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Obstetrics > UTI MR > Flashcards

UTI MR Flashcards

1
Q

most common complication in pregnancy

A

UTI

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2
Q

Predisposing factors of UTI

A

Short urethra
High levels of progestrone
Cortisol increase
Uterine enlargement
Physiological Glycosuria
Sex
Delivery
Instrementation

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3
Q

How high levels of progestrone increase chance of UTI

A

cause hypertrophy of smooth muscles in ureter narrowing lumen causing urine stasis

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4
Q

How high cortisol is factor of UTI

A

Suppresses immunity

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5
Q

Uterine enlargement

A

compresses ureters= urine stasis

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6
Q

Causative Organism

A

Most commonly E.Coli
Klebsiella
Streptococcus
Staph.aureus and saprophyticus
Proteus
Psuedomonas

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7
Q

Routes of infection

A

Ascending route
Lymphatic Spread
Hematogenous Spread

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8
Q

Severe type, requires hospitalization

A

Upper urinary tract infection

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9
Q

Mild, home treated UTI

A

Lower UTI

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10
Q

Part of urinary system that can be affected in Upper UTI

A

Kidney (Pyelonephritis)
Ureter (Ureteritis)

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11
Q

Part of urinary system that can be affected in Lower UTI

A

Bladder (cystitis)
Urethra(Urethritis)

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12
Q

Symptoms of Lower UTI

A

Dysuria
Burning micturation
Frequency (+6day +1 night)
Urgency
Hematuria (if there is stone)
Suprapubic or lower abdominal pain

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13
Q

Symptoms of upper UTI

A

Loin pain
Fever
Palpitation
Vomiting
Chills

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14
Q

Signs on examination of Upper UTI

A

Renal angle tenderness
High temp
Tachycardia
Signs of dehydration

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15
Q

Why right kidney is more affected in UTI in pregnant women

A

Uterus is dextro-rotated (coz colon on left side) so more pressure on right ureter.
Ovarian vein passes over right ureter compresses it (left passes adjacent to left ureter)

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16
Q

Investigation done for UTI

A

Midstream urine analysis
Culture and sensitivity
Nitrites
Ketone bodies
CBC (for WBC)
Random blood sugar
Renal function test

17
Q

Midstream urine analysis

A

Colour
Smell
+10^5 bacteria/ml
+10 pus cells (pyuria)
RBCs in urine

18
Q

Renal function test test for

A

creatinine and urea

19
Q

Presence of elevated white cells in urine (+10) but no bacteria

A

Sterile Pyuria

20
Q

Causes of Sterile Pyuria

A

Chlamydia
Gonorheaa
TB
Trichomonas Vaginalis
Herpes Virus
Renal stones
took antibiotic before sample
drank alot of water before sample
SLE
Kawasaki
Cancer

21
Q

Asymptomatic bacteruria

A

Presence of +10^5/ml of bacteria in 2 mid stream samples w/no symtoms

22
Q

Untreated Asymptomatic Bacteruria can cause

A

Progress to pyelonephritis
Preterm labour
ass. with Preclampsia and DM

23
Q

Diagnosis of Asymptomatic Bacteruria

A

Routine Analysis in 1st visit

24
Q

Treatment of Asymptomatic Bacteruria

A

Antibiotic
Ampicillin 500mg/6hrs
Cephalosporine, Nitofurantoin tablets

25
Q

Prophylaxis of UTI

A

fluid intake increase
empty bladder frequently t/out day and after sex

26
Q

Treatment of Upper UTI

A

Hospital admission
IV antibiotic
Paracetamol
Antiemetic
IV fluids

27
Q

IV antibiotic given to Upper UTI

A

Penicillin (Amoxicillin, Ampicillin, Augmentin)
Cephalosporin (Cefalexin, Cefazolin)

28
Q

If IV antibiotic for Upper UTI shows improvement after 48 hrs

A

Change to oral antibiotic

29
Q

If no improvement after 48 hours of IV antibiotic in Upper UTI

A

give Gentamicin

30
Q

No improvement on antibiotics for Upper UTI infections suggests

A

Renal Stone
Perinephric Abcess
Malformation (polycystic kidney)
Diagnose via U/S

31
Q

Antiemetic given in Upper UTI

A

Metochlopramide
Prochloroperazin

32
Q

Lower UTI treatment

A

Home treated
Broad spectrum antibiotic for 3 days (changed if no improvement according to culture result)

33
Q

Fetal complications of UTI

A

Miscarriage
IUFD
IUGR
Preterm Labour
Childhood asthma

34
Q

Maternal Complications

A

Septicemia
Perinephric abcess
Anemia
Renal failure
Pulmonary oedema

35
Q

Safe antibiotic in pregnancy

A

Penecillins
Cephalosporins

36
Q

Caution antibiotics

A

Gentamicin= ototoxicity

37
Q

Avoid in 1st trimester antibiotic

A

Trimetoprim = folate antagonist

38
Q

Avoid in 3rd trimester

A

Nitrofurantoin= Hemoplytic anemia
Sulphonamides = kernicterus

39
Q

Contraindicated in Pregnancy Antibiotics

A

Tetracycline
Ciprofloxacine
Chloroamphenicol

Obstetrics (15 decks)

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