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Urgent Care Guide > GU 1 > Flashcards

GU 1 Flashcards

1
Q

cystitis

A

lower UTI; bacterial infection of the bladder

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2
Q

lower UTI; bacterial infection of the bladder

A

cystitis

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3
Q

pyelonephritis

A

upper UTI; ascending bacterial infection of the kidney from the bladder

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4
Q

upper UTI; ascending bacterial infection of the kidney from the bladder

A

pyelonephritis

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5
Q

cystitis - pt common presents w/
4

A
  1. dysuria
  2. urinary urgency/frequency
  3. suprapubic pain
  4. +/- hematuria
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6
Q

pyelonephritis - pt commonly presents w/
4

A
  1. flank/back pain
  2. fever/chills
  3. +/- NV
  4. +/- symptoms of cystitis
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7
Q

vitals signs for upper/complicated UTI

A

+/- fever
tachycardia - think pain, sepsis

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8
Q

suprapubic tenderness is common in ____

A

cystitis

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9
Q

CVA tenderness is common in ____

A

pyelonephritis

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10
Q

UTI/pyelonephritis img/testing
2

A
  1. pregnancy test
  2. POC urine
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11
Q

UTI/pyelonephritis - urine cx recommended in who

A

suspected complicated or upper UTI

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12
Q

cystitis DD
5

A
  1. STI
  2. vaginitis
  3. genital HSV
  4. prostatitis
  5. urolithiasis
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13
Q

pyelonephritis DD
9

A
  1. MSK stain
  2. urolithiasis
  3. appendicitis
  4. biliary disease
  5. pancreatitis
  6. AAA
  7. SBO
  8. ovarian conditions
  9. ectopic pregnancy
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14
Q

UTI symptom relief rx
4

A
  1. NSAIDs
  2. acetaminophen
  3. phenozopyridine/Pyridium
    Adults 12+: 100-200 mg PO q8H x 2 days
    Peds 6-12 years 4 mg/kg/dose PO TID X 2 days after emails
    Can get AZO OTC but lower dose
  4. antiemetics i.e. ondansetron 4 mg PO q8h prn
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15
Q

cystitis rx
3

A

Per UTD
1. Macrobid 5 days
2. Bactrim 3 days
3. Fosfomycin 3 g once PO

  1. cephalexin 500 mg PO BID 5-7 days (first line in pregnant pts)
  2. nitrofurantoin 100 mg PO BID x 5 days (poor renal penetration, avoid in pts w/ renal insufficiency, pyelonephritis, 1st tri pregnancies)
  3. TMP/SMX DS/ Bactrim - 1 tab PO BID for 3-5 days
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16
Q

male patient UTIs should be treated as

A

complicated UTIs and require longer duration of tx - typically 7 days; may only need 5 days if needing a fluoroquinolone

17
Q

cystitis 1st line and duration

A

nitrofurantoin 100 mg PO x 5 days(F)/10 days(M)

18
Q

cystitis 2nd line and duration

A

TMP/SMX DS 160/800 mg BID x 3 days (F)/10 days(M)

19
Q

pyelonephritis rx

A
  1. cefpodoxime 200 mg PO BID for 10-14 days
  2. TMP/SMX DS 160/800 mg 1 tab BID 10-14 days
  3. ciprofloxacin 500 mg PO BID x 7 days
20
Q

UTI/pyelonephritis - f/u

A

with PCP in 2-3 days if sx persist or sooner if worsening

21
Q

UTI/pyelonephritis - when to refer to ER
5

A
  1. inability to tolerate PO
  2. concern for infected kidney stone - sx of kidney stone + fever or evidence of UTI on POC urine
  3. signs of sepsis
  4. complicated UTI - significant comorbidities such as uncontrolled DM, renal failure, pregnancy, immunosuppressed, known uro abnormalities (single kidney)
  5. failure of OP abx therapy (48-72 hrs)
22
Q

kidney stones

A

stones form in renal pelvis and typically become symptomatic w/ passage into the narrow ureter

23
Q

kidney stones - clinic pres can include
4

A
  1. acute onset of colicky, waxing/waning unilateral flank pain
  2. often w/ radiation to unilateral lower abd, groin, or genitalia
  3. NV
  4. hematuria
24
Q

kidney stones - general appearance
2

A

often unable to find a comfortable position
pacing/writhing in pain

25
Q

kidney stones - vitals and PE exam findings
3

A

VS typically normal - may have pain related tachycardia
+/- CVA tenderness
+/- abd/pelvic tenderness

26
Q

kidney stones - fever raises concern for

A

infected stones

27
Q

kidney stones - img/testing
2

A

POC urine (hematuria in 80-90%)
pregnancy test

28
Q

kidney stones - DD
6

A
  1. AAA
  2. appendicitis
  3. pyelonephritis
  4. biliary disease
    5 - Gyno concerns - pregnancy. ovarian conditions, cyst
  5. MSK strain
29
Q

kidney stones - overall tx care includes
3

A
  1. hydration
  2. analgesics
  3. antiemetics
30
Q

kidney stones - analgesia meds
3

A
  1. ketorolac - Weight ≥50 kg and <65 years of age: 30 to 60 IM once in office; Weight <50 kg or ≥65 years of age: 30 mg IM once while in office then
  2. PO NSAIDs i.e. ibuprofen
  3. opiates for severe pain
31
Q

kidney stones - antiemetic option

A

ondansetron 4 mg PO q6h prn

32
Q

kidney stone pt education
3

A
  1. keep hydrated
  2. most stones pass on their own w/in 4 weeks of onset of symptoms (5-10 mm most pass on their own, 10 mm or bigger may req tx)
  3. consider urine strainer to collect calculus
33
Q

kidney stone referral

A

urology

34
Q

kidney stones - when to refer to ER
4

A
  1. signs of systemic infection - concern for infected kidney stone (fever, evidence of UTI on urine)
  2. suspected urolithiasis in a pt with solitary or transplanted kidney, CKD
  3. unable to tolerate PO, hypovolemia
  4. consider referral to ER for imaging, especially in elderly pts or first episode

Urgent Care Guide (38 decks)

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