EXAM #1: UTI Flashcards

1
Q

What does upper urinary tract refer to?

A

Above the vesicoureteral valves

*This is the valve the the junction of the bladder and the ureters that prevents retrograde flow of urine

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2
Q

What does lower urinary tract refer to?

A

Below the vesicoureteral valves

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3
Q

What is the differene between a complicated and uncomplicated UTI?

A

Complicated= involvement of tissue structures or presence of co-morbidities

Uncomplicated= locoal effects ONLY without co-morbidities

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4
Q

What does pyelonephritis refer to?

A

Inflammation of the kidney, calyces, and pelvis

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5
Q

What is balanitis?

A

Inflammation of the glans penis

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6
Q

What does recurrence refer to in a UTI?

A

3+ UTIs in a single year

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7
Q

What does relapse refer to in a UTI?

A

Recurrence in the SAME MONTH, with the SAME ORGANISM

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8
Q

What does reinfection refer to in terms of a UTI?

A

Relapse AFTER 1 month, with a DIFFERENT organism

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9
Q

What is the definition of a UTI?

A

Greater than 10^5 CFU/mL of a single bacterial species in a clean catch urine

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10
Q

What is the most common cause of a UTI?

A

E. coli

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11
Q

When would you treat a patient with a clean catch urine showing LESS than 10^5 CFU/mL of a single bacterial species?

A

1) Pregnancy
2) Renal transplant
3) Urological surgery

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12
Q

When would you NOT treat a patient with a clean catch urine showing LESS than 10^5 CFU/mL of a single bacterial species?

A

1) Nursing home

2) Patient with catheter

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13
Q

What is the importance of the ratio of epithelial cells to WBCs in a UA?

A

Epithelial cells= WBC, then specimen is LIKELY CONTAMINATED

*Can’t make any decisions on infection from this

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14
Q

What elements of a UA are used to diagnose a UTI?

A

1) pH
2) Specific gravity
3) Nitrities
4) Leukocyte esterase
5) WBC
6) RBC

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15
Q

In a split catch sample, what does the first sample usually reflect?

A

Urethra

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16
Q

In a split catch sample, what does the second sample usually reflect?

A

Bladder

17
Q

Look at the first case. Where is the inflammation?

A

Urethra

18
Q

What is the likely diagnosis based on statistics?

A

Gonorrhea and/or chlamydia

19
Q

What is the empiric treatment for chlamydia?

A

1) Ceftriaxone 250mg IM

2) Azithromycin 1g PO

20
Q

Look at Case #3, what is the initial interpretation of the split catch urine?

A

Cystitis

21
Q

What is the first line antibiotic for acute uncomplicated cystitis in a female?

A

TMP-SMX

22
Q

What does lactate measure?

A

Tissue hypoperfusion

23
Q

What is a normal BUN/creatinine ratio?

A

20:1

24
Q

What is an elevated creatinine?

A

0.7- 1.3

25
Q

What is the black spot on the CT in case 4 in the right kidney?

A

Air in the renal pelvis

*Gas from bacteria

26
Q

What do procedure do you want to avoid in pyeloenephritis?

A

Foley catheter

27
Q

If that patient in case #4 has an obstructing renal stone causing an abscess, what is the appropriate treatment?

A

Surgery

28
Q

What drugs were recently moved further down the treatment algorithm for UTI?

A

Fluoroquinolones