Systems (UTI and Vaginal infections)

Question 1

Cystitis present with dusuria, freq, urgency, suprapubic pain, and WBC (but not WBC casts in urine).

Primarily caused by what mech?

Males infants with congenital fects , vesicuorueterla reflux. Elderly enlarged prostate.

Ascensinon to kidney results in : pyelonephritis, which presents in fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts.

Ten times more common in women (why?) Other predisposing factors include obstruction, kidney surgery, catheterization, GU malformation, diabetes, and pregnancy.

Labs: LET and NT what are the results and what do they mean?

Answer 1

• ascension of microbes from urethra to bladder
• b/c shorter urethras colonized by fecal flora
• LAbs
  
  • Leukocyte esterase test += bacterial UTI
  • Nitrite test += gram negative bacterial UTI

Question 2

UTI bugs

features: leading cause of UTI. colonies show green metallic sheen on EMB agar

Answer 2

E. coli

Question 3

UTI bugs

features: 2nd leading cause of UTI in sexually active women

Answer 3

S. saprophyticus

Question 4

UTI bugs

features: 3rd leading cause of UTI. Large mucoid capsule and viscuous colonies

Answer 4

Klebsiella pneumoniae

Question 5

UTI bugs

features: Some strains produce a red pigment, often nosocomial and drug resistant

Answer 5

Serratia marcescens

Question 6

UTI bugs

features: Often nosocomial and drug resistant

Answer 6

Enterobacter cloacae

Question 7

UTI bugs

features: Motility causes ‘swarning’ on agar produces urease, assoc w/struvite stones

Answer 7

Proteus mirabilis

Question 8

UTI bugs

features: blue green pigment and fruit odor, usually, nosocomial and drug resistant

Answer 8

Pseudomonas aeruginosa

Question 9

UTI bugs

Diagnostic markers meanings

• leukocyte esterase +
• Nitrite test +
• Urease test +
• Urease test -

Answer 9

UTI bugs

Diagnostic markers meanings

• Leukocyte esterase += bacterial
• Nitrite test += gram negative bacterial
• Urease test += urease producing bugs (proteus, klebsiella)
• Urease test -= E. coli, enterococcus

Question 10

SS: no inflammation, thin white discharge with fishy odor

Lab findings: clue cells, pH >4.5

What is the bacterial and how do you treat it?

Answer 10

• Bacterial vaginosis
• Metronidazole

Question 11

SS: inflammation, frothy grey-green foul smelling discharge

Lab findings: Motile trichomonads, pH>4.5

What is the bacterial and how do you treat it?

Answer 11

• Trichomoniasis
• Metronidazole and treat sexual partner

Question 12

SS: Inflammation, thick white cottage cheese discharge

Lab findings: Pseudohyphae, pH normal (4.0-4.5)

What is the bacterial and how do you treat it?

Answer 12

• Candida vulvovaginitis
• -azoles!