UTIs and Vaginal Infections

Question 1

cystitis (UTI)–presentation

Answer 1

• dysuria
• frequency
• urgency
• suprapubic pain
• WBCs (but not WBC casts) in urine

Question 2

cystitis (UTI)–what causes a UTI?

Answer 2

• primarily caused by ascension of microbs from urethra to bladder

Question 3

what does cystitis (UTI) cause?

Answer 3

• Males
  
  • infants with congenital defects
  • vesicoureteral reflux
• elderly
  
  • enlarged prostate

Question 4

what does ascension of microbes/UTI to the kidney cause, and how does it present?

Answer 4

• ascension to kidney results in pyelonephritis
  
  • presents with:
    
    • fever
    • chills
    • flank pain
    • costovertebral angle tenderness
    • hematuria
    • WBC casts

Question 5

what predisposes a patient to cystitis (UTI)?

Answer 5

• being a woman
  
  • 10x more common in women b/c shorter urethras colonized by fecal flora
• obstruction
• kidney surgery
• catheterization
• GU malformation
• diabetes
• pregnancy

Question 6

what bugs cause a UTI?

Answer 6

• Escherichia coli
• Staphylococcus saprophyticus
• Klebsiella pneumoniae
• Serratia marcescens
• Enterococcus
• Proteus mirabilis
• Pseudomonas aeruginosa

Question 7

cystitis (UTI)–diagnostic markers

Answer 7

• • leukocyte esterase
    
    • = evidence of WBC activity
• • nitrite test
    
    • = reduction of urinary nitrates of bacterial species (ie. E. coli)
• • urease test
    
    • = urease producing bugs (ie. Proteus, Klebsiella)

Question 8

what are the 3 common vaginal infections?

Answer 8

• bacterial vaginosis
• Trichomonas vaginitis
• Candida vulvovaginitis

Question 9

bacterial vaginosis–signs and symptoms

Answer 9

• no inflammation
• thin, white discharge (A) with fishy odor

Question 10

bacterial vaginosis–lab findings

Answer 10

• clue cells
• pH > 4.5

Question 11

bacterial vaginosis–treatment

Answer 11

• metronidazole

Question 12

Trichomonas vaginitis–signs and symptoms

Answer 12

• inflammation–“strawberry cervix”
• frothy, yellow-green, foul-smelling discharge

Question 13

Trichomonas vaginitis–lab findings

Answer 13

• motile trichomonads (B)
• pH > 4.5

Question 14

Trichomonas vaginitis–treatment

Answer 14

• metronidazole
• treat sexual partner(s)

Question 15

Candida vulvovaginitis–signs and symptoms

Answer 15

• inflammation
• thick, white, “cottage cheese” discharge (C)

Question 16

Candida vulvovaginitis–lab findings

Answer 16

• pseudohyphae
• pH normal (4.0-4.5)

Question 17

Candida vulvovaginitis–treatment

Answer 17

• -azoles