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Urinary Exam 2 > UTIs I and II > Flashcards

UTIs I and II Flashcards

1
Q

What is the most common cause of all UTIs?

A

E. coli

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2
Q

What is the second most common cause of UTIs?

A

S. saprophyticus

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3
Q

Staphylococcus saprophyticus:

A

Coagulase-negative

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4
Q

What is the third most common cause of UTIs?

A

Proteus mirabilis

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5
Q

What is proteus mirabilis?

A

Urease positive enterobe

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6
Q

What do urease positive bacteria do?

A

Convert urea to carbon dioxide and ammonia causing alkalization of urine

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7
Q

What stones form in alkaline urine?

A

Struvite (NH4MgPO4x6H2O)

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8
Q

What is the most important risk factor on bacteria for UTIs?

A

Fimbriae

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9
Q

Most common E. coli to cause UTI?

A

Uropathogenic E. coli (UPEC)

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10
Q

What causes most UTI in men?

A

Prostate inflammation

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11
Q

Why don’t you use urine in a catheter bag?

A

Bacteria multiply in the urine and human cells disintegrate in the urine

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12
Q

What are the three lower UTI symptoms of irritation?

A

Dysuria: burning pain
Urgency
Frequency of micturition

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13
Q

Why aren’t antibodies produced in lower UTIs?

A

It is a superficial infection

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14
Q

Important symptoms in an upper UTI?

A

Fever
Lower back pain
Vomiting

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15
Q

What often causes renal abscesses?

A

Staphylococcus aureus

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16
Q

What drugs do you give for upper and lower respectively?

A

Upper: non-oral (vomiting)
Lower: oral

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17
Q

What is pyuria?

A

Pus cells in the urine

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18
Q

What threshold of bacteriuria denotes a UTI?

A

100,000/mL of urine

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19
Q

What does one bacteria predominating the urine suggest?

A

UTI

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20
Q

What does more than one bacteria making up the 100,000/mL?

A

Contamination of the sample somehow not necessarily an UTI

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21
Q

What can cause sterile pyuria?

A

M. tuberculosis

Chlamydia

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22
Q

What type of stones does proteus mirabilis cause?

A

Struvite and calcium carbonate

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23
Q

What does the oxidase test distinguish between?

A

Enterobes (negative) and pseudomonas (positive)

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24
Q

What is found in all enterobes?

A

Nitrate reduction (nitrate to nitrite)

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25
Q

What can a urease test distinguish between?

A

E. coli and Proteus mirabilis

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26
Q

What are the lactose fermenters?

A

E. coli
K. pneumoniae
E. aerogenes

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27
Q

What color are the lactose fermenters on McConkey agar?

A

Red

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28
Q

What is staphylococcus’ coagulase test?

A

Positive

29
Q

What is streptococcus’ coagulase test?

A

Negative

30
Q

Three antibiotics to treat UTI?

A
  1. ) Bactrim (SMZ-TMP)
  2. ) Nitrofurantoin
  3. ) Quinolones
31
Q

How to treat patient with pyelonephritis that cannot eat or drink?

A

Hospitalization and IV beta-lactams or fluoroquinolones

32
Q

What are schistosomas?

A

Trematode flukes that have an intermediate snail host, infect through the skin, mature in the liver, can migrate to veins or colon/bladder,

33
Q

What does Schistosoma hematobium do?

A

Eggs cross into the bladder causing granulomatous inflammation, ulcer, polyps, and scaring-hematuria, dysuria

34
Q

What does S. japonicum and S. mansoni do?

A

Eggs cross into colon, causing hemorrhage and diarrhea

35
Q

How do you treat schistosomiasis?

A

Praziquantel to remove worms but may not reverse pathology

36
Q

What can S. mansoni cause?

A

Hepatomegaly and fibrosis; ascites and splenomegaly due to portal hypertension

37
Q

What schistosomas are found in China and Brazil?

A

S. japonica

S. mansoni

38
Q

What schistosomas are found in the middle east?

A

S. hematobium

39
Q

What do spirochetes have?

A

A flagella filament that their body wraps around

40
Q

How does Leptospira interrogans enter the body?

A

Through breaks in the skin or mucus from water that was infected by urine of animals

41
Q

What are the systemic symptoms of Leptospira interrogans?

A

Endothelial blood vessel damage

42
Q

What can leptospirosis cause?

A

Fever, chills, muscle pain, conjunctivitis, liver and kidney damage (Weil’s disease)

43
Q

What do you treat all spirochetes with?

A

Penicillin

Doxycycline

44
Q

How to diagnose leptospirosis?

A

Culture blood, urine, CSF

45
Q

What can carry RMSF?

A

American dog tick

Rocky mountain wood tick

46
Q

What can carry Lyme’s disease?

A

Blacklegged ticks

47
Q

What does rickettsia rickettsii cause?

A

RMSF

48
Q

What type of bacteria are rickettsia rickettsii?

A

Gram negative bacilli that are intracellular

49
Q

What does rickettsia rickettsii infect?

A

Endothelium leading to vasculitis in skin, lungs, spleen, CNS, heart, kidneys, thrombosis and hemorrhaging

50
Q

What does Transovarian infection mean?

A

If a tick is infected all of the eggs it lays are also infected meaning once there is disease in the area then there will always be the disease there

51
Q

When does the rash from RMSF start?

A

A day or two after the fever starts

52
Q

What type of progression does RMSF rash have?

A

Centripetal: starts on palms and soles

53
Q

What do you screen early with?

A

Finding antigen

54
Q

What do you screen late with?

A

Antibodies

55
Q

What to treat RMSF with?

A

Tetracyclines because they enter the cells

56
Q

What causes epidemic typhus?

A

Rickettsia prowazekii

57
Q

What is the carrier or R. prowazekii?

A

Pediculus humanus (louse)

58
Q

What causes endemic typhus?

A

Rickettsia typhi

59
Q

What carries Rickettsia typhi?

A

Rat fleas

60
Q

What does typhus cause?

A

Bacterial replication in endothelium causing vasculitis

61
Q

What does endemic mean?

A

Only animals (select population)

62
Q

What does epidemic mean?

A

Can affect humans (widespread)

63
Q

How to differentiate between typhus and RMSF?

A

Typhus rash starts on core and works out and is 5-9 days after the fever

64
Q

What do typhus antibodies cross react with?

A

Proteus vulgaris

65
Q

What can typhus cause?

A

Confusion, delirium

66
Q

What test tests for leukocytes in the urine?

A

Leukocyte esterase

67
Q

What is indicative of pyelonephritis?

A

Leukocyte casts

68
Q

Where are leukocyte casts formed?

A

Nephron tubules

Urinary Exam 2 (16 decks)

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