infections Flashcards

1
Q

cystitis

A

infx of the normal bladder most commonly caused by coliform bacteria (E. coli) and some gram positive (enterococci)

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2
Q

CF of cysitis

A

irritative voiding sx, suprapubic discomfort

grow hematuria may occur, sx inn women often may appear following sexual intercourse

PE- may elicit suprapubic tenderness

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3
Q

cystitis UA

A

pyuria, bacteriruria, varying degrees of hematuria

urine culture

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4
Q

imaging in cystitis?

A

only if suspected pyelonephritis, recurrent infx, or anatomic abnormalities

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5
Q

tx for cystitis

A

women- fluoroquinolone or nitrofurantoin (macrobid) X5 days

Bactrim if resistant bacteria

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6
Q

cystitis symptomatic relief

A

hot sitz baths, urinary analgesics,

phenazopyridine (azo)- turn pee orange/yellow

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7
Q

what is the most common cause of epidiymitis in men younger than 35? older than 35?

A

chlamydia and gonococci

E. coli

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8
Q

what are the clinical features of epidiymitis?

A

heaviness and dull, aching discomfort in the affected hemiscrotum which can radiate upt he ipsilateral flank

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9
Q

what may a hx of pt with epidim reveal?

A

healy lifftin, trauma, sexual activity

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10
Q

PE findings for epidid.

A

swollen and tender to touch, eventually becoming a warm, erythematous, enlarged scrola mass
+/- fever

+ positive phrens sign: pain relief w/ elevation

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11
Q

tx of epid. in men younger than 35? older than 35?

A

ceftriaxone IM + doxy or azithromycin (test for cure in 1 wk_

ciprofloxacin

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12
Q

pyelonephritis?

A

involves kidney parenchyma and renal pelvis

+most common in DM and elderly women

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13
Q

what is the most common causative agent of pylenephritis?

A

gram negative: e. coli (#1), proteus, klebsiella, enterbackter, psuedomonas

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14
Q

what is chronic pyelonephritis?

A

progressive inflammation of the renal interstitium cuased by bacterial infection

  • pts with vesicoureteral reflux (backward flow of urine into bladder)
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15
Q

what are the clinical features of pyelon?

A

fever, flank pain, shaking chills, irritative voiding sx

N, V, D

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16
Q

PE of pyelon?

A

Fever, tacycardia, CVA tenderness

17
Q

dx studies for pyelon?

A

CBC: WBC and left shift
UA: pyuria (pus), bacteriruia, hematura, WBC casts

+complicated cases: renal US may show hydronephrosis secondary to obstructions

18
Q

tx of pyleon?

A

FQ or bactrim

19
Q

tx of hospitalized pyleonep. pts?

A

IV FQ or ampicili or gentamicin while waiting for sensitivy results

20
Q

what if tx of pyleone. fails/?

A

US to exclude complicating factors like stones

21
Q

what is prostatitis?

A

caused by ascending infection of gram- neg rods

can be acutee or chronic

22
Q

what is the most common of the prostatitis syndromes?

A

chronic nonbacterial prostatitis: unknown cause

may present as an noninfectious inflammatory disorder perhaps w/ autoimmune origin (chrnic pelvic pain syndrome)

23
Q

what is a complication of acute bacterial prostatitis? (if fever doesnt resolved in 36 hours after tx)

A

prostatic abscess

24
Q

what are the clinical features of acute prostatitis?

A

sudden onset of high fever, chills, low back pain and perineal pain

25
what are the clinical features of chronic prostatitis?
variable : asx to acute symptomatology
26
what are the clinical features of acute and chronic prostatitis?
irritative bladder sx and some obstruction
27
PE of prostatitis?
porstate is swollen and tender; avoid vigorous prostae exam bc it may cause septicemia (if suspected acute)
28
what dx studies for prostatitis?
UA: pyruia, hematuria, bacteruria | Prostatic fluids: WBC
29
what bacteria cuases acute prostatitis?
e coli
30
what bacteria cuases chronic prostatitis?
enterococcus
31
tx of uncomplicated prostatitis?
cipro or levo or bactrim
32
tx of chronic prostatits?
FQ
33
what other meds may be helpful for prostatitis?
nsaids, alpha 1 blockers