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Clin Med- P > UTIs- Male > Flashcards

UTIs- Male Flashcards

1
Q

uncomplicated UTI: pt does not have a ___________ factor that would affect microbio, incidence, or recurrance rates. typically what type of person?

A

predisposing; young healthy person with no comorbidites and no hx of recurrent UTIs

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2
Q

what patients are considered to have complicated UTIs?

A

elderly, DM, recurrent UTIs, CA, comorbidites, and hx of known resistance

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3
Q

most UTIs are caused by what?

A

bacteria entering through the urethra

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4
Q

pyelonephritis develops when __________ ascend to the __________ via the __________. it can also be caused by _________ of the kidneys from ________

A

pathogens; kidneys; ureters; seeding; bacteremia

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5
Q

what is acute simple cystitis?

A

acute UTI that is confined to the bladder AND doesnt have normal symptoms (fever, flank pain, CVA tenderness, chills. pelvic/perineal pain)

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6
Q

what are two main categories of pts that require unique management of UTIs

A

pregnant women and renal transplant recipients

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7
Q

what is an acute complicated UTI?

A

acute UTI accompanied by signs or symptoms (fever, chills. flank pain, CVA tenderness, pelvic/perineal pain) that suggest infection beyond the bladder

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8
Q

what bacteria is the most common cause of uncomplicated UTIs?

A

E coli

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9
Q

E coli has ____ that help the bacteria adhere to _______ __________ in order to cause infection. ________ helps prevent E coli from adhering

A

pili (protein filaments); urinary structures; cranberry

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10
Q

what are four organisms that can cause complicated UTIs?

A

proteus, klebsiella, entercoccus, pseudomonas

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11
Q

what bacteria is more common in patients with health care exposures/instrumentation?

A

pseudomonas

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12
Q

____________ __________ is an occasional cause of pyelonephritis in young healthy women

A

staph saprophyticus

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13
Q

three risk factors for UTI with resistant organisms

A

1) . recent broad spectrum antimicrobial use
2) . health care exposures
3) . travels to parts of the world where multidrug resistant organisms are prevalent

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14
Q

uncomplicated UTI signs/symptoms (4)

A

urinary frequency, lower abd or back pain, cloudy and foul smelling urine, +/- fever

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15
Q

how to diagnosis uncomplicated UTI

A

based on hx, PE, and labs (PE is usually unremarkable)

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16
Q

what does UA show for uncomplicated UTI? (3) what test is usually not needed?

A

positive for nitrites, WBC esterace, and blood; culture is not done

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17
Q

what are three ABX options for uncomplicated UTI tx?

A

bactrim DS BID 3 days, keflex 500 mg BID 5-7 days or cipro 250 mg BID for 3 days

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18
Q

presence of ______ with or without pyuria in the absence of any UTI symptom is called _________ ___________. describe tx for this

A

bacteriuria; asymptomatic bacteriuria; does warrant tx in nonpregnant patients who arent undergoing urologic surgery

19
Q

pt populations of people at increased risk of UTI (and could present with complicated UTIs) 8 things

A

CA, recurrent UTIs, urinary obstructions, neurogenic bladders, sexually active women (with STD or recurrent UTIs), postmenopausal women, men with prostate dz, and elderly

20
Q

____________ and ________ ___________ are the most common predisposing factors for nosocomial UTIs

A

instrumentation and urinary cath

21
Q

_____ ______is the most common cause of gram neg septicemia in hospitalized pts

A

urinary cath

22
Q

________ pts are at an increased risk of UTIs; ______ pts often have complicated UTIs

A

diabetic; elderly

23
Q

presentation signs and symptoms for complicated UTI

A

may present with typical UTI symptoms but elderly/comorbidly ill pts will have altered mental status, anorexia, fatigue, weakness, and vague symptoms

24
Q

UA will show what for complicated UTI? what other test will you run compared to not doing in an uncomplicated UTI

A

positive for nitrites, WBC esterace, blood (may have elevated WBC on CBC); DO a culture

25
Q

tx of complicated UTI: base off ______, may require __________ for IV ABX if unstable or septic (______ = ABX)

A

culture; hospitalization (Rocephin)

26
Q

recurrent UTIs are more than ____ per year (with ________ testing)

A

4; positive

27
Q

common causes of recurrent UTIs (5)

A

menopause, poor hygiene, frequent diarrhea, sex, spermicide use

28
Q

eval for recurrent UTI includes what tests (6)

A

UA, microscopy positive urine cultures, pelvic exam, cystoscopy, urodynamics, renal US

29
Q

tx for recurrent UTI

A

acute- complicated type ABX for at least 7 days prophylaxis- macrobid, trimethoprim, or keflex ABX as needed

30
Q

_______ for prevention of recurrent UTIs in premenopausal women

A

fluids

31
Q

uncomplicated cystitis ABX: best for pregnancy? other good one but requires renal monitoring

A

macrobid- preg

keflex- renal dose adjustment

32
Q

complicated cystitis: tx may require ________. initial ABX therapy is _______ and then step down PO is ______

A

culture; ceftriaxone 1-2 weeks and then keflex 10-14 days

33
Q

uncomplicated pyelonephritis ABX for initial and step down therapy

A

initial- ceftriaxone 10-14 days and then keflex 10-14 days (OBTAIN cultures)

34
Q

after 50, __________ ________ becomes more common which can cause obstruction and increased risk of ______

A

prostatic hyperplasia; UTI

35
Q

UTI is the ____ most common infection in the elderly

A

2nd

36
Q

UTIs in elderly are more common for those living where or with what?

A

living in nursing home/extended care and who have indwelling cath

37
Q

elderly people with UTI present with what four things that are different than normal UTI symptoms?

A

altered mental status, fatigue, weakness, anorexia

38
Q

tx for UTIs in elderly

A

IV or PO ABX, removal of cath if possible

39
Q

some elderly pts with ________ ______ may have chronic asymptomatic bacteria which does or does not need ABX?

A

indwelling catheters; does not

40
Q

the ______ fluid in men has antimicrobial properties

A

prostatic fluid

41
Q

on a culture, a true UTI is presented when there are >_________ colony forming units of bacteria per mL of urine

A

greater than 100,000

42
Q

send culture on ____, _______ women, people with __________ UTIs

A

kids; pregnant; complicated

43
Q

if the patient has progressed to _______, figure out the cause and fix it, plus add ____ and _____

A

urosepsis; IVFs and ABX

44
Q

fluoroquinolones have black box warning for ___ ______

A

CNS toxicity

Clin Med- P (124 decks)

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