UTI

Question 1

What is the significance of 10^5CFU/mL urine?

Answer 1

• If you have >10^5 CFU/mL tell you significant bacteruria–>INFECTION present.
• <10^5 CFU/mL URINE usually is not significant. Unless is a GRAM+

Question 2

What are the diffrent mechanisms of infection of E.COLI regarding you renal system?

Answer 2

1.Ascending Pyelonephritis
2.Hematogenous spread.

Question 3

Most common cause 1.Community Acquired UTI
and 2.Hospital Acquired UTI?

Answer 3

1.E.Coli>Staph coagulase- (saprophyticus)
2.E.Coli>GRAM-(Klebsiella,Pseudomanas,Enterobacter)>GRAM+

Question 4

Does glycosuria have some effects on your bacteria in urine?

Answer 4

-Yes, promotes growth.

Question 5

Risk factors of developing UTI..

Answer 5

-Indwelling intrauterine devices, Diabetus mellitus, Renal transplantation, Female sex, Bladder dysfunction,urinary stasis,Nephrolithiasis,Congenital abn of urinary tract

Question 6

How does enlarge prostate promote UTI’s?

Answer 6

-Decr flushing reflex.
-Also seen in pregnancy,neurological abnormalities

Question 7

How does catheter increase risk of UTI?

Answer 7

-Prevents bacteria form being in contact with mucosa (has cytokines and neutrophils).By-passes it.

Question 8

Hooney-mooon Cystitis presentation

Answer 8

-Sexually active individuals–>
-Dysuria, Urgent bladder (incr frequency)–>detrusor overactivity,suprapubic pain,NO systemic effects

Question 9

Sterile pyuria shows and means what?

Answer 9

• +esterase (indicates presence of WBC) but -culture.
  -Usually ass with urethritis (Chlamydia Trachomatis + N.Gonorrhea)

Question 10

Acute Pyelonephritis presentation

Answer 10

-Dysuria,Incr frequency of urination,Fever,chills,nausea,vomiting, costovertebral angle tenderness.
-Presence of systemic manifestations.

Question 11

What does +nitrate dipstick means?

Answer 11

-Presence of GRAM- (Klebsiella,P.mirabilis,E.coli)
-Nitrate- tell you GRAM+ (Enteroccocus, Staph. Saprophyticus)

Question 12

Diagnosis

Answer 12

-Blunt renal calyxes
-Chronic Pyelonephritis

Question 13

Diagnosis

Answer 13

-Dilated kidney tubules filled with colloid
“Thyrodization of kidney”

Question 14

Chronic Pyelonephritis Pathogenesis

Answer 14

-Ass recurrent Acute Pyelonephritis, most likly due to vesiculo-urethral reflux, diabetus mellitus,BPH—>leads to sclerosis and Tubule ATROPHY

Question 15

-E.coli>Pseudomonas
-Low back pain+dysuria+Fever

Answer 15

-Acute Prostatitis

Question 16

Prostate examination:Warm,tender, boggy.

Answer 16

Acute Prostatits

Question 17

Uncomplicated UTI treatment?

Answer 17

-Empirically

Question 18

Complicated UTI?

Answer 18

-Needs direct treatment for more efficency.
Fluroquinolone,SMX-TMP,

Question 18

Complicated UTI?

Answer 18

-Needs direct treatment for more efficency.
Fluroquinolone,SMX-TMP,

Question 19

True or false?

Staghorn stones are seen bilterally?

Answer 19

True

Question 20

How does diabetus mellitus related to UTI?

Answer 20

-Stasis—> neurogenic bladder.

Question 21

What can Acute Pyelonephritis leads to…

Answer 21

-Chronic Pyelonephritis, Renal Papillary Necrosis

Question 22

What drug do we give pregnant women that have UTI?
-Why are they at risk for UTI?
-What other drug do we give to prevent neonatal meningitis?

Answer 22

-NITROFURANTOIN—PULMUNARY FIBROSIS.
Acts mayorly in kidney (few systemic effects)

-Urinary stasis due to compression.

-penincillins (prevents Group B strep meningitis)**