UTI, Pyelo, and ABs Flashcards

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1
Q

Urethritis is often associated with?

A

STI

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2
Q

Culture and Senstivity does not…

A

pick up GC and Chlamydia in a timely fashion

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3
Q

What are some predisposing factors for UTIs?

A

use of spermicide (as with diaphragm for contraception)

frequent sexual intercourse

*20-30% will have recurrence

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4
Q

What pt is at a greater risk of UTIs?

A

diabetic women - 2-3x higher incidence

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5
Q

If a post-menopausal women has recurrent UTIs, what are her predisposing factors?

A

hx of premenopausal UTIs

anatomic factors affecting bladder emptying (cystoceles, urinary Incontinence, residual urine)

tissue effect of estrogen depletion

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6
Q

What are predisposing factors for UTI in men?

A

prostatic hypertrophy

non-circumcised

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7
Q

What is ABU?

A

Asymptomatic bacteriuria

urine sample is obtained for another reason & shows bacteria on microscopic evaluation

*generally do not treat unless sx develop

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8
Q

What qualifies an uncomplicated UTI?

A
  • Non-pregnant female
  • No anatomic abnormalities
  • No instrumentation of the urinary tract
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9
Q

What qualifies a complicated UTI?

A
  • ANY pregnant female since
    • 2 patients
    • can lead to premature labor
    • low birth-weight babies
  • Anatomic variant (ex. single kidney)
  • Foreign body in the urinary tract
  • Extrinsic compression of ureter/bladder
  • Immune suppression conditions (diabetes)
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10
Q

What are the contributing factors for interstitial cystitis?

A
  • Chronic bladder infection
  • Inflammatory factors
  • Unusual pain sensitivity
  • Functional co-morbidities
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11
Q

What organisms are in the ddx for:

  1. Urethritis
  2. Vaginitis
  3. Cervicitis
A
  1. Gonorrhea, Chlamydia, Herpes
  2. Candida, Trichomonas
  3. Chlamydia, Neisseria
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12
Q

If urine dip and urine microscopic are negative, do you need a urine culture?

A

no - unless you’re thinking STI

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13
Q

What ABs are used for GC?

A

Ceftriaxone and Azithromycin

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14
Q

What ABs are used for chlamydia?

A

Azithromycin or doxycycline

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15
Q

How do you tx cystitis? pyelonephritis?

A
  1. Trimethoprim-Sulfamethoxazole
  2. Fluorquinolone–eg levofloxacin
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16
Q

What sx are seen with pyelonephritis?

A
  • Generally sicker
  • Fevers/chills
  • Body aches (esp back pain)
  • Typically ascending from lower tract infection
  • Positive CVA tenderness
17
Q

What are the most common precursors of pyelonephritis?

A
  • Same as UTI (most commonly ascending from lower tract)
    • Most common organism is E. Coli
  • Can be hematogenous spread to kidney instead of ascending, but very rare
    • Candida, Salmonella, Staph aureus
18
Q

What are the three big complications of pyelonephritis?

A
  1. Papillary Necrosis
  2. Emphysematous pyelonephritis
  3. Xanthogranulomatous pyelonephritis
19
Q

What is emphysematous pyelonephritis?

A

production of gas in nephric and perinephric area

*almost exclusively in diabetic pts

20
Q

What happens in xanthogranulomatous pyelonephritis?

A

suppurative destruction of renal tissue

can lead to abscess formation

21
Q

What is sepsis? what is septic shock?

A
  1. Suspected or documented infection and an acute increase in organ failure
    1. Dysregulated host response to infection
  2. Progressive organ dysfunction leading to marked increase in mortality
22
Q

What are the signs of shock?

A
  • fever or hypothermia
  • tachycardia
  • tachypnea
  • hypotension (can be unresponsive to fluid resuscitation)
  • circulating cytokines
  • endothelial injury
  • edema
  • decreased oxygenation of tissues
  • build up of lactic acid
23
Q

What are preventative measurements for UTIs?

A
  1. AB therapy
  2. pee after sex
  3. wipe front to back
  4. shower > bath
  5. cranberry products
  6. vitamin C
  7. increased fluid intake