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PHA332 > UTI in practice > Flashcards

UTI in practice Flashcards

1
Q

What are the symptoms of bladder (cystitis) infection?

A
  • Polyuria
  • Dysuria
  • Lower abdominal discomfort
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2
Q

What are the symptoms of urethra (urethritis) infection?

A
  • Burning on passing urine

- Discharge

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3
Q

What are the diagnostics of pyelonephritis?

A
  • Kidney pain/tenderness in back under ribs
  • New/diff myalgia, flu like illness
  • Pyrexia
  • Nausea/vom
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4
Q

What are the diagnostics of sepsis?

A
  • Altered metal state
  • Inc RR/HR
  • Low BP
  • Anuria
  • Mottled skin
  • Cyanosis
  • Non-blanching rash
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5
Q

How do you diagnose?

A

Dysuria, new nocturia, cloudy urine

  • 2/3 present UTI likely, dipstick not needed
  • 1 present: dipstick
  • 0 but other symptoms present (freq. suprapubic tenderness) dipstick
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6
Q

Urine dipstick results

A
  • Neg nitrites, leukocytes + RBC: UTI less likely
  • Neg nitrite but +ve leukocyte: could be UTI, send urine culture + consider treatment
  • +ve RBC w/ +ve nitrite or leukocyte: UTI
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7
Q

What happens if bacteria is confirmed even if pregnant women are asymptomatic?

A

Give antibiotics

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8
Q

What is given when a pregnant woman is suspected of having a UTI?

A
  • Symptomatic relief w/ paracetamol
  • Prescribe antibiotic 7d
  • Send MSU for culture
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9
Q

What happens if a group B streptococcus is isolated in a pregnant woman?

A

Prophylactic antibiotic offered during labour + delivery

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10
Q

What must we reduce to battle antibiotic resistance?

A
  • Ciprofloxacin
  • Cephalosporins
  • Co-amoxiclav
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11
Q

What must we inc to help against antibiotic resistance?

A
  • Nitrofurantoin
  • Trimethoprim
  • Pivmecillinam
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12
Q

When is co-amoxiclav recommended?

A
  • Pyelonephritis in pregnancy
  • Facial cellulitis/prophylaxis post dog/human bites
  • Diverticulitis
  • Persistent sinusitis 2nd line
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13
Q

What are the dosage + course length of first choice antibiotics?

A
  • Nitro: (eGFR >45) 100mg MR BD 3 days

- Trim: 200mg BD 3 days

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14
Q

What are the dosage + course length of second choice (no improvement for 48 hrs)?

A
  • Nitro (not 1st choice): 100mg MR BD 3 days
  • Pivmecillinam: initially 400mg, 200mg TDS 3 days
  • Fosfomycin: 3g single dose sachet
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15
Q

What are the adverse effects of nitrofurantoin?

A
  • GI: minimise by taking w/ food
  • Dizzy/tired
  • Itchy rash, allergic reaction, swollen salivary glands: stop
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16
Q

What is the mechanism of action of trimethoprim?

A
  • Inhibits DHFR tf blocks red of dihydrofolate to tetrahydrofolate, active form of folic acid, by susceptible organisms
  • Inhibitory activity for gram +ve aerobic cocci + some gram -ve aerobic bacilli
17
Q

What are the adverse effects of trimethoprim?

A
  • Mild GI
  • Pruritus + skin rash
  • Blood disorders

PHA332 (34 decks)

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