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PHRM 865 > Exam 3 - UTIs > Flashcards

Exam 3 - UTIs Flashcards

1
Q

what are examples lower urinary tract infections?

A

cystitis (bladder)
urethritis (urethra)
prostate (prostatitis)

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2
Q

what are examples of upper urinary tract infections?

A

pyleonephritis (kidney)

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3
Q

definition of uncomplicated UTI?

A

a young female with no structural/functional abnormalities

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4
Q

definition of complicated UTI?

A

some blocking the urine flow

in men, old people, or pregnant people

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5
Q

Definition of Recurrent UTI?

A

> /= 2 UTIs in 6 mos
or
/= 3 UTIs in 1 year

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6
Q

definition of reinfection vs recurrent UTIs

A

reinfection: occurs over 2 weeks after treatment (will be a diff bug)
recurrent: occurs within 2 weeks (will be same bug form first infection)

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7
Q

Definition asymptomatic bacteriuria?

A 
common in pts > 65 yo
significant bacteriuria (>10^5)  but NO symptoms
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8
Q

when to treat asymptomatic bacteriuria

A

if pregnant woman

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9
Q

Criteria for Significant Bacteriuria:

_____ CFU bacteria/mL in a symptomatic male

A

> /= 10^4

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10
Q

Criteria for Significant Bacteriuria:

_____ CFU bacteria/mL in asymptomatic individuals on two consecutive specimens

A

> /= 10^5

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11
Q

Criteria for Significant Bacteriuria:
_____ CFU coliforms/mL in a symptomatic females
or
_____ CFU noncoliforms/mL in a symptomatic females

A

> /= 10^2 coliforms

> /= 10^5 noncoliforms

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12
Q

2 pathogenesis ways for UTIs?

A 
ascending pathway (colonic pathway enters urethra/vagina --> bladder = colonization)
OR
hematogenous spread (infection comes from a distal site of infection)
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13
Q

Host defense mechanisms against UTIs?

A
  • Urine – low pH, high urea, osmolality extremes
  • Flushing/voiding/urinating
  • when bacteria into bladder – you diuresis more than normal to get it out
  • urinary mucus prevents adherence of bacteria
  • lactobacillus present in vagina (related to estrogen)
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14
Q

Common ADEs for acute pyelonephritis?

A

FLANK pain!

more systemic symptoms (fever/chills)

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15
Q

Abx options for UTIs?

A 
Macrobid
SMX-TMP
fosfomycin
FQs (not first line)
beta lactams (not first line)
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16
Q

Side effects of macrobid?

A

pulmonary toxicity**
antacids decrease rate of absorption
hepatoxicity
peripheral neuropathy

17
Q

Contraindications for macrobid?

A

CrCl < 30 mL/min
Pregnant women at term (38 - 42 wks)
neonates < 1 month of age

18
Q 
How long to treat UTI?
Macrobid:
SMX-TMP:
Fosfomycin:
FQs:
beta-lactams:
A 
macrobid: 5 days
SMX-TMP: 3 days
Fosfomycin: 1 day (one dose)
FQs: 3 days
beta lactams: 3 - 7 days
19
Q

How long to treat UTI?

If pt is complicated (diabetes, symptoms > 7 days, recent UTI, use of diaphragm, or > 65 yr old)

A

7 - 10 days of treatment

20
Q

How long to treat UTI?

If pregnant?

A

7 days!

21
Q

what UTI drugs should be avoided in pregnancy?

A

Macrobid (at term)

and SMX-TMP (in last trimester due to hyperbilirubinemia/kernicterus)

22
Q

Post coital therapy for UTI prevention?

A

1 dose SMX-TMP after sex (only 1 tab per day max)

23
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - Enterobacteriaceae?

A

Cipro or Levofloxacin

or SMX/TMP

24
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - Enterococcus species?

A

ampicillin
vanc
(or linezolid or levofloxacin)

25
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - Pseudomonas

A

ciprofloxacin

pip/tazo

26
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - FQ-R enterobacteriacease

A

ertapenem (ceftriaxone/meropenem)

27
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - ESBL/Amp-C producing enterobacteriaceae?

A

ertapenem (cefepime)

28
Q

Prostatitis Treatment - Primary empiric regimen:

Acute/Uncomplicated - FQ-R Pseudomonas

A

Imipenem (meropenem)

PHRM 865 (59 decks)

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