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UTIs Flashcards

1
Q

What are symptoms of lower UTIs?

A
  1. dysuria
  2. urgency
  3. urinary frequency
  4. suprapubic pain
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2
Q

What are symptoms of upper UTIs?

A
  1. fever
  2. flank pain
  3. N/V
  4. Clinical sepsis
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3
Q

What’s the difference between an acute and chronic UTI?

A

Chronic may have high bacterial load but no symptoms

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4
Q

What factors predispose you to an ascending UTI?

A
  1. maternal hx of UTIs
  2. First UTI < 15
  3. New sex partner
  4. condom use/spermicides
  5. Bladder overdistention
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5
Q

What genetic difference would predispose you to a UTI?

A
  1. Certain HLA types

2. Short uretural length

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6
Q

How do you diagnose UTIs?

A

Gram stain and culture
Urinalaysis with 5-10 WBC/hpf
Leucocyte esterase test
nitrite test

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7
Q

What is the criteria for treating a UTI?

A

Symptomatic and > 100 organsims

Asymptomatic and 10^5 organisms

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8
Q

What would you do to treat a UTI?

A

3 days of oral antibiotics. If more than 3 re-infections in a year, consider prophylactic antibiotics

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9
Q

How do you tell whether a recurring UTi is a relapse or a reinfection?

A

Relapse if symptoms recur within 2 weeks. In this case, you want to treat with a longer course of antibiotics

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10
Q

SHould you treat asymptomatic bacteriuria?

A

NO.

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11
Q

What are your options for treating a lower UTI?

A
  1. TMP-Sulfamethoxazole
  2. Cipro
  3. Nitrofurantoin
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12
Q

What are your options for treating an upper UTi?

A

CIPRO empirically.

–Can prophylaxis with cipor, cephalex, TMP-SMX

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13
Q

How do you treat an inpatient with an upper UTI?

A

Aminoglycoside and Ampicillin
Cipro
Zosyn

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14
Q

At what age can adolescents be treated confidentially?

A

15-24

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15
Q

Clue cells=buzzword for:

A

vaginosis

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16
Q

Strawberry cervix=buzzword for

A

trichomonas

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17
Q

Genital ulcers are caused by:

A

herpes or syphilis

18
Q

Causes of vaginitis

A

candidiasis
bacterial vaginosis
trichomoniasis

19
Q

Which serovars of chlamydia trachomatis causes STD infections?

A

D-K serovars

20
Q

What forms does chlamydia take?

A

Elementary body is extracellular

Reticulate body is intracellular

21
Q

What do you need to grow chlamydia?

A

Tissue culture==it’s an INTRA cellular organism! Can’t grow on its own. It also has NO peptidoglycan wall

22
Q

How does chlamydia get into cells?

A

Receptor mediated endocytosis

23
Q

What does chlamydia cause in the neonate?

A 
Inclusion conjunctivitis (cobblestoning)
Also interstitial pneumonia
24
Q

How do you diagnose chlamydia?

A

PCR
ligase chain rxn
NAAT

25
How do you treat chlamydia?
Azithromycin (1 dose) | Doxy (bid for 7 days)
26
Who should you screen for chlamydia?
1. females < 25 2. Males < 30, military, 3. history of STD 4. Retest 3 months after tx 5. HIV +
27
How does N. Gonorrhea cause infection? (pathogenesis)
Uses pili to attach to mucosal surfaces. Also IgA protease - -Most women are asymptomatic - -BUT men are commonly symptomatic
28
What are the different types of invasive gonococcal disease?
1. PID 2. Perihepatitis (Fitz-hugh-curtis) 3. Disseminated infection 4. septic arthritis
29
How do you diagnose gonorrhea?
PCR, ligase, nAAT
30
What can you grow gonorrhea on in culture?
If sterile: Chocolate agar | If NOT sterile: Thayer martin medium (Vanc, colistin, nystatin)
31
How do you treat gonorrhea?
Ceftriaxone ALSO concurrently treat for chlamydia with azithro/doxy
32
Syphilis--how do you diagnose this?
1. darkfield microscopy or direct immunofluorescence | 2. VDRL (do not culture! Also cannot see under microscopy)
33
What kind of a bug is chlamydia (gm pos/neg)?
Gram negative obligate intracellular organism. Cannot make ATP
34
What can gonorrhea ferment?
ONLY glucose
35
Which form of chlamydia is infectious?
The elementary body form
36
Which organisms cause urethritis?
Gonorrhea/chlamydia | --Trichomonas causes cervicitis and epididymitis but not urethritis
37
When would you want to treat an asymptomatic UTI?
In a pregnant woman
38
What does secondary syphilis look like?
Rash on hands and feet | Condyloma and lymphadenopathy
39
What does tertiary syphilis look like?
1. Benign gammatous lesions (granulomas) 2. Ascending aortitis 3. Neurosyphilis
40
What are the signs of neurosyphilis?
1. Asymptomatic (but abnormal CSF) 2. meningitis 3. tabes dorsalis (demyelination of posterior columns)

ID (24 decks)

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