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3rd Year Quick Review > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

classic sxs of UTI

A
  • dysuria
  • frequency
  • urgency
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2
Q

sx and sign seen in about 1/2 of pts w/ pyelonephritis

A
  • flank pain

- fever

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3
Q

risk factors for UTIs in WOMEN

A
  • DM
  • sexual activity
  • diaphragm use
  • vaginal atrophy
  • genetic predisposition
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4
Q

when is sexual activity a risk factor in MEN?

A

MSM

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5
Q

risk factors for UTIs in HETEROSEXUAL MEN

A
  • obstruction
  • ureterovesical reflux
  • prostatic hypertrophy
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6
Q

what are the MOST COMMON nosocomial infections?

A

UTIs

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7
Q

risk factors for UTIs in EITHER gender

A
  • DM
  • SCD
  • renal stones
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8
Q

what bug is specifically associated w/ urinary stones?

A

Proteus

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9
Q

when Proteus is identified in the urine (UTI), what should be done next?

A

imaging test to look for stones

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10
Q

group B strep (S. agalactiae) UTI is seen in

A

pregnancy

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11
Q

diagnosis for UTI

A
  • urine culture growing 100,000 or more of gram-negative organisms
  • gram-positive organisms or yeast can cause infection with lower colony counts
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12
Q

what is a positive urine culture in the absence of sxs called?

A

NOT a UTI; asymptomatic bacteriuria

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13
Q

MC gram-negative organism causing UTI

A

E. coli

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14
Q

MC gram-positive organism causing UTI

A

Enterococcus

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15
Q

uncommon cause for UTI if NO urinary catheter, and should raise concern for what?

A
  • Staphylococcus aureus

- bacteremia from another source seeding to the kidney

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16
Q

what is the FIRST step in evaluating whether to treat a positive urine culture?

A

determine if the pt has SIGNS or SYMPTOMS of infection

17
Q

treat ASYMPTOMATIC bacteriuria under ONLY 3 circumstances

A
  1. pregnant women
  2. pts about to undergo a urologic procedure
  3. renal transplant recipients w/i the first 3 mos
18
Q

why do you treat asymptomatic bacteriuria in pregnant women?

A
  • prevent progression to pyelonephritis

- decrease maternal and fetal morbidity and mortality

19
Q

treatment for asymptomatic bacteriuria in pregnant women

A
  • TMP/SMX during weeks 12-36 ONLY x 3 days
  • nitrofurantoin x 3 days
  • cephalexin x 3 days
20
Q

why do you treat asymptomatic bacteriuria in renal transplant recipients?

A
  • decrease r/o a SYMPTOMATIC UTI, which increases risk of rejection
21
Q

w/ SYMPTOMATIC UTIs, what is the next step?

A

determine if LOWER tract (cystitis), or UPPER tract (pyelonephritis)

22
Q

w/ SYMPTOMATIC UTIs, what is the next step after determining if lower vs upper tract?

A

complicated or not

23
Q

definition of complicated UTI

A
  • DM
  • structural anomalies
  • foreign bodies
  • prior resistant organisms
  • immunocompromised
  • male
24
Q

when do you NOT need a urine culture?

A

uncomplicated UTI

25
Q

when should imaging be performed in pyelonephritis?

A

ONLY if sxs PERSIST after 72 hours of culture-guided therapy

26
Q

treatment for uncomplicated cystitis

A
  • 3-day course of:
  • TMP/SMX
  • fluoroquinolone
  • cephalexin
27
Q

treatment for complicated cystitis or UNcomplicated pyelonephritis

A
  • fluoroquinolone
  • TMP/SMX
  • beta-lactam
  • depending on C+S data
28
Q

treatment for complicated pyelonephritis and/or hospitalized pts

A
  • 7-10 days unless bacteremic
  • fluoroquinolone
  • ceftriaxone
  • beta-lactam + beta-lactamase inhibitor
  • ampicillin + aminoglycoside
29
Q

when should a urinary catheter be changed in UTI?

A

ONLY if symptomatic

30
Q

recurrent UTIs can be differentiated into what 2 types?

A
  1. RELAPSE (same strain w/i 2 weeks of the end of previous tx)
  2. REINFECTION (different strain than the initial infection)

3rd Year Quick Review (10 decks)

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