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Renal > UTI lecture > Flashcards

UTI lecture Flashcards

1
Q

Acute cystitis

Acute pyelonephritis

A

Uncomplicated UTIs

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2
Q 
UTIs in:
pregnancy
elderly
children
males
catheter pts
A

Complicated UTIs

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3
Q

most common GU complaint

A

UTI

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4
Q

female to male ratio for pyelonephritis

A

30:1

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5
Q

Obstruction
Anatomic abnormality
Urologic dysfunction
Multi drug resistant uropathogen

A

Condition that may cause complicated UTI

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6
Q 
Females
Sexual intercourse (recent or frequent)
Diaphragm use
Spermicide use
Hx of UTI
Delayed post-coital micturation
A

UTI Risk factors

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7
Q

develops when pathogens ascend to the kidneys via ureters

A

Pyelonephritis

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8
Q

_______ accounts for 75-95% of uncomplicated UTIs

A

E. Coli

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9
Q 
Dysuria (or "burning")
increased urinary frequency
increased urinary urgency
suprapubic pain/discomfort
\+/- hematuria
voiding in small amounts
**AFEBRILE
A

Acute Cystitis

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10
Q 
\+/- cystitis signs PLUS
FEVER*
chills
flank pain
costovertebral angle tenderness
N/V
A

Acute pyelonephritis

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11
Q

what MUST you think about if you have blood in urine without discomfort

A

urine cancer

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12
Q

Pyuria
Bacteriuria
Varying degrees of hematuria
+ Leukocyte esterase (an enzyme released by leukocytes)
+ Nitrites (reflecting presence of bacteria which convert urinary nitrate to nitrite)
White cell casts – diagnostic for upper tract infx

A

Urinalysis in UTI

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13
Q

Urine culture with more than 100,000 bacteria cfu/mL

A

UTI

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14
Q

Hematuira
Leukocytes
Nitrites
WBCs

A

Can be seen in urinalysis of pt with UTI

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15
Q
  • TMP-SMX DS
  • Nitrofurantoin
  • Fosfomycin
A

First line agents for uncomplicated cystitis in women

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16
Q

Bacteria convert urinary nitrate into…

A

nitrite

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17
Q

Ciprofloxacin in acute cystitis

A

alternative agent for acute cystitis

18
Q

Pyridium in UTIs is used for…

A

pain! numbs bladder

**NO LONGER THAN 2 DAYS!!!

19
Q

Why should you not use Pyridium in UTIs for longer than 2 days?

A

Masks symptoms..should be starting to feel better after on antibiotics for 2 days

20
Q

Pyelonephritis with:
Mild to moderate illness
Stabilized with rehydration

treat with…

A

Outpatient oral antibiotics

21
Q 
Pyelonephritis with..
Severe illness
High fever, pain
Marked debility
Inability to maintain oral hydration or take PO rx
Pregnancy
Concerns about compliance

treat with…

A

Inpatient IV antibitoics

22
Q

DOC for outpatient acute pyelonephritis

A

Ciprofloxacin

23
Q

FQ or AMP+gentamicin or ceftriaxone

A

IV acute pyelo tx

24
Q

UTIs usually respond to tx within….

A

48-72 hours

25
Q 
Wipe from front to back
Increase fluid intake
Cranberry juice
Void often
Avoid irritants
Change birth control method
A

UTI prevention

26
Q 
Elderly
Pregnant
Children
Men
CAUTI
A

Special population UTIs

27
Q

Bladder and/or uterine prolapse
Loss of estrogen causing change in vaginal flora
Loss of lactobacilli in vaginal flora which results in periurethral colonization of E.coli
Concomitant medical illnesses (i.e., diabetes)

A

causes of UTIs in postmenopausal women

28
Q

Benign prostatic hypertrophy can cause

A

UTIs in men

29
Q

asymptomatic bacteriuria

A

can be seen in pregnancy

30
Q

Up to 40% risk of developing UTI, including pyelonephritis, during pregnancy
Associated with preterm birth, low birth weight & perinatal mortality
Present in 4-7% of pregnancies
Screen in 1st trimester with UC
If UC positive, treat and then repeat q trimester
Tx nitrofurantoin x 7 days
Suppressive therapy after 2 or more courses antibx

A

asymptomatic bacteriuria

31
Q

Most common pathogen that causes UTIs in children

A

E coli

32
Q

Most common cause of nosocomial infections in US

A

CAUTIs

33
Q

advanced age, underlying illness & duration of catheterization

A

risk factors for CAUTIs

34
Q

screen urine how many hours after removing catheter?

A

48 hours

35
Q

asymptotic CAUTIs….

A

do NOT require antibiotics

36
Q

3 or more episodes per year (confirmed by UC) or 2 UTIs in last 6 months

A

recurrent UTIs

37
Q

vaginal estrogen in postmenopausal women

A

can help prevent UTIs

38
Q

Isolation of a single organism on UC from an individual without s/s of UTI

  • *Women – at least 2 occasions of 100,000 CFU/ml
  • *Men – at least 1 occasion of 100,000 CFU/ml
A

Asymptomatic bacteriuria

39
Q

Do you treat asymptomatic bacteriuria in:

  • Pregnant women
  • Prior to urologic procedures
  • After renal transplantation
A

YES

40
Q

What type of technique used to collect urine specimen?

A

Clean catch

41
Q

Diagnosis of ________ is often based on patient’s history alone (96% probability) in women presenting in outpatient setting with triad and no vaginal discharge

A

acute cystitis

42
Q

Should Pyridium be used as initial therapy?

A

NO!

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