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AII Week 4 > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

Acute Cystitis

A

Bladder infection, UTI

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2
Q

Acute Cystitis Etiology

A

Due to coliform bacteria (E coli) or G+ bacteria (enterococci)

  • Infection ascends from urethra to bladder
  • Rare in men and implies a pathologic process that requires further investigation
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3
Q

Acute Cystitis S/S

A

Dysuria, urinary frequency, urgency, usually afebrile

  • Gross hematuria
  • Suprapubic tenderness
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4
Q

Acute Cystitis Lab

A 
UA: pyuria, hematuria, bacteriuria
-leukocyte esterase and nitrites
-WBCs and RBCs under scope
Urine culture: pos
Urine culture and sensitivity if empiric tx fails or an early relapse (less than 2 wks)
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5
Q

Acute Cystitis Management

A

Tx: Trimethroprim/ Sulfamethoxazole x 3 days
or Nitrofurantoin x 5 days
-Fluoroquinolone in pts with allergy but areas have high rates of resistance

Symptomatic relief: hot sitz baths or urinary analgesics

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6
Q

Acute Cystitis Prevention

A

-Complicated cases should be further investigated to determine the underlying cause
-Don’t use spermicide or diaphragm as birth control (for a variety of reasons…)
Women w/ 3+/year should get prophylactic abx therapy (single dose at bedtime or at time of intercourse)

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7
Q

Recurrent Cystitis Etiology

A
  • Occurs after a documented infection has resolved

- due to: genetic predisposition, altered vaginal flora, post coital infection

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8
Q

Recurrent Cystitis S/S

A

Same as acute but quick relapse

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9
Q

Recurrent Cystitis Lab

A

Urine culture and sensitivity

-consider urologic work up to evaluate anatomical abnormalities

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10
Q

Recurrent Cystitis Management

A

Tx for 7-14 days

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11
Q

Asymptomatic bacteriuria Etiology

A

More common with older age, spinal cord injuries, hemodialysis pts

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12
Q

Asymptomatic bacteriuria S/S

A

No local or systemic symptoms can be present!!

-Usually discovered when undergoing unrelated urine culture screening

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13
Q

Asymptomatic bacteriuria Lab

A

Urine culture pos without symptoms

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14
Q

Asymptomatic bacteriuria Management

A

Do not treat!! Unless pregnant, before urologic intervention, prior to hip replacement, if they become symptomatic

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15
Q

Pyelonephritis

A

Infectious inflammatory disease involving the kidney parenchyma and renal pelvis

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16
Q

Pyelonephritis Etiology

A

Most common: E. coli, Proteus, Klebsiella, Enterobacter, Pseudomonas

17
Q

Pyelonephritis S/S

A

Must have: Fever, flank pain, irritative voiding

-shaking chills, N/V/D, urgency, frequency, dysuria, tachycardia, costovertebral tenderness, HA

18
Q

Pyelonephritis Lab

A

CBC
UA: pyuria, bacteriuria, hematuria, WBC casts
Urine culture: positive
US of bladder/kidney/ ureter to rule out obstruction

19
Q

Pyelonephtitis Management

A

Inpatient: IV ampicillin and an aminoglycoside until afebrile for 24 hrs then oral abx x 3 wks
Outpatient: fluoroquinolone x 2 wks

20
Q

Acute Bacterial Prostatitis Etiology

A

Usually caused by E coli or Pseudomonas

21
Q

Acute Bacterial Prostatitis S/S

A

Fever; irritative voiding; pelvic pain; ‘exquisite” tenderness on rectal exam; tender prostate
-pain with ejaculation

22
Q

Acute Bacterial Prostatitis Lab

A

Urine culture: pos
CBC: leurkocytosis and left shift
UA: pyuria, bacteriuria, hematuria

23
Q

Acute Bacterial Prostatitis Management

A

Fluoroquinolone or TMP-SMX x 2-4 wks
Acutely ill - admit for IV abx: ampicillin and gentamicin plus above tx
Consider testing for HIV and other STIs

24
Q

Acute Bacterial Prostatitis Prevention

A

Wear a condom with anal sex

25
Q

Chronic Bacterial Prostatitis Etiology

A

-Usually a result of bladder outlet obstruction
G(-) rods
Less commonly Enterococcus

26
Q

Chronic Bacterial Prostatitis S/S

A

Irritative voiding; dull and poorly localized low back, perineal or suprapubic discomfort; prostatic secretions

  • Can be asymptomatic
  • Many men have no history of acute infection!!
27
Q

Chronic Bacterial Prostatitis Lab

A

Culture secretions or postprostatic massage urine specimen

UA: normal unless 2nd cystitis

28
Q

Chronic Bacterial Prostatitis Management

A 
Anti-inflammatory agent
Tx: prolonged course of Fluoroquinolone or TMP-SMX
-Refer to a urologist
-Hot sitz bath
-Relax pelvic floor with micturition
29
Q

Chronic Bacterial Prostatitis Prevention

A

Difficult to cure!

-Symptoms and recurrent UTIs can be controlled with suppressive abx therapy

30
Q

Epididymitis Etiology

A

Sexually transmitted: Chlamydia trachomatis or Neisseria gonorrhoeae
Nonsexually: G(-) rods

31
Q

Epididymitis S/S

A
  • Painful enlargement of the epididymis, relieved by scrotal elevation
  • Fever, irritative voiding, scrotal swelling
  • Pain in scrotum may radiate along spermatic cord
  • urethral discharge
32
Q

Epididymitis Lab

A

UA: pyuria, bacteriuria
Sexually: gram stain of discharge, test for CT/GC
Nonsexually: UA, urine culture

33
Q

Epididymitis Management

A

Sexually: abx x 10-21 days; treat partner
Nonsexually: abx x 21-28 days; bed rest with scrotal elevation

34
Q

Epididymitis Prevention

A

Delayed or inadequate tx may result in epidiymorchitis, decreased fertility, or abscess formation

AII Week 4 (7 decks)

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