UTI (lec 18)

Question 1

Uncomplicated UTI microbes?

Answer 1

e. coli (G-)
p. mirabilis (G-)
kleb pneumoniae (G-)
staph saprophyticus (G+)

Question 2

Primary source of UTI microbes?

Answer 2

GI tract

except s. saproph (skin)

Question 3

Only time M > F for UTI?

Answer 3

babies

uncircum -> G-

Question 4

What things cause stasis in preggos?

Answer 4

1) ureter block by uterus
2) progesterone ↓ mm tone -> valves don’t close
3) ↓ in auto peristalsis

Question 5

UTI predisposing factors for W?

M?

Answer 5

Menses -> loss of N flora and epithelia
Postmeno -> prolapse (stasis), N flora Δs

BPH (stasis/reflux)

Question 6

e. coli adhesions: FimH?

Answer 6

Mannose-sensitive fimbria

Bind lower UT mucosa,
Mannose blocks binding

Question 7

e. coli adhesions: P fimbria?

Answer 7

Mannose resistant

Colonize upper UT epith
Bind P blood group antigen

Question 8

Hemolysin is?

Answer 8

cytotoxic enz

Question 9

LPS is?

Answer 9

endotoxin in G-

Question 10

Aerobactin is?

Answer 10

siderophore

scavenges iron

Question 11

Urease is?

Answer 11

Enz that hydrolyzes urea to ammonia
↑ urine pH
Creates struvite crystal biofilm on catheters

Question 12

Urease producing microbes?

Answer 12

p. mirabilis (swarming)

s. saprophyticus

Question 13

K antigen is?

Flagellum virulence?

Answer 13

Capsular polysacc -> antiphag (G-)

Flagellum -> swarming

Question 14

Descending º microbe?

Source?

Answer 14

s. aureus, m. tb, cand albicans

hematogenous, lymphatic

Question 15

Urethritis is?

Sxs?

Answer 15

localized inflam of urethra

dys/poly
freq/hesitancy

Question 16

Urethritis a/w what in females?

Males?

Answer 16

cystitis

prostatitis

Question 17

Urethritis etiology?

Answer 17

STD:
chlamy, gonorr, t vagin

Non-STD

Question 18

Cystitis sxs?

Answer 18

same + hemat, suprapub tender

bacteriuria/pyuria

Question 19

Pyelonephritis sxs?

Answer 19

same + flank pain/CVA tender

fever, N/V

Question 20

+ lab results for UTI?

Answer 20

culture >= 10^5 AND leuko >= 10^5
or
>= 10^2 + acute sxs

ANY count if sample drawn thru aspiration
or
ANY count if s. aureus

Question 21

Dip results and specific bugs?

pH
LE
Nitr

Answer 21

Urease producers ↑ pH to ~7

LE+ for pyuria

Nitrites produced by e. coli, proteus and kleb

Question 22

Uncomplicated cystitis tx?

Answer 22

3 days

cephalosporin/amox (β-lac CW inhib)

Question 23

Uncomplicated pyelone?

Answer 23

10 days

Fluoro (cipro/lexoflox) (DNA inhib)

Question 24

UTI prophylaxis?

Answer 24

Methamine hippurate

formaldehyde formation in urine

Question 25

Phenazopyridine is?

Answer 25

UTI analgesic

Question 26

Complicated UTIs (different from Clin Med’s UTI lecture)?

Answer 26

Pyelon w/i 1 yr
Sxs >= 7days w/o tx
UTI in childhood

Question 27

Recurrent UTI?

Answer 27

3 or more SYMPTOMATIC bacteriuria w/i 1 yr