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GU Flashcards

1
Q

Most common pathogen causing UTI

A

E. Coli

Gram neg bacilli from the gut = 80%

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2
Q

1st line treatment for UTI
Course of tx?

A

Nitrofurantoin
M= 7-10d
F= 3d
Pts with comorbid conditions = 7-10d

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3
Q

What is the indication for phenazopyradine?

A

Anti-spasmodic- can be prescribed for UTI to prevent bladder spasm
SI- orange urine

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4
Q

Indication for fluvoxate?

A

Anti-spasmodic- prevent bladder spasm in UTI - makes urine bright orange

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5
Q

Who do you prescribe cephalosporins to with UTIs?

A

Reserve for pregnant ppl and Children

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6
Q

indication to follow-up with UTI

A

If blood present in the urine- ensure eradication with treatment to r/o cancer

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7
Q

Preferred medicine for OAB

A

Mirabegron

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8
Q

Post-menopausal women with OAB tx

A

Estrogen topical
Peasized amount in general genital area
Once daily x 2-4 wks
The twice weekly

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9
Q

Nitrites in urine indicate what?

A

Gram negative bacteria ie. ecoli

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10
Q

Causes of elevated BUN x4?

Low BUN?

A

Elevated- Renal Injury / high protein diet / hemolysis / CHF

Low- liver damage

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11
Q

What type of Casts in UA indicate:
Normal?
Infx?
Glomeural dysfunction?

A

N- Hyaline
Infx- WBC
Glomerular dx- RBC

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12
Q

Pt has a + Urine dip for protein. What is this measuring?
What should you order?

A

Albumin in urine——- NOT microambumin
Order 24h Urine

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13
Q

Causes of hematuria x5

A

Renal Colic
Cystitis
Pyelo
Cancer
Menses contam.

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14
Q

Treatment of Asymptomatic Bacteriuria

A

None EXCEPT Pregnant persons!

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15
Q

UTI’s in what population are more likely to become Pyelo

A

Children <3y & Pregnant person

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16
Q

Multiple bacteria on Urine C&S suggests what?

A

Sample contamination

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17
Q

Uncomplicated UTIs treatment

A

Septra (TMP/SMX) x 3d ——20% resistance rates
If likely resistant or allergic to sulfa-
Nitrofurantoin x 5d

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18
Q

What/ who are considered Complicated UTIs?
Considerations for treatment?

A

** Must treat for a minimum of 7d
Men
Children
Pregnant persons
Ppl with comorbid conditions
Immunocompromised
Recurrent UTI’s
Anatomical abnormalities

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19
Q

Recurrent UTI definition

A

F- >/= 3 per year or 2 in 6 months
Never normal in Males

R/o structural abnormalities/ other etiology

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20
Q

If UTI symptoms persist beyond 48-72 with abx treatment- what’s next?

A

Order C&S and UA
Change abx and extend course to 7 days

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21
Q

UTI definition (organism count)

A

> 100 000 CFU/mL of one organism

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22
Q

Pyelonephritis treated with Quinolones (ie. Ciprofloxacin or Levofloxacin) can be treated for ____ days

A

7 days = shorter

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23
Q

Describe Kidney position

A

Retroperitoneal at CVA
R is lower than L due to displacement by Liver

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24
Q

+++ Squamous epithelial cells in urine mean ?

A

Contamination

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25
Normal WBC count? Normal Neuts ?
WBC- 10.5 Neuts- > 80%
26
Presence of band or stabs in CBC indicate what?
Serious bacterial infx
27
Spermicides do what to females?
Increase risk of UTI
28
Oliguria is ?
< 400 ml urine / day
29
Normal urine output
1500 cc / day
30
RPR & VDRL are used for what?
Screening tests for syphillis Non-treponemal If + order treponemal test
31
What test is confirmatory of syphallis ?
FTA-ABS - treponemal test
32
Tx Primary/ secondary/ early latent (<1yr) Tx latent (>1yr)
Pen G 2.4 million U IM x1 Latent = x 3
33
T/F- 1. If a patient tests positive for gonorrhea, always treat for chlamydia. 2. If a patient tests positive for chlamydia and negative for gonorrhea- treat for both.
1. TRUE 2. False
34
Gonorrhea treatment
Ceftriaxone IM x1 + chlamydia treatment
35
Chlamydia treatment
Azithryomycin x 1 or doxy x 7d
36
NAAT are highly sensitive for what STIs?
Chlamydia & Gonorrhea Collected via urine (pref for males) / SWAB of vag/crevix/urethra/pharynx/rectum
37
If infected with G&C- when do you test for cure? If pregnant?
3 months 3 weeks
38
PID / Proctitis treatment
Ceftriaxone IM x 1 + Doxy x 14d +/- Metronidazole x 14d
39
Treponema Pallidum causes what dx?
Syphilis
40
Test of cure for syphilis
RPR or VRDL at 6 and 12 months after treatment
41
Treating sexual partners- syphilis
Within 90 days even if screening test neg
42
T/F- acute retroviral syndrome / primary HIV = flu like symptoms - non contagious time
FALSE- highly contagious time- treat HIV ASAP
43
What locations are most common of HSV-1 vs HSV-2
HSV-1 = oral mucosa HSV - 2 = genitals
44
STD symptoms + new swollen knee pain (or other joint)- think——?
Disseminated gonorrhoea infection
45
Acute febrile reaction within 24 hours after treatment of syphilis or lymes disease
Jarisch-Herxheimer Rxn
46
Fitz-Hugh- Curtis syndrome/ perihepatitis ?
Gonorrhea and/or chlamydia infx of the liver capsule
47
HIV tests
HIV 1 & 2antibodies P24 antigen —— if + the lab will differentiate antibodies If inconclusive- order HIV RNA
48
Viral load measuring in HIV? What is successful treatment?
Number of HIV RNA in 1ml of plasma Tx success = < 50 copies/ ml
49
Increased CD4 count suggests what of HIV therapy?
Responding to ART = good! Viral load decreases and CD4 count increases
50
ELISA is screening test for ?
HIV
51
Normal CD4 counts?
> 500 cells
52
Monitoring viral load with HIV treatment?
Initial = q1-2 months until undetectable Then q 3-4 months
53
Thrush + Kaposis Sarcoma + pneumocystitis jirovecii are suggestive of what?
AIDS
54
AIDS is defined by an absolute CD4 count less than?
200
55
PCP prophylaxis in pts with HIV is when CD4 count is less than?
200
56
Prophylactic PCP treatment is?
Bactrim Sulfa allergy - Dapsone
57
High risk oncogenes HPV types are ?
16 & 18
58
1st episode treatment of herpes Flare tx?
Antiviral (valcyclovir or acyclovir or famcyclovir) x 7-10 days Same X 5 days
59
What is imiquimod indicated for?
Immune modulator treatment for genital warts that can be used at home by pt
60
Podofilox/ podophylla/ imiquimod are contraindicated in ———-
Pregnancy
61
Tzanck smear is used to detect what infection
Varicella/ HSV
62
Genital herpes treatment duration: Primary- Recurrent-
1st- 7-10d Recurrent - 5d
63
Bacterial vaginitis treatment
Metronidazole x 7d
64
Trichamoniasis treatment Partner?
Metronidazole x 1 Yes- treat partner at same time
65
Western blot test
Confirms HIV dx
66
Clue cells on saline wet mount ?
BV

AANP Exam (11 decks)

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