GU: UTIs & Prostatitis Flashcards
most common cause(s) of UTIs
- E. coli - overall m/c
- s. saphrophyticus - in young, sexually active women
- klebsiella
- proteus
demographic most commonly affected by UTIs?
women
what are the most manifestations of UTIs?
- urethritis
- cystitis
- hemorrhagic cystitis
- asymptomatic bacteriuria (ABU)
- pyelonephritis
urethritis presentation?
UTI manifestation: only urethra inflamed
- dysuria
cystitis presentation?
UTI manifestation: urethra + bladder inflamed
- dysuria AND
- urgency / increased frequency / small urine volume
- suprapubic tenderness - pre & post micturition
- pyruria (WBCs in urine)
hemorrhagic cystitis
UTI manifestation: inflammation of urethra + bladder
- sx of cystitis + blood in the urine
how to distinguish cystitis from glomerulonephritis?
cystitis will not present with
- HTN
- abnormal renal function
pyelonephritis - presentation
UTI manifestation: urethra + bladder + uteters + kidneys affected
- sx of cystitis, AND
-
back pain
- flank pain
- costo-vertebral angle tenderness
-
systemic affects:
- fever
- nausea/vomiting
- immune: PERIPHERAL LEUKOCYTES, WBC casts
-
back pain
untreated pyelonephritis can progress to?
sepsis
septic shock
UTI relapse vs UTI reinfection
- relapse: recurrent UTI < 2 weeks after preceeding infection
- reinfection: recurrent UTI > 2weeks after preceding infection
when do males start to experience a rapid increase UTIs?
- their 5th decade
- d/t inc incidence of BHP
major risk factors for UTIs
- other GU problem: kidney stones, prostatitis
- catheters
- sexual intercourse
- pregnancy
dx of a UTI
confirm pyuria and bacteriuria
- pyruria: confirmed by
- + dipstick test for leukocyte esterase
- bacteriuria: confirmed by
- + dipstick test for nitrite (note that s. saphrophyticus does NOT reduce create nitrites)
- gram stain
- semiquantitative test
dx of cystitis (acute uncomplicated)
- reliable hx:
- at least 1 cystitis symptom
- pt has risk factors for UTI
- if not reliable hx:
- pyuria or bacteriuria dipstick tests
- > 1,000 CFUs/ml
- pyuria or bacteriuria dipstick tests
pyelonephritis (acute, uncompicated) dx
- reliable hx
- physical exam indicative (dysuria + inc frequency/small volume + suprapubic pain + flank pain/costo-verbral tenderness + fever/nausea/vomiting)
- additional lab tests of hx not reliable:
- CFUs > 10,000
- WBC casts
-
Ab-coated bacteria
- is bacteria makes it to the kidneys, it is more likely to contact the blood being filtered and trigger an immune response- will be attacked with & coated by Ab