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DU PA UTI
Duke PA Urinary Tract Infections
| Question | Answer |
|---|---|
| _____ is predominantly an infection of sexually active individuals, usually men. | urethritis |
| The symptoms are pain and burning during urination, and some discharge may occur at the urethral meatus | urethritis |
| Urethritis may be _____ in origin or it may be caused by Chlamydia trachomatis or Ureaplasma urealyticum | gonococcal |
| Bacterial infection of the urinary bladder | cystitis |
| bacterial infection of teh kidney | pyelonephritis |
| Cystitis and pyelonephritis are more common in ____ | women |
| instrumentation (catheterization, cystoscopy), pregnancy, anatomic abnormalities of the genitourinary tract, and diabetes mellitus | UTI risk factors |
| Incidence of cystitis and pyelonephritis increase with ____ | age |
| Most UTI's ascend through a _____ | portal entry in the urethra |
| ____ is the most common isolate in UTI's | E. coli |
| Suprapubic pain, discomfort or burning sensation on urination and frequent urination | common symptoms of UTI |
| Back or flank pain, or the occurance of a fever suggests involvement of the | kidneys, or prostate |
| Older or debilitated patients with UTI may present with | no symptoms referable to the urinary tract |
| Older or debilitated patients with UTI may present with | fever, altered mental status, hypotension |
| UTI urinalysis may show | WBC's, RBC's and slightly increased protein |
| The presence of at least 10 WBC's/mm(3) of midstream urine by counting chamber is defined as pyuria | pyuria |
| the presence of WBC casts in an infected urine sample indicates the presence of | pyelonephritis |
| Urine for culture should not be obtained from a | catheter bag |
| ______ tests are not essential for patients with uncomplicated cystitis unless treatment fails | culture and sensitivity |
| Recurrent UTI's in men should always raise the suspicion for | anatomic alterations of the urinary tract |
| Possible UTI organisms that will not grow on routine culture medium | Chlamydia, N. gonorrhoeae, or Ureaplasma |
| if a UTI is unresponsive to the first course of antibiotics patients should receive | doxycycline or azithromycin |
| empiric therapy for uncomplicated UTI's can be | a short course of amoxicillin, TMP-SMZ, or ciprofloxacin |
| short course therapy is not recommended for | women with a history of UTI's |
| All patients with complicated UTI's should have | repeat urine cultures 1-2 weeks after treatement completion |
| should be performed in all men with UTI (escept those with urethritis) because of the hight frequency of correctable anatomic lesions in this population | urologic evaluation |
| if a 6 week course of antibiotics active against the bacterial isolate is not effective then the possiblility of _____ should be investigated | structural abnormalities or prostatic infection |
| Urine cultures showing bacterial growth in the absence of symptoms | asymptomatic bacteriuria |
| does not need to be treated in otherwise healthy/non-pregnant individuals | asymptomatic bacteriuria |
| The occurence of pyuria in the abscence of bacterial growth on culture of urine | sterile pyuria |
| If this condition occurs in the patient with lower UTI symptoms then chlamydia, gonoccocal infections, vaginitis, or herpes simplex infection shoulb be considered | sterile pyuria |
| symptoms of back or perineal pain and fever are common with | prostatitis |
| Acute prostatitis may be caused by gonococcus but is most often caused by | gram-negative bacilli |
| Prostatic abscesses can be | drained with ultrasound guidance |
| Should be suggested in men with recurrent UTI | chronic prostatitis |
| Treatment of _____ is hampered by poor penetration by most antimicrobials | chronic prostatitis |
| fever, flank pain, CVA tenderness, N/V | signs and symptoms of upper UTI |
| dysuria, frequency, urgency, suprapubic pain, =/- hematuria | signs and symptoms of lower UTI |
| vaginal d/c or odor, pruritis, dyspareunia, external dysuria (labial pain with urination), but no frequency or urgency | vaginitis |
| dysuria and frequency with no vaginal disharge or irritation is ___ in more than 90% of cases | cystitis |
| presence of WBC casts indicate | upper tract infection |
| common in UTI but not urethritis or cervicitis | hematuria |
| indicates presence of bacteria, more specific than sensitive | nitrites |
| an enzyme made by neutrophils in response to bacteria | leukocyte esterase |
| as a general rule ____ is a UTI occuring in a healthy young nonpregnant woman | uncomplicated acute cystitis |
| septra | TMP-SMX |
| don't give ____ for acute cystitis | amox-clav |
| first line for acute uncomplicated cystitis | TMP-SMX |
| best course length of antibiotics for uncomplicated UTI | three day short course |
| should be considered as and alternative to TMP-SMX in the treatment of uncomplicated acute cystitis | nitrofurantoin |
| macrobid | nitrofurantoin |
| big guns used for complicated infections/allergy to TMP-SMX, risk factors for TMP-SMX resistance | fluoroquinolones |
| used to treat symptoms of acute cystitis-is not an antibiotic | phenazopyridine |
| Pyridium | phenazopyridine |
| An infection occurring in anyone OTHER than a healthy young non-pregnant woman | complicated UTI |
| urine culture is essential with | complicated UTI |
| nonsecretor phenotype | higher risk of UTI |
| strongest risk factor for UTI | frequency of intercourse |
| in postmenopausal women ____ can be an effective prophylaxis because ti leads to an increase of lactobacilli and a decrease in E. coli | intravaginal estriol cream |
| in recurrent UTI ___ evaluation should be done if concerned about structural or functional abnormality of GU tract | urological evaluation |
| when doing a urological evaluation start with | CT or renal US |
| treatment of cystitis in men | 7-days of TMP-SMX, trimethoprim, or FQ |
Created by:
bwyche
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