infections

Question 1

UTI’s can involve what tissues?

Answer 1

mucosal tissue (cystitis), soft tissue (pyelonephritis, prostatitis).

Question 2

signs of UTI?

Answer 2

dysuria, internal discomfort, urinary freq and urgency, without fever. supra pubic tenderness not common.

Question 3

signs of pyelonephritis?

Answer 3

fever, back pain, n/v, CV tenderness, flank pain.

WBC - leukocytosis, neutrophilia, and bandemia

Question 4

presentation UTI in elderly?

Answer 4

confusion, urinary incont, dementia. muscle weakness.

Question 5

hemorrhagic cystitis symptoms?

Answer 5

large amounts of blood in urine. vituses is commoe cause. and self limiting. irritative voiding sytmpoms common.

Question 6

Diagnostics of UTI?

Answer 6

UA - leukocytes, nitrates, protein, and blood.

when leukocyte esterase + nitrates = gram negative bactera.

Culture - 10^5 CFU

Question 7

what are the possible gram negative organisms causing UTI?

Answer 7

ecoli, proteus, K. pneum

Question 8

what are possible gram Positive cause UTI bacteria?

Answer 8

S. saprophyticus. entercocci

Question 9

Can nitros be used in elderly?

Answer 9

NO! due to renal function needding to be strong!

Question 10

when is prophylaxis UTI tx approp?

Answer 10

2+ utis within 6 months or 3 or more episode in 12 months.

note also risk of pulmonary fibrosis.

Question 11

what is alkaline urine indicative of in UA?

Answer 11

if with positive leuok most likely proteus organism!

Question 12

Tx of acute uncomplicated UTI, nonpregnant

Answer 12

TMP-SMX BID 3-5 days
or cipro x 3 days

sulfa allergy: nitro x 5 days

Question 13

tx recurrent UTIs?

Answer 13

TMP- SMX 1 SS tab QID longterm

TMP-SMX 1 DS tablets postcoitus or 2 DS talets at first sign

Question 14

Acute pyelonephritis?

Answer 14

cipro 500 mg BID, ER 1000mg qd, x 7 days

or levo 750 qd, etc x 5 days.

Amox -Clauv, cephalosporin, TMP-SMX DS 14 days