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infectious diseases > UTI > Flashcards

UTI Flashcards

1
Q

Why is UTI more common in women?

A

Because the urethra is closer to the perianal region

Short urethra

Sexual contact

Adhesion to the epithelium

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2
Q

What is the most common UTI causing organism?

A

Escherichia coli

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3
Q

What does the normal flora of the urethra include?

A

Lactobacilli
Staphylococci

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4
Q

More than —% of cases are caused by a single bacterium?

A

> 95%

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5
Q

What are the bacteria that causes high incidence of UTI in pt with structural urogenital anomalies AND recurrent UTI’s??**

A

Proteus

Pseudomonas

Klebsiella and enterobacter spp.

Enterococci and staphylococci

“P.E.P.SIELLA”

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6
Q

***What is the management for ACUTE CYSTITIS

A

Fosfomycin trometamol

Nitrofurantoin

Trimethoprim-sulphamethoxazole

Fluoroquinolones

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7
Q

List 6 facts about staphylococcus saprophyticus?

A

Gram +

Coagulase -ve

Causes infection in sexually active young women

Reaches the kidney by hematogenous route

Causes intra-renal perirenal abscess

5-15% of acute cystitis

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8
Q

………… microorganisms rarely causes UTI’s

A

Anaerobic

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9
Q

Which microorganism causes UTI in catheterized patients receiving antibiotic therapy

A

Candida(fungi)

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10
Q

Which agent causes HEMORRHAGIC CYSTITIS
in pediatric pt and allogenic bone marrow recipients?

A

Adenovirus

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11
Q

What are the upper UTI?

A

Pyelonephritis
Perinephritic abscess

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12
Q

What are the lower UTI?

A

Urethritis
Cystitis

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13
Q

What is the most common pathogenesis of UTI

A

Ascending pathway; bacteria enter through the urethra and move upwards.

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14
Q

Tru or false: The kidney is frequently affected in patients with Staphylococcus aureus bacteremia or endocarditis.

A

True

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15
Q

***what are the protection mechanisms of UTI?

A

Elimination by voiding

Antibacterial properties of urine

Defense mechanism of bladder mucosa

Acid environment in vagina

Prostate secretion

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16
Q

Risk factors of UTI

A

Urinary obstruction

Catheterization,urethral dilation, cystoscopy

Renal treatment

Vesicoureteral reflux: inc pressure in bladder causes agent to reach kidney

Neurologic: spinal injury and sclerosis(causing dec. bladder emptying)

Dehydration

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17
Q

List 5 risk factors of UTI in females? ***

A

Sexual intercourse

Lack of urination after sex

Spermicidal & Diaphragm

Diabetes m

Pregnancy

Vaginal atrophy/estrogen deficinecy

Pelvic prolapse/cystocele

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18
Q

UTI risk factors in men? ***

A

Uncircumcision

Transfer of Vaginal E.coli while sex

Prostate hypertrophy

Condom catheter

Homosexuah/ rectal intercourse

prostatic enlargement–>obstruction

19
Q

TRUE or FALSE;
SIGNIFICANT BACTERIURIA; Presence of at least 200,000 bacteria per ml in the urine in excess of the possibility of contamination from the anterior urethraà infection

A

False
True 100,000 bacteria

20
Q

Symptoms of cystitis?

A

Frequent urination

Suprapubic pain

Bloody, cloudy urine

Burning

Urgency

21
Q

Which of cystitis or pyelonephritis have prominent CBC values?

A

Pyelonephritis

22
Q

What are the symptoms of pyelonephritis?

A

Dysuria

Pollakiuria(frequent urination)

Urgency

Flank/lower back pain

Fever

23
Q

Which factors cause complicated UTI’s?

A

Urological anomalies

Pregnancy

24
Q

What are the risk factors in COMPLICATED UTI?

A

“ the Male Prostate prevents UTI in Diabetes, PKD, urolithiasis or neurogenic bladder patients”

“In Postmenopausal women who dont get Pregnant have hx of recurrent /childhood UTI’s “

“Hospital-acquired UTI caused by indwelling Catheter, Stents, renal Transplant, Nephrostomy

25
Q

What is the difference between between relaps and reinfection?

A

RELAPS; Recurrence of bacteriuria with the same causative organism despite treatment

REINFECTION; recurrence of infection with a different microorganism - a new infection

26
Q

***what is the criteria for UROSEPSIS/Sepsis Syndrome due to UTI?

A

2 or more +UTI:
1-temp>38 C or <35 C
2-tachycardia: HR>90b/m
3-RR>20 or PaCO2<32mmHg
4-WBC>12,000 or <4,000 or >10% young form

27
Q

What is the management if pt doesn’t recover after cystitis or pyelonephritis treatment?

A

CT scan

28
Q

How to sample urine?

A

1-clean vagina enterance with water-SF (NOT ANTISEPTICS)

2-First morning Midstream urine

29
Q

What is the most accurate indicator of infection in dipstick?

A

Leukocyte esterase
Nitrate
PH(less or more than 5.5-6.5)

30
Q

What does a positive leukocyte esterase indicate?

A

Pyuria(puss in urine)

31
Q

What does a positive nitrate indicate?

A

Enterobacteria (E.coli, klebsiella, proteus)

32
Q

In which agents does it show negative NITRATE test?

A

Acinobacter
?pseudomonas aeruginosa
Staph saprophyticus
Enterococcus spp
+
Streptococcus spp
Staphylococcus spp
Mycoplasma spp
Nisseria Gonorrhea
Hemophilis influenza

33
Q

Which bacteria causes an alkaline pH(by breakiing down urea )

A

Proteus
Providencia
Morganella

(associated with magnesium ammonium phosphate crystals and stone formation.)

34
Q

***What are the sterile pyuria agents (urethral syndrome=absence of growth in culture in presence of symptoms)?

A

(Stealth killers)

• Chlamydia
• Mycoplasma
• Ureoplasma
• Trichomonas
• Gonococci
• Candida
• Tuberculosis
• Stone
• Foreign body
• Glomerulonephritis

35
Q

Tx for complicated pyelonephritis in pregnants?

A

Broad spectrum beta lactams

36
Q

Tx for complicated cystitis in pregnants?

A

Cephalexin or fosfomycin

37
Q

Describe Gonococcal urethritis

A

Dysuria

Sudden onset

Spontaneous dysuria and discharge

Spontaneous discharge and hyperemia in urethral meatus

Incubation 4 days

38
Q

Describe non-Gonococcal urethritis

A

Either dysuria or discharge

Onset within days

Long Incubation period (2-23 days)

Mucopurulent or serous discharge(whitish-yellow)

Spont discharge and hyperemia in urethral meatus

39
Q

** tx for GNC:

A

Ceftriaxone

40
Q

** tx for NGNC:

A

Azithromycin
Doxycycline

41
Q

**Which are nitrate positive causing uti bacteria?

A

“Enter the Escheria Klub of Proteus land”
1-enterobacteria
2-E.coli
3-klebsiella
4-proteus

42
Q

A pt comes with purulent dischrage from urethra what is the treatement?

A

Pt has gonococcal urethritis
Tx: ceftriaxone

43
Q

A pt comes with mucopurulent/serous dischrage from urethra what is the treatement?

A

Pt has non-gonococcal urethritis
Tx: azithromycin(1g) or doxycycline(100mg for 7days)

infectious diseases (4 decks)

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