UTIs Flashcards
presents with:
Dysuria
Urinary urgency & frequency
Hematuria
Suprapubic/flank pain
Pyuria (WBCs)
+ leukocyte esterase (produced by white blood cells)
± nitrites (gram - bacteria)
Bacteriuria on urine culture
Diagnosis & mcc?
Cystitis
E. Coli
Positive nitrites are specific for ____
gram-negative bacteria (E coli, Klebsiella, Proteus)
belonging to the Enterobacteriaceae family
pt with intermittent urges to urinate and is sometimes unable to make it to the restroom and leaks urine has ____.
⎯
Initial evaluation/diagnostics for urinary incontinence (2)
Urgency Incontinence
(s/t overactive detrusor muscles in the bladder)
⎯
Urinalysis
Postvoid residual volume
Management of Pediatric UTIs include:
Antibiotics (_____)
First febrile UTI:
Age <2: _____
Age ≥2: _____
Recurrent febrile UTIs (regardless of age): ____
3rd Gen cephalosporin (Cefiximine)
Age <2: renal & bladder U/S
if abnormal → voiding cystourethrogram
Age ≥2: observation alone
Recurrent febrile UTIs: renal & bladder U/S and voiding cystourethrogram
Asymptomatic bacteriuria (ASB) in pregnancy increases the risk for _____, all patients require urine culture screening at the initial prenatal visit and treatment as indicated.
acute pyelonephritis (& pre-term labor)
(Tx: 3rd Gen Cephalosporin, Fosfomycin, Amoxicillin-clavulanate)
Uncomplicated urinary tract infection (UTI) refers to infection confined within the bladder and is confirmed with urinalysis. Patients can be treated empirically without a urine culture
effective first-line treatment options include (3)
TMP-SMX
Nitrofurantoin (women only)
Fosfomycin
(Urine culture only if initial treatment fails)
Nocturnal enuresis in the setting of polyuria, polydipsia, and weight loss in children is suggestive of new-onset
type 1 diabetes mellitus
(autoimmune destruction of pancreatic beta cells and osmotic diuresis due to glucosuria)
A ____ is indicated to assess for predisposing urologic abnormalities (vesicoureteral reflux) in a child with ≥2 febrile urinary tract infections, abnormal renal ultrasound, high fever with an unusual pathogen, or signs of chronic kidney disease.
voiding cystourethrogram
Children age <2 years with a first febrile urinary tract infection (UTI) should receive 1-2 weeks of antibiotics and a ___ to evaluate for abnormalities that may lead to recurrent UTIs.
renal and bladder ultrasound
Diagnosis should be considered in an infant with fever ≥39 C (102.2 F) with no identifiable source because occult infection is common in this age group and presentation is nonspecific ( fussiness, poor feeding).
Urinary tract infection
(Get a urinalysis and urine culture)
_____ is common in elderly men, especially in the setting of postoperative period with underlying benign prostatic hyperplasia. Diagnosis is made using ____.
Acute urinary retention (AUR)
bladder ultrasound
Presents with weak or spraying urine flow and incomplete emptying in adult males.
Postvoid residual volume is increased (>200).
Diagnosis, confirmation, and treatment?
Urethral stricture
urethrography or cystourethroscopy
urethral dilation
spinal cord injury (UMN) results in loss of detrusor contractility. Diagnosis?
Neurogenic Bladder
(Urinary Retention)
Normal Pressure Hydrocephalus interrupts cortical input to UMN in brain controlling mictruition resulting in _____.
Urge incontence
S2-S4 Sacral Nerves (LMNs) relay signals to the detrusor and sphincters.
Lower spinal cord injuries/compressions like in Cauda Equina or tethered cord syndrome result in _____.
Overflow Incontinence
(under active bladder)
