Urinary Tract infections Flashcards
what criteria determines if you have asymptomatic bacteriuria?
- colony count > 10^5 cfu/ml but not UTI symptoms with or without pyuria
When should you treat asymptomatic bacteriuria?
- If patient is pregnant
- persistent bacteriuria 48 hours after removing urinary catheter.
- Urologic procedures where bleeding is anticipated.
what is urethritis?
inflammation of urethra usually as a result of STI’s
what is cystitis?
inflammation of bladder and urethra
what is prostatitis?
inflammation of the prostate
what is pyelonephriis?
inflammation of the kidney
what is urospesis?
Must have altered mental status+ drop blood pressure+ UTI symptoms and 2 or > of the following
- Temp > 38 C < 36 C
- > 90 beats per minute
- RR > 20 breaths/min
- paCO2 < 32mmHg
- WBC > 12, 000/ mm3 or < 4,000/mm3
What are the risk factors for UTIs?
woman
- pregnant
- vagina atrophy
immunocompromised
- children, elderly
- diabetes
Obstruction
- catheterization &hospitalization
- unable to void
- kidney stones
- tumors
which organisms are most likely to be involved in UTI? (community acquired)
Gram - E.coli ** most common proteus mirabilis kleibsiella enterobacter pseudomonas
Gram +
S. Saprophyticus
Broup b streptococcus
enterococcus
which organisms are most likely to be involved in UTI? (hospital acquired)
PEK
CAPES
enterococcus
staphylococcus
what is dysuria
painful burning urination
what is hematuria?
blood in urine
what is bacteriuria?
bacteria in urine
what’s pyuria?
WBC is urine
what is nocturia?
waking up to urinate at night
what are the lower urinary tract infection subjective symptoms?
dysuria urgency frequency nocturia suprapubic pain back pain hematuria
what are the lower UTI objective symptoms?
cloudy urine pyuria hematuria elevated pH leukocyte esterase \+- nitrates bacteriuria
If you are nitrite positive in ur urine, what does that say about the organisms?
they are enteric gram negative rods
If you have alkaline urine, what does that say about the organisms?
they are enteric gram negative rods
If you are leukocyte esterase positive in ur urine, what does that mean?
indicates pyuria (WBC in urine)
what are the upper UTI subjective signs and symptoms?
all the lower UTI signs and symptoms and flank pain fever chills nausea/vomiting weight loss \+CVA tenderness
when should you obtain/order a culture for a UTI?
- if it is an upper UTI
- if it is a complicated UTI
- Failed treatment for lower UTI
when is a UTI considered a complicated UTI?
- involves upper urinary tract +- systemic complications
- catheterization, instrumentation, kidney stones, tumors
- children, elderly, immunocompromised patients
- pregnancy
- men
- hospital-acquired
- high frequency of recurrence.
when is a UTI considered an uncomplicated UTI?
- lower urinary tract: cystitis, urethritis
2. pre-menopausal, non pregnant woman age 15-45