UTIs Flashcards
Why should you consider the ureters as vascular structures?
Vasodilators help pass stones
What is the normal level of post-void residual?
Less than 50ccs
What type of bacteria usually causes sepsis 2/2 catheter placement?
Gram negatives (e. coli)
What defines the upper and lower urinary tract?
Upper = above the vesicoureteral valves
Lower = below that
What are complicated UTIs?
Involvement of tissue structures with instruments or co-morbidities
What are uncomplicated UTIs?
Local effects only or upper tract without comorbidities
What is inflammation of the glans of the penis called?
Balanitis
What is a recurrence of UTIs?
3 or more UTIs per year
What is a relapse of a UTI?
Recurrence in a month with same organism
What is a reinfection?
Relapse in more than one month, but usually a difference organism
Who usually have UTIs as neonates: males or females?
Males d/t urogenital malformations
Which gender usually has UTIs in the child bearing years?
Women
When does the incidence of UTIs become equal in each gender? Why?
Above 50 years of age d/t prostate problems
What are the risk factors for UTIs (2)?
Reflux or prior h/o them
Does circumcision increase the incidence of UTIs?
Yes
Does sex increase the incidence of UTIs?
Yes
What defines a UTI?
More than 10^5 organisms in a clean catch of urine
What are the two usual causative agents in UTIs?
E. coli
S saprophyticus
Do you treat asymptomatic UTIs?
If pregnant, or prior to renal transplant, but otherwise no
What are the four different types of urine samples?
random
First void
Clean catch
Catheter
Why discard the first 15-20 mL of urine with a cath?
Not sterile catch
What are the bacteria findings from a urine catch reported as?
Yes or no, a lot or a little
How do you determine a contaminated specimen of urine?
Epithelial cells = WBC
What is the significance of pH in urine testing?
bacteria with urease will have high pH
What are the 6 major components reported in a urine dipstick analysis?
pH Sp grav nitrites Leukocyte esterase WBC RBC
What is the normal urine sp gravity?
1.010
What is the significance of nitrites in the urine?
Some gram negative bacteria will convert nitrates to nitrites
What, generally, do the first and second samples of urine represent?
Environment of the urethra and bladder respectively
What STDs cause dysuria?
GC or Chlamydia
What is the treatment for GC/chlamydia?
Ceftriaxone or Azithromycin
Why is it important to distinguish infection from irritation with UTIs?
Irritation will not respond well to abx
What are the usual infectious causes of UTIs?
e.coli
Chlamydia
Gonorrhea
herpes
Why is a wash better than a swab to diagnose UTIs?
wash off more than swab off
How many days are needed for abx to work with UTIs?
3
What type of abx can cause urethral candidiasis?
Cephalosporins
Why get lactate with sepsis?
Measures tissue level perfusion
What is emphysematous pyelonephritis?
kidney infection with a gas-producing bacteria
true or false: foleys are appropriate to drain urine with a pyelonephritis pt
false
Pyelonephritis with a stone = ?
Intrabdominal abscess
