ID - urinary tract

Question 1

Cystitis is:

Answer 1

infection of the bladder

Question 2

Pyelonephritis is:

Answer 2

infection of the kidney parenchyma & renal pelvis

Question 3

Cystitis is usually caused by:

Answer 3

E. coli

Question 4

Pyelonephritis is usually caused by:

Answer 4

gram negatives including E. coli, Proteus, Klebsiella, Enterobacter, Pseudomonas

Question 5

Symptoms of cystitis are:

Answer 5

frequency, urgency, dysuria

suprapubic discomfort

Question 6

Symptoms of pyelonephritis are:

Answer 6

frequency, urgency, dysuria
fever
flank pain / CVA tenderness
shaking chills
NVD
tachycardia

Question 7

Lab findings for cystitis are:

Answer 7

urinalysis:
~pyuria
~bacteriuria
~varying degrees of hematuria
urine culture:
~positive for offending organism

Question 8

More pyuria and more bacteruria means more severe symptoms of cystitis, and less pyuria and less bacteruria means less severe symptoms of cystitis.
T/F?

Answer 8

FALSE.

Degree of pyuria/bacteruria does not necessary correlate with severity of symptoms

Question 9

Lab findings for pyelonephritis are:

Answer 9

~CBC has leukocytosis & left shift
~urinalysis: pyuria, bacteruria, varying degress of hematuria
~urine culture: heavy growth of offending organism

Question 10

Cystitis treatment:

Answer 10

short-term abx

cephalexin, nitrofurantoin, fluoroquinolones

Question 11

Pyelonephritis treatment:

Answer 11

inpatient: IV ampicillin + aminoglycoside
outpatient: quinolone

Question 12

What is recurrent cystitis?

Answer 12

More than 3 episodes of cystitis per year

Question 13

What is the treatment for recurrent cystitis?

Answer 13

Prophylactic abx (TMP-SMX, nitrofurantoin, cephalexin) single dosing at bedtime or time of intercourse

Question 14

What is ddx for pyelonephritis?

Answer 14

appendicitis
cholecystitis
pancreatitis
diverticulitis
(GI disorders usually have normal urinalysis)

Question 15

Septic shock can occur with pyelonephritis.

T/F?

Answer 15

TRUE