UTI

Question 1

men incur UTIs with BPH… why?

Answer 1

urinary stasis

Question 2

most common UTI

Answer 2

fecal E. coli

Question 3

why is e. coli such a good colonizer?

Answer 3

fimbraie which allows them to adhere really well

Question 4

The most potent risk factors for UTI in healthy women are sexual intercourse, the use of a diaphragm/spermicide, and a history of UTI.

Answer 4

yep, unfortunately

Question 5

why is it common for elderly women lead to overgrowth of gram negative bacteria

Answer 5

vaginal atrophy leads to reduction of lactobacilli in the vagina allowing these gram negative to spreads

Question 6

cystitis

Answer 6

superficial infection confined to the bladder

Question 7

pyelonephritis

Answer 7

invasive infection with fever, increased WBC and flank pain/tenderness

Question 8

main defense that the body has for not getting UTI

Answer 8

flushing effect of urine

**little role of immune defenses or PMNs

Question 9

for a diagnosis of UTI and you are trying to confirm with colony counts what is a good way to judge probability?

Answer 9

symptomatic vs asymptomatic patients

higher probs. with symptomatic patients so accept lower counts

Question 10

if there is Low bacterial counts and poor response to antibiotics in sexually active patients: what should we consider?

Answer 10

STD

Question 11

pyuria does not prove active infection

Answer 11

yep but absence of pyuria makes unlikely

Question 12

urinalysis tell us about what type of cells?

Answer 12

white cells

Question 13

If risk factors for infection with MDR gram negative use a

Answer 13

carbapenem

Question 14

MDR what does it mean

Answer 14

at least 3 resistance for three different drug classes

Question 15

pyelonephritis treatment

Answer 15

we want to treat strongly

• ceftriaxone
• piperacillin/tazobactum

Question 16

disadvantage of nitrofurantoin?

Answer 16

low blood levels

Question 17

Longer interval to recurrence, same or different organism

Treat again: short course, no imaging

Answer 17

reinfection

Question 18

Same organism
Short interval to recurrence
Suggests subclinical pyelonephritis
Treat for 7-14 days
If relapse again, consider imaging (U/S or CT scan)

Answer 18

relapse

Question 19

prevention of reinfections

Answer 19

1. changing contraceptive from diaphgram to pill
2. episodic ab
3. vaginal estriol cream for post-menopausal women

Question 20

in asymptomatic bacteriuria treatment has no benefit in most groups even if there is pyuria

Answer 20

yeppppp, it may even cause some harm such as causing C.difficile infection

Question 21

2 exceptions to treat asymptomatic bacteriuria

Answer 21

1. pregnant women

2. cytoscopy or other urologic procedure

Question 22

acute complicated UTI is a UTI with any of the following list (4)

Answer 22

1. fever
2. systemic symptoms
3. flank pain
4. pelvic/perineal pain

Question 23

what is so bad of foley catheter?

Answer 23

serve as highway for bacteria to enter the bladder… UTI speedway