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Infectious Disease > UTIs > Flashcards

UTIs Flashcards

1
Q

Cystitis definition

A

Inflammation of the bladder (rare in males d/t longer urethra)

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2
Q

Urethritis definition

A

inflammation of the urethra, with frequent dysuria. Usually associated with STDs

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3
Q

Pyelonephritis definition

A

Inflammation of the kidneys nd the renal pelvis, with flank pain and tenderness, bacteria, pyuria and fever

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4
Q

Prostatitis definition

A

Inflammation of the prostate

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5
Q

Bacteriuria definition

A

Presence of bacteria in the urine

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6
Q

Relapse of UTI

A
  • Primarily seen after a kidney infection
  • Same organism that was present in the previous infection
  • Onset: w/in 2 weeks after completion of therapy
  • Causes: inadequate initial therapy, prostatic tissue involvement (men), renal tissue involvement, structural abnormality
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7
Q

Reinfection of UTI

A
  • Primarily seen with lower tract infections
  • Different organisms
  • Onset: several weeks to months after therapy
  • Causes: vaginal colonization with organisms from the intestinal tract, other hygienic concerns
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8
Q

Common pathogens that cause UTIs

A

E. coli (most common)
Proteus mirabilis
Klebsiella pneumoniae
Staphylococcus saprophyticus (particularly in young, sexually active females)

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9
Q

Predisposing factors for UTIs

A 
Instrumentation
Obstruction to free flow of urine
Difficulty evacuating the bladder
Females
Pregnancy
Sexual intercourse
Decrease in host resistance: DM, cancer, chronic steroid use
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10
Q

Ways to diagnose UTIs

A

UA

Culture and sensitivity testing

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11
Q

UA

A

Pyuria and bacterial colony count of > 1000 bactera/ml of urine
Leukocyte esterase dipstick test
Nitrate assay test
Color, specific gravity, pH, glucose, protein, blood

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12
Q

Culture and sensitivity testing

A

Midstream clean catch specimen (preferred method)
Catheterization
Suprapubic bladder aspiration
Blood cultures

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13
Q

Clinical presentation of cystitis

A

Dysuria
Frequency
Urgency
Suprapubic pain

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14
Q

Acute uncomplicated cystitis common organisms

A

E. coli

S. saprophyticus

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15
Q

Acute uncomplicated cystitis treatment

A

Bactrim x 3 days
Nitrofurantoin x 5 days (avoid if pyelonephritis suspected)
FQs x 3 days (levo and cipro only)
Fosfomycin x 1 dose (avoid if pyelonephritis suspected)
Beta lactams x 3-7 days (cefdinir, cefaclor, cefpoxidime, augmentin)

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16
Q

Pts with acute uncomplicated cystitis but do not qualify for the short course

A 
Recent ABX use
DM
Cancer
Immunocompromised
UT abnormality
Pregnancy
Hospital acquired UTI
Instrumentation
17
Q

Complicated cystitis preferred popul;ations

A

DM
> 65 yo
Recurrent infections

18
Q

Complicated cystitis treatment

A

Duration 7-10 days
Bactrim
FQs (levo/cipro)
Augmentin

19
Q

Urethritis clinical presentation

A 
Usually associated with STD
Dysuria
Frequency
Pyuria
Treat the suspected STD
20
Q

Pyelonephritis clinical presentation

A

Flank pain and tenderness
Bacteruria and pyruia
Fever

21
Q

Acute pyelonephritis s/sx

A 
Symtoms of cystitis plus:
Loin pain
CVA tenderness
Fever, chills
Hematuria
N/V
Granular casts
22
Q

Chronic pyelonephritis s/sx

A 
Absence of physical findings
Occasional fever
H/A
Malaise
Periodic flank pain
Intermittent sx of lower UTI
23
Q

Mild/Acute/Outpatient treatment of pyelonephritis

A

(uncomplicated)
Cipro 500mg BID x 7 days (or equiv XR form)
Levofloxacin 750mg QD x 5 days
Bactrim DS BID x 14 days
Oral Beta lactam x 10-14 days (cefdinir, cefaclor, cefpodoxime, augmentin)

24
Q

Inpatient pyelonephritis treatment

A

-IV empiric therapy until clinically improved and afebrile for 24-48 hours, then may change to oral therapy to complete a minimum of 14 days total course
FQs (levo/cipro)
Aminoglycosides +/- ampicillin
Extended spectrum cephalosporin +/- aminoglycoside
Extended spectrum penicillin +/- aminoglycoside
Carbapenems +/- aminoglycoside (any carbapenems if not worried about pseudomonas)
Aztreonam (if severely allergic to the other beta-lactams) +/- aminoglycosides

25
Q

Acute prostatitis clinical presentation

A 
Chills/fever
Perineal pain
Nocturia
Dysuria
Lower abdominal and back pain
Urinary urgency, retention
Malaise
26
Q

Chronic prostatitis clinical presentation

A 
Neither febrile not toxic
Asymptomatic between episodes of recurrent UTIs
Dysuria
Frequency
Nocturia
Pain in lower back, testicles
Suprapubic and perineal pain
27
Q

Prostatitis common organisms

A

E. coli
K. pneumoniae
Proteus spp.
P. aeruginosa

28
Q

Duration of treatment for prostatitis

A

Acute: 21 days
Chronic: 4-6 weeks

29
Q

Therapy for prostatitis

A

Bactrim

FQs

30
Q

Recurrent UTIs

A

Assume that it is a reinfection with a different organism

  • If < 3 episodes/yr = treat as separate occuring infection with short course
  • If >3 episodes/yr or 2 UTIs w/in 6 months = long-term prophylaxis may be indicated
31
Q

Medications for long-term prophylaxis of recurrent UTIs

A

TMP, Bactrim, nitrofurantoin, FQs

32
Q

Medications for post-coital prophylaxis of recurrent UTIs

A 
Bactrim
Nitrofurantoin
Keflex
FQs
Void after intercourse
33
Q

Therapy for UTIs in pregnant patients

A 
Duration: 7-10 days
Keflex
Augmentin
Nitrofurantoin
Bactrim (except 3rd trimester - kernicterus)
34
Q

Therapy for UTIs in children

A

Amoxil
Augmentin
Keflex
Cefuroxime

35
Q

Adjunctive urinary analgesics

A

Phenazopyridine (100-200mg TID after meals, PRP)
Adequate hydration
Cranberry juice
Good personal hygeine

Infectious Disease (19 decks)

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