Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FA17 Nephrology > UTI & Pyelonephritis > Flashcards

UTI & Pyelonephritis Flashcards

1
Q

uncomplicated UTI

A

UTI

no structural or functional abnormalities

no comorbidities

not associated with GU tract instrumentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

patients with uncomplicated UTI

A

young

healthy

non-pregnant women

normal anatomic and functioning urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

why are women more susceptible to UTI

A

shorter urethrae for uropathogenic bacteria to ascend

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

diagnostic criterion for UTI

A

bacterial colony count 10^5 CFU/mL

obtained via urine C and S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

complicated UTI

A

UTI in patients with functional or structural abnormalities

infection in presence of comorbidities (renal dz, pregnant, DM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risk factors for complicated UTI

anatomy

A

cystocele
rectocele
prostate hypertrophy
pregnancy (uterine enlargement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

risk factors for complicated UTI

A

nursing home/catheter

neonate

comorbid or neurologic diseases

atypical pathogen exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

clinical features of complicated UTI

A

may vary or be absent

fever, pain, systemic inflammation may be absent

typically: weakness, malaise, AMS, abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

organisms of complicated UTI

A

more likely to be infected with resistant organisms

management of pts is same as pylo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC pathogen for UTI

A

e.coli (>80%)

can adhere to wall and ascend via pili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

increased risk for UTI

A

incomplete bladder emptying

post menopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

incomplete bladder emptying and UTI

A

disrupt bladder’s ability to eradicate bacteria from mucosal surface

increased susceptibility to infection

esp. found in its with neurogenic bladders, prolapsed uterus, BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

postmenopausal women and UTI

A

decreased estrogen

encourages transition from lactobacillus to e.coli colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

asymptomatic bacteriuria

A

10^5 CFU in 2 successive cultures without symptoms

found mc in patients with catheters, also in females of nursing homes, males, pregnant women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who gets treatment of asymptomatic bacteriuria

A

recommended ONLY in pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

acute cystitis

A

UTI isolated to bladder

acutely symptomatic w/ >10^5 CFU

otherwise healthy, w/o coexisting pyelo, non pregnant females, no obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clinical features of cystitis

A 
frequency 
urgency 
suprabuic pain 
hesitancy 
visible hematuria

no fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

nature and severity of symptoms are determined by

A

etiology or organisms

portions of urinary tract involved

patients ability to mount immune and inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

history of vaginal discharge or irritation is associated with

A

vaginitis
cervicitis
pID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pyelonephritis

A

infection of upper urinary tract, involving renal parenchyma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

presentation of pyelonephritis

A

subtle, difficulté to distinguish

FLANK PAIN 
voiding irritation
FEVER (systemic illness) 
tachycarida 
n/v
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

complications of pyelonephritis

A

missed diagnosis could lead to deterioration or urosepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

pyelonephritis can progress into three patterns of renal infections:

A
  1. acute bacterial nephritis
  2. renal abscess
  3. emphysematous pyelo

order imaging if response to tx is inadequate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

urosepsis

A

may or may not exhibit symptoms of UTI

fever or hypothermia
rising HR
elevated respiratory rate
leukocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
severe urosepsis symptoms
``` HoTN organ dysfunciton hypoperfusion oliguria AMS ```
26
two methods of collecting a urine sample
clean catch | catheterization
27
diagnosis of UTI based on history
can be made with moderate probability if pt has dysuria, frequency and urgency false positive rate is 43%
28
clean catch
midstream voiding avoid collection of initial or last voided
29
catheterization indicated
can't void spontaneously too ill immobilized extremely obese only do in these patients bc can cause UTI with cath
30
storage of urine
should be tested immediately or refrigerated to avoid colonization within the specimen
31
urine dipstick
preformed on fresh uncentrifuged urine quick and easy
32
positive urine dipstick
nitrate or leukocyte esterase supports diagnosis of UTI (negative test result doesn't exclude it) 75% sensitive and 60% specific - negative result doesn't exclude diagnosis bc it can't detect acinetobacter, enterococcus, peudomonas, staph
33
`leukocyte esterase
enzyme released by leukocytes reflects pyuria
34
nitrite
positivity nitrite indicates presence of enter-bacteria
35
what can cause false positive in urine dipstick
substances that turn urine red i.e. Pyridium or ingestion of beets
36
urine WBC count values
pyuria <5 suggests alternative diagnosis >5 in symptomatic patient indicates + test
37
problems with UA
false positive can occur when vaginal or fecal contamination present can't detect chlamydia infection contamination of sample must be considered if evidence of squamous cells on UA
38
diagnostic accuracy is improved with
history + dipstick + UA
39
urine culture not on who?
patient with typical symptoms of cystitis or uncomplicated UTI and positive findings on UA pyuria on microscopic exam, postive leukocyte esterase or urine nitrite majority of these respond to empiric therapy
40
indications for urine culture
``` complicated UTI pregnant women adult male relapse or reinfection septic pts ```
41
blood culture
indication in patients with suspected clinical sepsis don't typically alter management
42
imaging UTI
NOT typically done done on male, elderly, diabetic, severely ill pts with pyelo if there is suspect of renal stone or non responsive to initial therapy
43
kidney US in UTI
evaluate for obstruction and focal parenchymal abnormalities
44
CT scan UTI
kidney stonesempysematous pyelonephritis
45
plain film radiography
used to track kidney stones thru urinary tract
46
uncomplicated UTI treatment
nitrofurantoin (Macrobid) TMP-SMX (Bactrim) 5 days, no culture req.
47
complicated UTI treatment, pyelonephritis
cipro, levaquin urine culture recommended 7 day tx or 14 days for recurrent or pyelonephritis
48
hospitalized UTI treatment
ceftriaxone/Rocephin IV
49
complicated UTI treatment, pyelonephritis susceptible by C and S
``` TMP SMX (Bactrim) Augmentin ```
50
urethritis tx
ceftriaxone/rocephin IM azithromycin (Zithromax) OR Doxy(vibramycin) culture psotivie for Chlamydia or Gonorrhea
51
outpatient follow up for whom?
healthy females tolerating fluids and meds 85% discharged return to ED if: increased pain, fever, vomiting
52
adjunctive therapies at discharge
increased fluid intake and frequent voiding bladder anesthetic agents (Pyridium) post coital voiding cranberry juice wipe front to back
53
admission criteria UTI + adjunct tx
unable to retain fluids/meds patients with signs of urosepsis concomitant kidney stone failed outpatient therapy systemic analgesics and antiemetics PRN for pyelo patients ALL PATIENTS GET IV MEDS
54
chronic cath patients and asymptomatic UTI
almost universal screening is not indicated antibiotic tx of asymptomatic patients does not affect outcome - therefore rarely treat may be protective
55
when is screening recommended for asymptomatic UTI
pregnancy prior urological procedures
56
prevention of catheter associated UTI
avoidance of unnecessary cath use of sterile technique removal of cath ASAP
57
why must we treat UTI in pregnant women
acute pyelo can precpiatet preterm labor, bcaterimia and septic shock
58
screening for UTI in pregnancy
once a week for 12 weeks week 16 do urine C and S
59
treatment of asymptomatic UTI in pregnant pos
nitrofurantoin (microbic) 100 mg PO x 10 days cephalexain (keflex) 500 mg PO bid x 10 days
60
ABX not to use on pregnant patients
Bactrim Fluroquinolones Tetracycline
61
tx of pyelonephritis in pregnant patient
hospitalize, hydrate, Rocephin/Ceftriaxone continue until afebrile 48hrs and flank pain resolved switch to oral therapy 10-14 days and discharge
62
UTI in HIV/AIDS
patients are resistant to TMP-SMX so give fluoroquinolone upon initial treatment unless urine culture indicates something else
63
pediatric UTI
most common serious bacterial infection possible in all children very common but children don't show similar symptoms
64
gross hematuria
1 mL of whole blood/L of urine visible to naked eye
65
microscopic hematuria
not visible >3 RBS/HPF
66
pathophysiology of hematuria
any process that results in infection, inflammation or injury to GU tract can cause painless after 50 yrs of age increased risk of renal, prostate, bladder CA
67
uroepithelial cancer risk factors
``` >50 y/o male smoking family history of bladder CA occupational exposures in chemical, rubber, leather industry ```
68
common causes of hematuria
UTI (MC) kidney stone neoplasm trauma glomerulonephritis anticoagulation side effect

FA17 Nephrology (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions