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Clin Med GU > UTI > Flashcards

UTI Flashcards

1
Q

How do you diagnose a UTI

A

urinalysis and culture

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2
Q

How do you treat a bacterial UTI

A

remove any catheters and obstruction and give abx

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3
Q

Where can bacterial UTIs infect

A

urethra
prostate
bladder
kidneys

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4
Q

What are some symptoms of a bacterial UTI

A

urinary frequency/urgency
dysuria
lower abdominal pain
flank pain

*can lead to sepsis

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5
Q

Where are female UTIs most common

A

pyelonephritis
cystitis

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6
Q

Where are UTIs in males most commonly

A

Urethritis
prostatitis

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7
Q

At what age do UTI incidence increase

Are females still at highest risk?

A

> 50

No b/c with age, males get prostate enlargment

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8
Q

What is the risk factors for UTIs in females

A

Sex
diaphragm &spermacide use
new sex partner in past year
h/o recurrent UTIs
first UTI at early age
menopause

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9
Q

What are increased risks for UTI in both sexes

A

Immunocompromised state
stones/ obstructions
congential abnormalities
catheter use / recent urinary procedure

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10
Q

What is the most likely causative organism of a UTI in a normal GU tract

What other organisms are less common but can be sen

A

E.Coli

(-)Kledbsiella, (-)pseudamonas, staph (+)saprophyticus

**typically a gram negative bacteria

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11
Q

What type of UTIs are considered uncomplicated

A

lower UTI
cystitis/pyelonephritis
no comorbidities

no structural/functional abnormalities present

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12
Q

What are complicated UTIs

A

children
pregnancy
structural/functional damage
comorbidities
recent urinary procedures

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13
Q

Classifications of UTI

A

Urethritis
cystitis
acute urethral syndrome
acute pyelonephritis

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14
Q

What is generally the cause of urethritis

Which sex more susceptible

A

generally STI

both sexes

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15
Q

What is cystitis

When would men get this

A

infection of bladder

generally secondary to urethral instrumentation

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16
Q

Who gets acute urethral syndrome

Symptoms?

A

females

low colony counts, dysuria, pyuria that resembles cystitis

17
Q

What is acute pyelonephritis

What is the cause

A

bacterial infection of kidney parenchyma

ascension of bacterial through the urinary tract

uncommon in men

18
Q

What is the clinical presentation of urethritis

A

dysuria = main symptom
purulent discharge

19
Q

What is the clinical presentation of cystitis

A

Sudden onset frequency, urgency, painful voiding, small volumes

suprapubic pain is common, turbid urine, low grade fever

20
Q

What is the clinical presentation associated with acute pyelonephritis

A

same as cystitis +
fever/chills/flank pain
tender
possible enlarged kidney
CVA tenderness on affected side

21
Q

What is the typical presentation for UTIs in elderly

A

altered mentation
acute incontinence
GI complaints/symptoms
urinary retention

22
Q

When should urethral syndrome be considered in females

A

when they have repeated dysuria and pyuria but no bacteria

23
Q

When is a urine culture ordered

A

when there is a complicated UTI
pathogen that needs to be identified
Spsis

24
Q

When should structural abnormalities be investigated

A

> 2 episodes of pyelonephritis
complicated bacteria
always same bacteria
nephrolithiasis suspected
painless gross hematuria
fever persists>72 hours

25
Q

When are UTIs treated with abx

What is used

A

All forms of symptomatic UTI

fluoroquinalones (cipro/levo), bactrim, nitrofuratoin

if + dysuria -> phenazopyradine (48-72hr) w/ abx

26
Q

How is urethritis treated

A

ceftriaxone IM
+
azythro (1x dose)

doxy BID x 7days alternative

27
Q

What is first line treatment for uncomplicated cystitis

A

Nitrofuratoin BID x 5 days
or
Bactrim BID x 3 days

28
Q

What is the first line treatment for acute pyelonephritis

A

Cipro BID x 7 days
Levo BID x 5 days

double check resistance, E.Coli can be resistant to sulfa

29
Q

Which patients with UTI should be treated for pain/fever

what is used

A

All patients

NSAIDs / tylenol

Clin Med GU (11 decks)

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