dysuria

Question 1

differential for dysuria

Answer 1

in women of reproduc age:

• lower UTI (cloudy, malodorous urine)
• vaginitis (vaginal discharge, perineal pruritus)
• upper UTI (uncommon)
• urethritis
• perineal trauma
• interstitial cystitis (freq and urgency for 6 months w/ neg work up)

in older women:
-vaginal atrophy

in men:

• prostatitis (common)
• urethritis (uncommon)

Question 2

dysuria is not as diagnostic of UTI in children, men or elderly women: true or false

Answer 2

true

Question 3

red flags for a complicated infec

Answer 3

male gender
infant or geriatric age
symptoms >7 days
immunosuppressing condition
episode of acute pyelo within past year
known anatomic abnormality
diabetes mellitus
fever
flank pain or tendernss

Question 4

urine dipstick detects

Answer 4

blood, nitrite, leukocyte esterase

Question 5

nitrite test is sensitive or not for UTI?

Answer 5

not

Question 6

urinalysis includes

Answer 6

dry reagent test strip (dipstick)

microscopy of centrifuged urine sample

Question 7

direct microscopy of urinary sediment is used to look for

Answer 7

WBCs
RBCs
bacteria
white cell casts

Question 8

when is urine culture useful

Answer 8

confirm infection and identify the organism and identify organism and antibiotic susceptibilities when evluating dysuria in children, men, older women, and younger women who have high likelihood of upper tract infec or infec w bac not likely to respond to first line antibiotics

Question 9

commonly used antibiotics to treat uncomplicated lower urinary tract infec in women

Answer 9

TMP/SMX
TMX alone
nitrofurantoin
fluoroquinolone (ciprofloaxcin)