UTI Flashcards
1
Q
Symptoms of cystitis:
A
- Frequent urination
- Dysuria
- hematuria
- suprapubic pain
(remember, not associated with systemic signs)
2
Q
Symptoms of pyelonephritis:
A
- costovertebral angle tenderness
- urgency
- systemic symptoms: fever, chills, nausea, vomiting
3
Q
Uncomplicated UTI: def
A
- Lower urinary symptoms in otherwise healthy young non-pregnant women
4
Q
Complicated UTI: def
A
- pregnant women
- men
- obstruction
- immunosuppression
- renal failure
- renal transplant
- nosocomial UTI
- cathéter-associated UTI
- renal stones
- pyelonephritis
5
Q
Catheter associated UTI:
A
source of UTI from catheter
6
Q
Main pathogens for non-complicated UTI
A
- E.coli
- S. saprophyticus
- enterococcus
7
Q
Main pathogens for complicated UTI
A
Same as non-complicated +
- Ab resistant E.coli
- pseudomonas
8
Q
Main pathogens for catheter associated UTI
A
- corynebacterium urealyticum
- candida
9
Q
Diagnosis for UTI:
A
- urine sample, preferably in mid-stream
- urine dipstick: only gives an initial idea of the disease, whether is hematuria, nitrites, proteinuria etc…
- urinalysis: test for presence of bacteria, hematuria, presence of WBCs, nitrites
- urine culture: to determine the pathogen
10
Q
Goal of UTI treatment:
A
- 1st thing to do is symptomatic relief
- if no response -> perform an imaging
11
Q
Treatment of UTI: antibiotics used
A
Clinical response should occur within 24 hours, except for pyelonephritis, should occur within 48-72 hours
- Nitrofurantoin: highly active for E.coli
- TMP + SMX (sulfamethoxazole + trimethorprim)
- fosfomycin
- beta-lactams: amoxicillin
- fluoroquinolones: ciprofloxacin, levofloxacin. For uncomplicated pyelonephritis and complicated UTI
12
Q
Treatment of UTI: prophylaxis of recurrent UTI
A
- nitrofurantoin
- TMP + SMX orally daily
- antibiotics for 4-6 weeks
13
Q
Treatment of UTI: uncomplicated cystitis
A
- Nitrofurantoin: highly active for E.coli
- TMP + SMX (sulfamethoxazole + trimethorprim)
- fosfomycin
- beta-lactams: amoxicillin
- fluoroquinolones: ciprofloxacin, levofloxacin.
14
Q
Treatment of UTI: uncomplicated pyelonephritis
A
- fluoroquinolones
In case of fluoroquinolone resistance -> use ceftriaxone or gentamicin
15
Q
Treatment of UTI: complicated UTIs
A
- any of the normal used antibiotics is recommended
- when diagnosis of cystitis vs pyelonephritis is unclear -> give TMP + SMX
- UTI in men: TMP + SMX
- if resistant E.coli: nitrofurantoin or fosfomycin (but not for pyelonephritis)
