EXAM #1: UTI Flashcards
What does upper urinary tract refer to?
Above the vesicoureteral valves
*This is the valve the the junction of the bladder and the ureters that prevents retrograde flow of urine
What does lower urinary tract refer to?
Below the vesicoureteral valves
What is the differene between a complicated and uncomplicated UTI?
Complicated= involvement of tissue structures or presence of co-morbidities
Uncomplicated= locoal effects ONLY without co-morbidities
What does pyelonephritis refer to?
Inflammation of the kidney, calyces, and pelvis
What is balanitis?
Inflammation of the glans penis
What does recurrence refer to in a UTI?
3+ UTIs in a single year
What does relapse refer to in a UTI?
Recurrence in the SAME MONTH, with the SAME ORGANISM
What does reinfection refer to in terms of a UTI?
Relapse AFTER 1 month, with a DIFFERENT organism
What is the definition of a UTI?
Greater than 10^5 CFU/mL of a single bacterial species in a clean catch urine
What is the most common cause of a UTI?
E. coli
When would you treat a patient with a clean catch urine showing LESS than 10^5 CFU/mL of a single bacterial species?
1) Pregnancy
2) Renal transplant
3) Urological surgery
When would you NOT treat a patient with a clean catch urine showing LESS than 10^5 CFU/mL of a single bacterial species?
1) Nursing home
2) Patient with catheter
What is the importance of the ratio of epithelial cells to WBCs in a UA?
Epithelial cells= WBC, then specimen is LIKELY CONTAMINATED
*Can’t make any decisions on infection from this
What elements of a UA are used to diagnose a UTI?
1) pH
2) Specific gravity
3) Nitrities
4) Leukocyte esterase
5) WBC
6) RBC
In a split catch sample, what does the first sample usually reflect?
Urethra
In a split catch sample, what does the second sample usually reflect?
Bladder
Look at the first case. Where is the inflammation?
Urethra
What is the likely diagnosis based on statistics?
Gonorrhea and/or chlamydia
What is the empiric treatment for chlamydia?
1) Ceftriaxone 250mg IM
2) Azithromycin 1g PO
Look at Case #3, what is the initial interpretation of the split catch urine?
Cystitis
What is the first line antibiotic for acute uncomplicated cystitis in a female?
TMP-SMX
What does lactate measure?
Tissue hypoperfusion
What is a normal BUN/creatinine ratio?
20:1
What is an elevated creatinine?
0.7- 1.3
What is the black spot on the CT in case 4 in the right kidney?
Air in the renal pelvis
*Gas from bacteria
What do procedure do you want to avoid in pyeloenephritis?
Foley catheter
If that patient in case #4 has an obstructing renal stone causing an abscess, what is the appropriate treatment?
Surgery
What drugs were recently moved further down the treatment algorithm for UTI?
Fluoroquinolones
