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Adult Health > GU > Flashcards

GU Flashcards

1
Q

Bacteria of UTI

A

90 % e.coli gram -

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2
Q

UTI - Eval

A

UA = WBC, Nitrates, RBC

CVAT abdominal exam

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3
Q

Acute UTI

A

Acute simple cystitis

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4
Q

Relapsed UTI

A

Same pathogen occurs within 2 weeks of completion of UTI TX

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5
Q

Recurrent UTI

A

Arises more than two weeks after TX may or may not be caused by same pathogen

> 2 infections in 6 months or > 3 infections in one year

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6
Q

Complicated UTI

A

co morbidity - DM, immunospression, reduced renal function indwelling catheter , nuerogenic bladder

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7
Q

Intermediate susceptibility

A

May be effective but will have to five a higher dose that’s normal or more freq

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8
Q

MIC

A

Minimum inhibitory concentration
>100,000 organisms
Want the lowest number

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9
Q

UTI- uncomplicated TX

A

Bacteria : E. coli
Duration 3-5 days
Drugs : Nitrofunatoin BID x 5 days
Bactrim BID x 3 days (sulfa) Cipro x 3 days

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10
Q

UTI complicated

A 
Duration : 7-10 days
Drugs : 
Bactrim x 7 days 
Trimethoprim x 7 day (if sulfa allergy)
Cipro ( if PCN allergy)
Amplicillen ( not great cause it is QID )
Augmentin ( PCN allergy)

Can consider phenazopyrdine for bladder pain TID x 2 days

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11
Q

Preventative UTI

A

Post sex - one dose after sex
Recurrent : nitrofurin or bactrim 1 day for x 6 months

Refer to urology if 3 UTI in 6 months

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12
Q

Intersistial cystitis

A

Painful free urinations with voiding 60 times a day , nocturia, no infection, no response with antibitoics

Theory: leaking of teh inner lining of the bladder thereby inflaming the bladder wall

TX: elmiron - may take 2-4 month for relief
Elavil ( not great for elderly) - to relieve pain and urinary freq
Antihistamine - help with sleep and nocturia
Neurontin - help with nueropathic pain

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13
Q

Pyelonephritis

A

Infection of kidney
Can lead to atrophy and scarring of kidney may lead to renal failure

More common in women
Gram - ecoli, proteus

Sudden onset hight fever, shaking, flank pain

UA : bacteria RBC, WBC’s,
CVAT, WBC casts ***

TX: bactrim BID x 14 days
Amoxicillin TID x 14 days
Cipro BID x 10 days

Need to improve in 48-72 hours

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14
Q

Prostatitis

A

Common in adult male

4 types : acute bacterial , chronic bacterial, non bacterial, prostatidyna

Ecoli - bacterial
Chlamydia - non bacterial

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15
Q

Prostatodynia

A

Pain, discomfortn, problem with urinary flow, - may cause infertility or prostate ca

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16
Q

Prostatitis ROS / PE

A

Prostate - enlarged, tender , boggy,
GU - look for lesions and discharge
UA : WBC and Blood

17
Q

Prostatitis TX

A

> 35 no STI
Bactrim or cipro ( 500 mg higher dose) for four weeks

< 35 STI
Ceftriazone PLUS Doxycline X 10 days
Cefixime + doxycline
Ceftriazone PLUS azothryomcin ( 1 time dose ) = g/c

18
Q

BPH

A

Benign condition

Obstructive
- hesitancy , decreased force of stream post void dribbling,
Irritating
- freq, urgency, nocturia ( r/t decreased bladder capacity or infection)

PE: enlarged, non tender, firm but spongy

19
Q

PSA

A

ACA - PSA at start at 50
45 if at risk (AA, 1st degree relative)
40 if at greater risk ( 1 st degree relative )

USPSTF - recommends against PSA screening

20
Q

BPH treatment

5 -alpha reductase inhibitors

A

Proscar - dont give to men with pregnant wives

Dutasteride - concern for sexual function

21
Q

BPH - alpha blockers

A

Relaxes bladder neck
Take with meals

Flomax - give at bedtime

22
Q

BPH / erectile dysfunction

A

Phosphosiesteride type 5 inhibitor

Tadalafil - cialis
Can help with both
Take without regard to imting of sexual activity

23
Q

Urge UI

A

Bladder muscles contract forcefully and unexpectedly and as a result internal sphincter is unable to retain urine

“ i know I have to go but i cant get there”

24
Q

Stress

A

Loss of urine with use of abdominal muscles after coughing, laughing

25
Q

Overflow

A

Blockage of urethra causes bladder to overstretch,

Silently leak

26
Q

Functional UI

A

Unrelated to anatomy but rather immobility to tolitiing

27
Q

DIAPPERS

A

Delirium , INfection, Atrophic urethritis , Pharm, Psychological, endocrine, restricted mobility, stool impact

28
Q

Post void residual

A

Measure of urine left in bladder after voiding by catheter or bladder scan

< 50-100 normal
100-400 monitor
>400 needs urology

29
Q

UI - Drugs

A

Anticholinergics

  • OXYbutynin - most common 5 mg TID , 2.5 for older adults
  • Detroit -

Side effects : hot, dry, mad, blind, red

30
Q

Scrotal pain

A

Need to find underlying problem

31
Q

Variocele

A

Varicose veins in spermatic cord - may see blue hue along scrotal sac, semen count low

  • ligation for Vein
32
Q

Hydrocele

A

Fluid acclimation from a tumor, infection or trauma - will see transluminate

None may require surgical intervention

33
Q

Torsion

A

Redness, swelling, sudden onset, EMERGENCY must be treated in 6 hours or risk of necrosis

Occurs more in left testicle

Surgical intervention

34
Q

Hernia

A

Swelling, pain especially with straining, worse with standing, improves when lying down

  • surgery
35
Q

Epididymitis

A

Consistent with infection - redness swelling, extreme tenderness, relief with elevation of scrotum,

E.coli or STD

Treat with antibiotic

36
Q

Acute epididymitis men > 35

A

Most likely caused by bacteruria

Levo 500 mg daily for 10 days

Ofloxacin 300 mg 10 days

37
Q

Acute epididymitis < 35

A

Ceftriazone PLUS levo X 10 day ( g/c + enteric)

Ceftriazone PLUS doxy BID 10 days

38
Q

Kidney Stone

A

Peak age 20-30 not after 50
Men > w
Caused by foods - purines, fish, meat, calcium

Severe flank pain, groin n/v/, blood in urine
Fever, tachy, sweating,

1 stone = calcium which can be treated wit allopurinol

Adult Health (12 decks)

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