Urinary Tract Infection

Question 1

cystitis

Answer 1

most common UTI
s/x dysuria, urinary frequency & urgency
no fever
no costovertebral angle tenderness, and no flank pain.

Question 2

what is uncomplicated cystitis

Answer 2

woman who is not pregnant
has not had nay recent tx with abts 
has not has another UTI w/in last 6 months (or 2 UTIs in the last 12 months) 
no decrease immunity 
no sign of upper tract infection 

treat w/o culture

Question 3

what is complicate cystitis

Answer 3

pregnant women
recent abt
have had another UTI w/in last 6 month (or other UTI in the past 12 months)
decreased immunity from another condition.

**require culture & sensitivity tests for DX

Question 4

what is asymptomatic bacteriuria

Answer 4

does not cause the pt to experience any symptoms, but coincidental urinalysis shows bacteria in the urine.
TX not needed unless woman is pregnant

Question 5

pyelonephritis

Answer 5

when infection in the bladder ascends to kidneys

s/s: FEVER, CHILLS, BACKPAIN, CVA TENDERNESS and FLANK PAIN

Question 6

diagnostic testing for pyelonephritis

Answer 6

urine dipstick - first concentrate urine, positive leukocyte esterase or nitrite specific for UTI

urine microscopic reveals RBC, WBC, & WBC casts (sample from pts with cystitis alone usually do not show casts)

• *STANDARD DX : URINE CULTURE sensitivities to antibiotics ascertained at the time of the culture will guide to appropriate treatment.
• -> it is not need for symptomatic who meet criteria from uncomplicated bacterial cystitis.

Question 7

Indication for urine culture

Answer 7

pregnancy
signs of upper tract infection
recent urinary tract infection
recent antibiotic treatment
chronic disease affecting the immune system
*complicated cystitis
empiric treatment must be initiated prior to obtaining the culture and sensitivity results and then modified if the results indicate resistance or pt is not improving….

Question 8

treatment for uncomplicated acute bacterial cystitis

Answer 8

Trimethoprim-sulfamethoxazole BID x 3days
(equal effectiveness as 7 days tx)
**notify if symptoms persist after 48 hours ***