Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med 3 > Pyelonephritis, Cystitis, and Asymptomatic Bacteriuria - Exam 2 > Flashcards

Pyelonephritis, Cystitis, and Asymptomatic Bacteriuria - Exam 2 Flashcards

1
Q

what is an acute complicated UTI/Pyelonephritis?

A

infection of the kidney upper urinary tract (kidneys and ureters)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is an acute uncomplicated cystitis?

A

infection of the bladder (lower urinary tract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the most common pathogens for cystitis?

A

e. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what if you see lactobacilli on U/A for cystitis?

A

it is usually a contamination b/c it is normal vaginal flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pathogenesis of cystitis?

A

colonization of the vaginal introitus -> ascends urethra into bladder

could be d/t structural issue (short urethral syndrome)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risk factors for developing UTIs?

A

recent sexual intercourse, UTI hx, spermicides alone, diaphragms, indwelling catheters, diabetes, structural abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cystitis signs/sx’s?

A

Dysuria, Frequency, Urgency, Suprapubic pain, Hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the most valuable diagnostic test for cystitis?

A

U/A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does a U/A or dipstick detect?

A
  • Leukocyte esterase
  • Enzyme released by leukocytes -> reflects pyuria
  • Nitrites

Presence of enterobacteria -> converts urinary nitrate into nitrite
-False positives with bladder analgesics (Ex: Phenazopyridine - pyridium)

-WBC, RBC, Protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

do you have to get a urine culture for cystitis?

A

up to you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cystitis tx?

A

Macrobid, Bactrim, Cipro

can treat symptomatic female even if UA comes back negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cystitis tx for symptomatic pt?

A

Phenazopyridine (pyridium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

why don’t mean get has many UTIs as women?

A

structural differences

-have longer urethras than women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

risk factors for men getting UTIs

A

insertive intercourse (insertive partner usually gets the UTI) and uncircumcised men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what structures does pyelonephritis involve?

A

the kidney parenchyma and renal pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

most common pathogen for pyelonephritis?

A

E. coli

17
Q

other pathogen for pyelonephritis? (HINT: think common in healthcare)

A

pseudomonas -> someone with indwelling catheter

18
Q

pathogenesis of pyelonephritis?

A
  • Begins with colonization of the vaginal introitus with fecal flora
  • Ascends into bladder, ureters, kidney
  • Can have seeding from bacteremia
19
Q

pyelonephritis signs and sx’s

A

UTI sx’s but more body sx’s - these people are much more sick!!!

Dysuria, Frequency, Urgency, Suprapubic pain, Hematuria

Fever, Chills, Flank pain, CVA tenderness, Nausea/Vomiting

20
Q

pyelonephritis labs?

A

U/A, urine culture, CBC (elevated w/left shift)

Blood cx - sepsis

21
Q

imaging for pyelonephritis?

A

none unless think there is a renal mass, then get renal US

22
Q

indications for hospitalizations for pyelonephritis

A

fever hasn’t gone down, sepsis, unable to take meds PO, urinary tract obstruction

23
Q

pyelonephritis treatment?

A

Fluoroquinolones (only PO recommendations for outpatient)
-Cipro, Levo

Alternative Treatments:
-Bactrim PO, Augmentin PO, Cefpodoxime PO

24
Q

symptomatic tx for pyelonephritis?

A
  • Phenazopyridine
  • Motrin, acetaminophen
  • Anti-emetics -> Zofran
  • IV fluids
25
Q

acute cystitis in pregnant women and pyelonephritis in pregnant women are considered what?

A

complicated

26
Q

signs and sx’s of acute cystitis in pregnant women?

A

usually asymptomatic (but still get treated)

27
Q

what are you looking for in UA’s for UTI and pregnancy?

A

Looking for ketones b/c babies don’t like ketones

28
Q

outpatient treatment for UTI and pregnancy?

A
  • Macrobid
  • Augmentin
  • Cefpodoxime
  • Fosfomycin
29
Q

what meds should be avoided in the treatment of UTI and pregnancy?

A

FLUOROQUINOLONES!!!

30
Q

UTI in pregnancy usually due to what?

A

anatomic changes during pregnancy

Pressure on bladder, increase in size of ureters due to smooth muscle relaxation, immunosuppression

31
Q

traditionally treated UTI in pregnancy for how long?

A

24 hours

32
Q

inpatient tx’s for UTI in pregnancy?

A
  • IV beta-lactams
  • Penicillin derivatives
  • Cephalosporins (Cefazolin; Ceftriazone)
33
Q

what is asymptomatic bacteriuria?

A

UTI found w/out sx’s

34
Q

what is urine normally in asymptomatic bacteriuria?

A

sterile

35
Q

prevalence of asymptomatic bacteriuria increases with?

A

age

-Elderly walking around with UTIs and don’t know it

36
Q

asymptomatic bacteriuria most common in?

A

pregnant women

37
Q

asymptomatic bacteriuria tx?

A
  • Appropriate to treat and screen in pregnant women and patients undergoing urologic procedures
  • Use of antibiotics same as cystitis
  • Don’t treat the elderly, but will treat pregnant women

Clin Med 3 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions