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CCFP > Urinary Tract Infection > Flashcards

Urinary Tract Infection Flashcards

1
Q

List THREE risk factors for UTIs

A 
Female gender
Previous UTI
Sexually active female
Increased age
Genitourinary Tract Abnormalities
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2
Q

How can children with UTIs sometimes present?

A 
Often vague symptoms:
Decreased appetite
Fever
Irritability
Vomiting
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3
Q

How can the elderly sometimes present with a UTI?

A 
Vague symptoms:
Delirium
Functional decline
Abdominal pain
Falls
Incontinence
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4
Q

List FIVE symptoms of cystitis

A 
Dysuria
Frequency of urination
Urgency of urination
Suprapubic tenderness
Absent vaginal discharge/irritation
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5
Q

What may be a sign of cystitis?

A

Cloudy urine

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6
Q

45yo F with pain on urination, urinary frequency and suprapubic pain presents to you office. She does not have vaginal discharge or irritation. What would you do on a focused physical examination?

A

Vitals: Temp (normal = cystitis), BP and HR (hypotension and tachycardia = pyelonephritis)
Abdo exam - suprapubic tenderness
CVA tenderness = pyelonephritis

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7
Q

List FIVE common bacteria responsible for UTIs:

A 
Klebsiella
E. coli
Enterococcus
Proteus
Staphylococcus saprophyticus
Staphylococcus aureus
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8
Q

You suspect your patient has a UTI what test would you do to confirm your suspicions?

A

Urinalysis

Urine dipstick if urine is cloudy otherwise not useful. Urine dipstick also useless in catheterized patients.

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9
Q

List the indications for urine culture.

A 
Complicated UTIs
Female >65yo
Suspected pyelonephritis
Recurrent UTIs
Failed Antibiotics or Persistent urinary symptoms
Unclear urinalysis
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10
Q

42yo female was found to have bacteria in her urine on dipstick. She is otherwise asymptomatic. What do you do? What if this was a man?

A

Reassure her that there is no need to be concerned.

No urine culture needed as patient is asymptomatic.

Same management in men.

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11
Q

In a patient with a UTI who you suspect may have a complicating urolithiasis, how would you confirm this suspicion?

A

Abdominal ultrasonography or Computed Tomography Scan of Abdomen

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12
Q

What is the definition of recurrent UTI?

A

2 or more UTIs in 6 months OR >2 positive cultures in 1yr

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13
Q

What is the definition for a UTI reinfection?

A

Infection with new organism >2wks after initial infection

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14
Q

What is the definition of a UTI relapse?

A

Repeat/continued infection with same organism within 2wks of completing ABx for UTI

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15
Q

How would you treat acute cystitis in pregnant women?

A

Amoxicillin 500mg po tid x 7d
Macrobid 100mg po bid x 5d
Fosfomycin 3g in 1/2 cup water po x 1

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16
Q

How would you treat uncomplicated UTI in a female?

A

Septra 2tabs po bid x 3 days
Trimethoprim 200mg po daily x 3 days
Macrobid 100mg po bid x 3 days

17
Q

How would you treat an uncomplicated UTI in children?

A

TMP/SMX (dose TMP 10mg/kg/day divide by 2) po bid x 7-14d

Nitrofurantoin (5mg/kg/day divided by 4) qid x 7-14d

18
Q

How would you treat a pyelonephritis OR complicated UTI?

A

Septra 2tabs po bid x 7-14d
Trimethoprim 200mg po daily x 7-14d
Macrobid 200mg po bid x 7-14d
Ciprofloxacin 500mg po bid x 7-14d

19
Q

How would you treat cystitis that recurs in female less than 1 month after treatment?

A

Septra 2tabs po bid x 7-14d
Trimethoprim 200mg po daily x 7-14d
Macrobid 100mg po bid x 7-14d

20
Q

How do you treat recurrent infections of cystitis in females?

A

Septra 1tab po 3/wk or postcoital x 6mo
Trimethoprim 100mg po qhs or postcoital x 6mo
Macrobid 100mg po qhs or postcoital 6mo
Reassess for discontinue after 6 months

21
Q

How do you know if a patient has a complicated versus an uncomplicated UTI

A

Uncomplicated = otherwise healthy, premenopausal woman, not preggers, normal GU anatomy

Complicated = men, preggers

  • Hx of GU instrumentation (catheters, ureteric stents, procedures, transplants)
  • Metabolic abnormalities (renal disease)
  • Underlying disease (bad DM control, polycystic kidney dz, immunosuppression)
  • GU tract abnormalities (BPH, strictures, renal stones, renal cysts, vesicoureteral reflux, posterior urethral valves)
22
Q

Describe a patient who would be considered to have an uncomplicated UTI

A

Otherwise healthy, pre-menopausal female, not preggers with no GU abnormalities

23
Q

What factors make a UTI become complicated?

A

Male gender
Preggers
Metabolic abnormalities (renal failure, DM)
Underlying Dz (poor DM control, Polycystic kidney Dz, immunosuppression)
Hx of Urinary Tract instrumentation (catheters, stents, procedures, transplants)

24
Q

List the indications for Renal-bladder U/S and VCUG

A
  • 1st UTI in male
  • 1st UTI in female less 3y
  • complicated pyelonephritis
  • recurrent UTI
  • FHx renal abnormalities

CCFP (11 decks)

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