UTI Flashcards
Cystitis – necessary number of colony forming units during midstream catch?
100,000
Most common cause of septic shock in pregnancy?
Pyelonephritis
Urethritis – most common cause?
Chlamydia
Urethral syndrome?
Urgency and dysuria caused by urethral inflammation of unknown etiology (negative urine cultures)
Types of UTIs?
Urethra – ureteritis
Bladder – cystitis
Kidneys – pyelonephritis
Bacteria that cause UTIs?
- E. coli (80%)
- Staphylococcus saprophyticus
Klebsiella, Pseudomonas, Proteus, Enterobacter, GBS, chlamydia
Symptoms of lower tract infection (cystitis)?
Dysuria, urgency, urinary frequency
Gross hematuria should raise suspicion of?
Nephrolithiasis or hemorrhagic cystitis
Significant bacteriuria?
100,000 – if midstream
10,000 if catheterized
1000 – if symptomatic
Drugs for simple cystitis? Don’t use which drug?
Bactrim, nitrofurantoin, norfloxacin, ciprofloxacin, cephalosporins
Don’t use ampicillin because of resistance from E. coli
Urethritis versus cystitis - signs/symptoms?
Both have urgency, frequency, dysuria
Urethritis may also have tender urethra and purulent drainage
Organisms that cause urethritis?
Chlamydia, gonococcus, trichomonas
Patients with typical UTI symptoms, but sterile culture and no response to standard anabiotics – consider? Tests? Treatment?
Urethritis; gonococcus/chlamydia cultures; Ceftriaxone or doxycycline respectively
Signs of pyelonephritis? Tx?
Fever, flank pain, nausea/vomiting
Bactrim or fluoroquinolone for 10-14 days
When to hospitalize for pyelonephritis? Tx?
- Unable to take oral medications
- Pregnant
- Immunocompromised
Ampicillin and gentamicin OR cephalosporin
Difference in treating pregnant women with acute Pyelonephritis?
Following resolution of fever and symptoms, continue to treat with suppressant antimicrobial therapy (nitrofurantoin 100 mg daily) for rest of pregnancy
Patient under treatment for pyelonephritis presents with dyspnea tachycardia – diagnosis?
ARDS from endotoxin released from bacterial lysis
ARDS?
Alveolar and endothelial injury leading to leaky pulmonary capillaries, causing
- hypoxemia
- large Aa gradient
- loss of lung volume
If there’s no clinical improvement after 72 hours of appropriate antibiotic therapy for pyelonephritis, suspect?
Ureterolithiasis or perinephric abscess
Endotoxin release from bacterial lysis in pregnant pts can result in?
- ARDS
2. Uterine contractions and preterm labor
Treatment of ARDS?
Supportive, with careful fluid management
If pregnant patient is not giving suppressive therapy after resolution of pyelonephritis, recurrence rate?
One third
