collection for culture

50
Q

The decision to admit a patient with UTI is based on ___

A

age, host factors, and response to initial ED interventions

51
Q

oral bladder analgesics that reduced dysuria

A

phenazopyridine 200 mg PO TID

52
Q

in pregnant women. First-line treatment for asymptomatic bacteriuria and simple cystitis is either ___

A
  1. amoxicillin 500 milligrams PO two to three times daily for 3 to 7 days or
  2. cephalexin 500 milligrams two to four times daily for 3 to 7 days.
53
Q

avoid nitrofurantoin in what trimester of pregnancy?

A

1st

54
Q

initial antibiotic for patient with UTI and HIV AIDS

A

Fluoroquinilones

Section 10: Renal and Genitourinary Disorders (8 decks)

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