week 14- UTI Flashcards
dysuria
pain or burning with or after urination
if have dysuria probably have a
UTI
UTI- main cause?
Infection of the urinary tract is usually due to bacterial invasion of the structures involving the urinary tract (can be any of the structures between the urethra to renal pelvis)
SLIDE 5
Which of the following statements is true?
* Upper urinary tract infections are less common compared to lower urinary tract infections, but they tend to be more severe.
* Upper urinary tract infections are more common compared to lower urinary tract infections, but they tend to be less severe.
* Both upper and lower urinary tract infections are equally common, and the severity of infection varies.
- Upper urinary tract infections are less common compared to lower urinary tract infections, but they tend to be more severe.
Which of the following infections is considered a lower urinary tract infection?
* Pyelonephritis
* Cystitis
* Urethritis
* Prostatitis
- Cystitis
2 types of UTI
uncomplicated and complicated
what is an uncomplicated UTI
UTI in an individual with a normal urinary tract system
complicated UTI
- UTI in patients with any of the following:
- Male sex
- Pregnancy
- Functional or anatomic abnormality of the urinary tract (urinary tract obstruction, polycystic renal disease, nephrolithiasis, neurogenic bladder)
- Diabetes mellitus
- Immunosuppression
- Indwelling urinary catheter
- Recent urinary tract instrumentation
- Systemic infection (such as bacteremia or sepsis)
who are uncomplicated UTIs most common in
most common in young, sexually active women
UTIs are how much more likely in women than men and what is the reason for this
UTIs are 4x more likely in women than men
* Proximity of urethral meatus to the rectum * Shorter urethral length
risk factors for men getting UTIs
homosexuality, lack of circumcision
risk factors for UTI
- Female sex
- Anatomical defects that lead to stasis, obstruction and urinary reflux
- Sexual intercourse
- Use of spermicides or a diaphragm
- A new sexual partner in the past year or multiple sexual partners
- Previous UTI
- Urethral catheterization or other foreign body
- Decreased resistance to microbial organisms
acute cystitis is an infection of what
bladder
what is the most common UTI
acute cystitis
how to diagnose acute cystitis
diagnosed when pyuria and bacteriuria are accompanied by urinary symptoms confined to the bladder
most common bacteria causing acute cystitis
E. coli
“KEEPS” pneumonic
* K = Klebsiella pneumoniae
* E = Escherichia coli (75–95%)
* E = Enterococcus faecalis
* P = Proteus mirabilis
* S = Staphylococcus saprophyticus, group B streptococcus
symptoms in acute cystitis
- Dysuria
- Suprapubic pain
- Urinary frequency
- Urinary urgency
- Hematuria
what is there an absence of in acute cystitis
Absence of penile/vaginal discharge, costovertebral angle (CVA) tenderness, nausea, vomiting, fever
atypical presentation of acute cystitis in elderly
- Delirium
- Functional decline
- Acute confusion
- Lethargy
- Generalized weakness
symptoms and signs that increase UTI in women
- Dysuria (LR = 1.5)
- Frequency of urination (LR = 1.8)
- Hematuria (LR = 2.0)
- Back pain (LR = 1.6)
- Costovertebral angle tenderness (LR = 1.7)
- Self-diagnosis in patients with recurrent UTI (LR = 4.0)
symptoms and signs that decrease probability of UTI
- Patient complaint of vaginal discharge (LR = 0.3)
- Vaginal discharge on examination (LR = 0.7)
- Vaginal irritation (LR = 0.2)
- Absence of dysuria (LR = 0.5)
- Absence of back pain (LR = 0.8)
how helpful is one symptom in acute cystitis
- Individual symptoms and signs will only modestly increase the post-test probability
- No sign or symptom on its own is powerful enough to ‘rule in’ or ‘rule out’ the diagnosis of UTI
combining symptoms in acute cystitis; which 2 are most helpful
- Dysuria and frequency without vaginal discharge or irritation yields a high likelihood of UTI (LR = 24.6)