UTI/Kidney stone PBL Flashcards

1
Q

Some risk factor for acute cystitis:

A

Recent use of a diaphragm with spermicide

frequent sexual intercourse

history of UTI

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2
Q

Risk factors for UTI in healthy, post menopausal women:

A

sexual activity

diabetes mellitus

incontinence

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3
Q

Risk factors for pyelonephritis in young healthy women:

A

frequent sexual intercourse

a new sexual partner

UTI in the previous 12 months

maternal history of UTI

diabetes

incontinence

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4
Q

percent of recurrence in women with one UTI:

A

20-30%

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5
Q

Diagnostic gold standard for UTI:

A

urine CULTURE

requires 24 hrs to obtain

**an additional 24 hrs may be required to identify specific organism

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6
Q

First line abx for uncomplicated UTI in women:

A

nitrofurantoin

TMP-SMX

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7
Q

First line abx for UTI in men:

A

fluoroquinolones (cipro)

TMP-SMX

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8
Q

Three main mechs to keep urinary tract free of infx:

A

acidity of urine

act of urination

mucosal lining of the urinary tract

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9
Q

Most common pathogen of UTI:

A

E. coli

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10
Q

Three pathogens of uncomplicated UTI:

A

E. coli

Staph. saprophyticus

other enteric microorganisms

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11
Q

Three major factors for colonization of the urinary tract:

A

Environment

Host

Microorganism

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12
Q

E. coli adhesion VF that facilitates binding to renal epithelial cells:

A

P fimbriae

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13
Q

type 1 pilus binds to_________ in bladder uroepithelial cells.

A

uroplakins

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14
Q

Women with recurrent UTI are most likely to have had their first UTI before age__? And?

A

15

have maternal hx of recurrent UTI

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15
Q

Gene polymorphism and subsequent IL-receptor abnormality associated with recurrent UTI?

A

CXCR1

IL-8 receptor

**impairs neutrophil host response

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16
Q

Main symptom distinguishing cystitis from pyelonephritis:

A

fever

17
Q

Can uncomplicated UTI be treated on the basis of history alone?

A

Yes

18
Q

Urine dipstick looks for?

A

nitrites

leukocyte esterase

19
Q

Common UTI abx with risk of C. diff?

A

TMP-SMX

fluoroquinolones

ampicillin

20
Q

Common UTI abx without risk of C. diff?

A

nitrofurantoin

21
Q

Second line tx for uncomplicated UTI?

A

fluoroquinolones

Beta-lactams

22
Q

Use second line tx in regions where TMP-SMX resistance exceeds?

A

20%

23
Q

Which fluoroquinolone cannot be used in UTI?

Why?

A

moxifloxacin

doesn’t reach high enough conc in urine

24
Q

Drugs that increase risk of achilles tendon rupture?

A

fluoroquinolones

25
Q

First line for acute, uncomplicated pyelonephritis?

A

Fluoroquinolones

26
Q

Tx of UTI in early pregnancy?

Do NOT give?

A

Nitrofurantoin, ampicillin, cephalosporins

Don’t give SMP or fluoroquinolones!!!

27
Q

Complicated UTI tx should be guided by:

A

urine culture results

28
Q

Stones that cannot be seen on XR?

A

Uric acid stones (rosettes)

Cystiene (hexagonal)

29
Q

type 1 pilus

A

binds to bladder epithelial cells uroplakin

**all strains posses the gene but not all express

30
Q

How to differentiate between E. coli and Klebsiella or P. mirabilis?

A

E. coli is urease negative

31
Q

Pathogen associated with struvite stones?

A

P. mirabilis

32
Q

Pathogens that alkalinize urine (>7.9)?

A

Mostly P. mirabilis (splits urea)

some Klebsiella, Serratia