Infeksi Saluran Kemih

Question 1

Infeksi Saluran Kemih

Answer 1

Gangguan BAK + Demam

Question 2

Infeksi Saluran Kemih (4)

Answer 2

Pielonefritis
Sistitis
Prostatitis
Uretritis

Question 3

Pielonefritis

Answer 3

→ Nefro = ginjal
Nyeri pinggang/flank
Nyeri ketok CVA/tapping pain

Question 4

Sistitis

Answer 4

→ vesika urinari
Nyeri perut bawah
Nyeri tekan suprapubik
80% demam (-)
Nyeri saat ingin berkemih

Question 5

Prostatitis

Answer 5

→ Prostat
RT → prostat membesar, hangat, nyeri

Question 6

Uretritis

Answer 6

→ Uretra
Piuria
- GO
- Non GO

Question 7

Etio Infeksi Saluran Kemih

Answer 7

💡 K E E PP S

Klebsiella
E. coli → paling sering
Enterobacter
Pseudomonas → kateter, Proteus mirabilis → batu struvit/infeksi laki-laki
Staphylococcus sp

Question 8

Klasifikasi Infeksi Saluran Kemih (8)

Answer 8

ISK Simtomatik
ISK Asimtomatik
ISK Atas
ISK Bawah
ISK Non Komplikata
ISK Komplikata
ISK Rekuren: Re-Infeksi
ISK Rekuren: Relaps

Question 9

ISK Simtomatik

Answer 9

Gejala (+)

Question 10

ISK Asimtomatik

Answer 10

Gejala (-)

Question 11

ISK Atas

Answer 11

= Ginjal

Question 12

ISK Bawah

Answer 12

≠ Ginjal
Uretritis, prostatitis, sistitis

Question 13

ISK Non Komplikata

Answer 13

Semua ISK pada wanita dewasa yang tidak hamil

Wanita gemoy seperti kita → tidak ribet

Question 14

ISK Komplikata

Answer 14

Laki-laki, wanita hamil, anak, kelainan saluran kemih, premenopause (usia tua p)?

Question 15

PP Awal Infeksi Saluran Kemih

Answer 15

Urinalisa → leukosituria (>5/LPB), nitrit (+), bakteri (+), leukositesterase (+)

Question 16

PP Tepat (Gold Standard) Infeksi Saluran Kemih

Answer 16

Kultur urin → Jumlah bakteri

• Asimtomatik
  ≥10^5/CFU
• Simtomatik
  ≥10^3-10^4/CFU
• Kateter
  ≥10^3/CFU
• Aspirasi suprapubik
  Berapa pun

Question 17

Rekomendasi cara pengambilan urin

Answer 17

Midstream/pancar tengah

Question 18

Lama Tx ISK Non Komplikata

Answer 18

ISK Atas 7 hari → jika berulang → kultur urin tx 7-14 hari

ISK Bawah 3-5 hari, kecuali prostatitis 14 hari-6 minggu

Question 19

Lama Tx ISK Komplikata

Answer 19

7-14 hari

Question 20

Tx Sistitis Dewasa

Answer 20

💡 1. Kotri, 2. Kuinolon

1. Kotrimoksazol 2x960 mg
2. Ciprofloxacin 2x500 mg, levofloxacin 1x500 mg

Question 21

Tx Sistitis Anak

Answer 21

💡 Kuinolon → ganggu pertumbuhan tulang
1. Kotri, 2. B-lactam

1. Kotrimoksazol 10 mg/kgBB, dibagi 2 dosis
2. Amoxicilin 20-40 mg/kgBB

Question 22

Tx Sistitis Bumil

Answer 22

1. B-lactam
2. Cephalosporin

Question 23

Tx Pielonefritis Dewasa

Answer 23

💡 1. Kuinolon, 2. Kotri

1. Ciprofloxacin 2x500 mg, levofloxacin 1x500 mg
2. Kotrimoksazol 2x960 mg

PN berat cephalosporin IV (ranap) → indikasi: anak, hamil, gangguan hemodinamik, gejala berat

Question 24

ISK Rekuren: Re-Infeksi

Answer 24

Infeksi kembali interval >6 minggu, tetapi dengan mikroorganisme berbeda

Question 25

ISK Rekuren: Relaps

Answer 25

Infeksi kembali dengan mikroorganisme **sama**

Question 26

Tx Prostatitis

Answer 26

💡 1. Kuinolon, 2. Kotri 1. Ciprofloxacin 2x500 mg 2. Kotrimoksazol 2x960 mg