Renal and Reproduction Patho Flashcards
1
Q
What is UTI
A
Infection/inflammation of urinary epithelium usually caused by bacteria from gut flora
2
Q
Where are UTIs
A
Anywhere along urinary tract:
- urethra (urethritis)
- prostate
- bladder (cystitis)
- ureter
- kidney (pyelonephritis)
3
Q
Defense Mechanisms against UTIs
A
- Acidity of urine
- Contains urea
- Pee frequently to get bacteria out
- Sphincters = one way out
- Epithelial cells = first physical barrier
- Secretions (mucous) capture bacteria
4
Q
Risk Factors for UTI
A
Impact body’s abilities to stop pathogens:
- Estrogen-deficiency (postmenopausal women and prepubertal children): leads to increased risk of irritation and inflammation
- Obstruction: constipation, pregnancy, kidney stones (urine sits for longer)
- Age: premature newborns, prepubertal children (bowel incontinence), potty training is important
- Dysfunction: neurogenic bladder, defects (congenital or fistulas = openings)
- Poor personal hygiene
- Sexual activity
- Use of antibiotics/spermicides
- Indwelling cath/instrumentation
- Reflux of urine
- Female
- Immunodeficient conditions
5
Q
UTI Uropathogens
A
- Most common: E. coli (helps us know how to treat and prevent)
- Properties (make them harder to eradicate): ability to attach to uroepithelial cells, ability to attach to latex cath, express toxins, create biofilms
6
Q
Clinical Manifestations of Cystitis
A
- Frequency
- Urgency
- Dysuria
- Pain
- Hematuria or cloudy urine
7
Q
Clinical Manifestations of Pyelonephritis
A
- Same as cystitis
- Also fever
- Chills
- Nausea
- Vomiting
- CVA tenderness
- Anorexia
8
Q
Atypical Presentation in Peds of UTI
A
- Signs of discomfort, frequency of urination, odor, crying (when peeing), not playing, accidents, anorexia, malaise
9
Q
Atypical Presentation in older adults of UTI
A
- Confusion, psychosis, change in mental status
- No fever
10
Q
Evaluation for UTI
A
- History and physical: history of UTI, risk factors, s/s
- Urine: collect specimen (analysis and culture), look for protein, WBCs, nitrates, blood
- This might be hard to get clean catch, if incontinent, pregnant
- Imaging: done if UTI is a repeated issue
11
Q
Treatment for UTI
A
- Antibiotics (choice related to history)
- Uncomplicated = UTI without other issues
- Complicated = UTI with structural abnormalities/blockage/repetitive infection/impaired immune system
- Comfort care: analgesia
12
Q
Prevention of UTI
A
- Pee frequently
- Wipe front to back
- Pee after sex
- Hydrate
- Catheter care (and remove catheter asap)
- Estrogen replacement
13
Q
What is PID
A
- Infection of oviducts/ovaries/adjacent reproductive organs
- Cervicitis: inflammation of cervix
- Endometritis: inflammation of uterus
- Salpingitis: inflammation of oviducts
- Oophoritis: inflammation of ovaries
14
Q
2 stages of PID
A
- Vaginal/cervical infection: screening for this
2. Migration of microorganisms to upper genital tract
15
Q
2 most common causes of PID
A
- Gonorrhea or Chlamydia are most common
