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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
Q

what are the clinical features of chronic prostatitis?

A

variable : asx to acute symptomatology

26
Q

what are the clinical features of acute and chronic prostatitis?

A

irritative bladder sx and some obstruction

27
Q

PE of prostatitis?

A

porstate is swollen and tender; avoid vigorous prostae exam bc it may cause septicemia (if suspected acute)

28
Q

what dx studies for prostatitis?

A

UA: pyruia, hematuria, bacteruria

Prostatic fluids: WBC

29
Q

what bacteria cuases acute prostatitis?

A

e coli

30
Q

what bacteria cuases chronic prostatitis?

A

enterococcus

31
Q

tx of uncomplicated prostatitis?

A

cipro or levo or bactrim

32
Q

tx of chronic prostatits?

A

FQ

33
Q

what other meds may be helpful for prostatitis?

A

nsaids, alpha 1 blockers

GU (3 decks)

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