UTIs Flashcards

1
Q

pyelonephritis symptoms

A

Flank/back pain

high fever, chills

headache

nausea / vomiting

spetic shock possible

+/- cystitis symptoms

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2
Q

most common pathogens in children

A

enterobacter spp

klebsiella spp

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2
Q

non-Abx prophylaxis

A

Methanamine salts - converted to formaldehyde and ammonia in acidic urine

Cranberry juice - may help with prevention (block adhereance of e-coli?)

Ascorbic acid - acidifies urine (unlikely)

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3
Q

body responds to UTI via ___ and ____

A

exfoliation and neutrophil recruitment

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3
Q

causes of persistence

A

Inadequate therapy

chonic bacteria prostatitis (infxn habored in prostate)

urethral diverticula)

fistula

urinary stasis (reflux, poor emptyting)

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4
Q

Nitrate dipstick utility

A

detects action of bacteria on dietary nitrates via nitrate reductasse

High specitivity, LOW sensitivity

rules in UTI, but negative does not rule out

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4
Q

reinfection =

persistence =

A

reinfection - from bacteria outside UT (New infection)

peristence - bacteria focus within UT (previous infxn doesn’t resolve)

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5
Q

bladder inflammation and resulting pain due to

A

leukocyte infiltration of bladder

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6
Q

bood dipstick detects

A

peroxidase activity of erythrocytes

(rxn catalyzed by myeoglobin and hemoglobin, possible false positives)

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6
Q

uncomplicated treatment course

complicated

A

uncomplicated - 3-5d Abx (sometimes up to 7d)

complicated - correct fxnl defect, Abx for 7d, often 10-14d

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8
Q

chemical strip test utitlity

A

urinary blood

pus (leukocytes)

bacteria,

pH

specific gravity

protein

glucose

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9
Q

complicated UTI pathogens

A

E coli

ENterobacteriacease (Klebm enterobacter, proteus, morganell, providencia)

Gram negativs - peseudomonas, acinetobacter

Gram positives - S aurea, Coag neg staph, GBSS, eteroccoci, Corynebacterium)

Yeast and gungi (candidia torulopsis)

Parasites (schistosoma, haematobium)

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10
Q

do not treat asymptomatic bacteriruria EXCEPT in cases of

A

pregnancy (prevent pre-term)

kids with reflux

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12
Q

microscopic analysis utility

A

definitve test for blood (RBCs) and pus (leukocytes)

false positives in dipsticks confirmed

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13
Q

complicated vs uncomplicated

A

complicated - structural or fxnl abnl of GU OR

presence of comorbidity which increases risk of infection or failure of therapy

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14
Q

imagin indicated for

A

complicated (some)

predisposing factors (GU anomalies, Hx of stones)

lack of response to therapy

recurrent pyelonephritis)

(CT is best for stones)

15
Q

risk factors for asymptomatic bacturiria

A

elderly women

pregnancy

diabetes

use of cathetars

spinal cord injury

(generally do not treat)

16
Q

Adjunvant tests for UTI

A

Blood testing - CBC, basic chemistry (creatinine, electroyltes

Imaging for posible hydronephrosis, stones, abscess

18
Q

senstivity testing for UTI treatment response (levels)

A

sensitive - will likely respond to typical ABx does

Intermediate - may reequire higher ABx concentrations

Resistant - response not likely at safe levels

20
Q

uncomplicated UTI pathogens

A

E coli

S Saphrophyticus

Enterobacteriaceasse (Klebsiella, Enterobacter, Proteus, Salmonella, Shigella)

Gram Positives ( S aureus, GBBS, enteroccoci)

21
Q

species of particular importance to female UT

A

lactobacillus

22
Q

most common UTI pathogen in adults

most common nosocomial

A

adults - uropathogenic e-coli (UPEC)

nosocmial - pseudomonas aerginosa

23
Q

descending UTI due to

A

hematogenous spread

24
Q

UA dipstick LE detects

A

leukocyte esterae - detects pyuria (WBCs in urine)

25
Q

in UT, luekocytes only found in ____ during times of health

A

urethra

26
Q

cystitis presenting symptoms

A

dysuria

frequency and urgency

suprapubic pain

cloudy/smelly urine

heamturia (gross is more concerning)