Wk 3 Pyelonephritis

Question 1

What is pyelonephritis?

Answer 1

A type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels to one or both of your kidneys

Question 2

What is an UTI protective factor concerning pH?

Answer 2

Acidic

Question 3

Presence of __ is a UTI protective factor

Answer 3

Urea

Question 4

What type of secretions are protective factors against UTIs for men?

Answer 4

Prostatic secretions

Question 5

What type of secretions are protective factors against UTIs for women?

Answer 5

Urethral gland secretions

Question 6

Why are women at higher risk for UTIs compared to men?

Answer 6

Urethra is shorter, smaller and in closer proximity to the anus
Higher risk for perineal irritation
Pregnancy/sexual activity

Question 7

Urine flow is __-directional

Answer 7

Uni-directional

Question 8

As age increases…

Answer 8

the risk for UTI increases

Question 9

Up to 50% of nursing home residents have __

Answer 9

bacteriuria

Question 10

How do condoms increase the risk of getting a UTI?

Answer 10

Spermicide is irritating to the vagina

Question 11

5 risk factors for a UTI

Answer 11

Urinary stasis
Immobility
Incontinence
Altered LOC
Bad personal hygiene

Question 12

Pathogenesis of a UTI is an __ pattern

Answer 12

ascending

Question 13

In what order does a UTI develop?

Answer 13

Contaminated perineum 
Urethra
Bladder
Ureter
Kidneys

Question 14

What is the major risk factor for an upper UTI (pyelonephritis)?

Answer 14

Pregnancy

Question 15

What is the etiology of pyelonephritis? (2 things)

Answer 15

Ascending infection, typically with E. coli

Bloodstream infection

Question 16

Why is pyelonephritis a problem?

Answer 16

Can lead to tissue damage, and down the road kidney failure

Question 17

What are symptoms of pyelonephritis? (6)

Answer 17

Fever
Chills
Costovertebral angle tenderness
Dysuria
Nausea/Vomiting
Anorexia

Question 18

What is urosepsis?

Answer 18

Severe systemic response to pyelonephritis

Question 19

Who is at high risk for urosepsis? (3)

Answer 19

Elderly patients
Diabetics
Immunocompromised patients

Question 20

Urosepsis has a high…

Answer 20

mortality rate

Question 21

Someone who has recurrent UTIs may receive conventional therapy which is __-__ days

Answer 21

7-14

Question 22

A patient with an upper UTI is typically…

Answer 22

Admitted to the hospital to receive IV antibiotic therapy

Question 23

What is first line treatment for a UTI?

Answer 23

Bactrim

Question 24

What two drug make up bactrim?

Answer 24

sulfamethoxazole and trimethoprim

Question 25

What is the major adverse side effect of bactrim?

Answer 25

anaphylaxis, otherwise well tolerated

Question 26

What is another first-line antibiotic used to treat UTIs

Answer 26

Cirpofloxacin, works locally

Question 27

What is the MOA of ciprofloxacin?

Answer 27

inhibits DNA replication by inhibiting bacterial DNA topoisomerase and DNA-gyrase.

Question 28

What class is ciprofloxacin part of?

Answer 28

fluoroquinolone

Question 29

What is the adverse effects of ciprofloxacin?

Answer 29

GI upset

Question 30

What is the black box warning for ciprofloxacin?

Answer 30

tendinitis and tendon rupture

Question 31

What drug is used for more complex cases of UTIs?

Answer 31

Vancomycin