UTI-Schoenwald

Question 1

MC cause of UTIs?

Answer 1

• *Most UTIs are caused by enteric organisms that we carry

- **E coli most frequent cause

Question 2

Gram ______ rods common cause of UTIs

Answer 2

negative

Question 3

Which gender experiences more frequent UTIs?

Answer 3

Women more often experience UTI than men

Question 4

UTI:

-Sx?

Answer 4

Dysuria, frequency, low back pain, fever

Question 5

UTI:

-sx in the elderly

Answer 5

Elderly often are lacking common symptoms but may experience mental status change

Question 6

Untreated UTI can lead to _____

Answer 6

**urosepsis

note: cant bill for urosepsis, must say Urinary infection 2/2 sepsis

Question 7

UTI:

Ascending infection can lead to ________

Answer 7

pyelonephritis (Kidney infection)

Question 8

UTI encompasses:

Answer 8

any of the collecting system (ureters, urethra, bladder, BUT usually starts in the urethra/bladder area)
-and if it gets in the blood–> usually becomes pyelonephritis)

Question 9

Pyelonephritis is usually due to ______ UTI

Answer 9

ascending

Question 10

Pyelonephritis:

• Organisms?
• Sx?
• PE?

Answer 10

• Same organisms as UTI
• Sx include: flank pain, fever,nausea and vomiting

-PE: –***CVA tenderness

Question 11

Pyelonephritis:

• Labs?
• tx?

Answer 11

Labs: **WBC casts (in UA)

-Tx: IV or PO antibiotics 10-14 days (targeted to organism)

(empiric tx is targeted towards e coli– ie ceftriaxone, fluoroquinolones, bactrim

Question 12

UTI:

-lab findings for UA?

Answer 12

Urinalysis (UA):

• Alkaline ph, positive leukocyte esterase, positive nitrite
• +/- Hematuria

Question 13

Urinary tract infection:

-classified as?

Answer 13

uncomplicated vs complicated

Question 14

What is the difference Complicated Vs Uncomplicated UTI:

Uncomplicated=

Answer 14

Infection in:

• Healthy, no underlying condition
• non pregnant
• pre menopausal female

-intact/no anatomical abnormality urinary tract system

Question 15

UTI: Complicated=

Answer 15

Infection in:

• Predisposing conditions present (immunosuppression,diabetes)
• Male sex
• Pregnancy
• Previous hospitalization
• Indwelling catheter
• Recent treatment with abx
• Sx present ≥7 days
• Functional or abnormal anatomic urinary tract system
• Recent urinary tract intervention

Question 16

Tx: uncomplicated UTI

Answer 16

can have short course of antibiotics 3 days

Question 17

Tx: complicated UTI

Answer 17

• 7-10 days of treatment
• Target antibiotic therapy to organism
• **Options, nitrofurantoin, cipro, levaquin, bactrim, amoxicillin, cephelexin

Question 18

UTI Tx PEARLS

Answer 18

• *Nitrofurantoin works in the bladder only (it will NOT tx pyelonephritis or blood stream infections)
• Nitrofurantoin needs good renal fxn to be metabolized- CAUTION with use in elderly–**Beers Criteria
• Pregnancy may require 10-14 days if treatment, amoxicillin and cephalexin are safe in pregnancy

Question 19

Look at Beers Criteria PDF (meds used w/ caution)

Answer 19

PDF schoeny posted