OME UTI

Question 1

UTI - most common bacteria

Answer 1

GNRs
E coli
Klebsiella
Proteus

Question 2

What makes a UA positive for UTI

Answer 2

+ Leukocyte esterase
+Nitrites
>10 WBC/hpf

Question 3

Urethritis - path and pt presentation

Answer 3

Path: STD (g/c)

Pt p/w discharge

Question 4

Urethritis treatment:

Answer 4

Ceftriaxone x1 IM + Azithromycin PO x1

or

Doxy PO x7 days

Question 5

What else should you check for in a pt w/ urethritis?

Answer 5

HIV

Question 6

Who should you screen (and treat) for asymptomatic bacteriuria?

Answer 6

Pregnant patients
(and pt who had urologic procedure)

Everyone else, do not treat if asymptomatic

Question 7

Patient presentation for cystitis:

Answer 7

Patient usually female.
P/w: urinary u/f/d
(no systemic signs/no fever, chills, etc)

Question 8

Treatment for cystitis:

Answer 8

Empiric tx

• Bactrim (unless pt w/ CKD)
• Nitro
• Fosfomycin

Tx for 7 days if complicated
Tx for 3 days if uncomplicated

Question 9

Patient presentation for pyelonephritis:

Answer 9

Urinary u/f/d
+Fever, chills
CVA tenderness

Question 10

Pyelonephritis - what should you see on UA?

Answer 10

WBC casts

Question 11

Pyelonephritis treatment:

Answer 11

IV ceftriaxone (hospital) 
PO ciprofloxacin (ambulatory) 

Abx for 10 days
Monitor for perinephritic abscess

Question 12

When to worry about perinephritic abscess?

Answer 12

Pt w/ pyelonephritis w/o improvement in 72 hours

Question 13

dx/labs for perinephritic abscess:

Answer 13

Order CT scan or US

Question 14

Perinephritic abscess treatment:

Answer 14

Incision and drainage

Abx for 14 days (IV ceftraixone, PO cipro?)