Diagnostic Modailites In Primary Care For Infectin - Week 4 PBLo Flashcards
How to treat women <65 yrs for UTI?
Exclude STIs
Main symptoms: dysuria/ nocturia/ cloudy
2 or more symptoms: consider antibiotics and skip dipstick
1 = dipstick for certainty
0 = look for other symptoms
If none of above symptoms = no dipstick
Send cultures to confirm diagnosis
How to treat UTIs in men <65 yrs old?
Check STIs/prostatitis
MSU for culture (dipping less reliable)
Consider Abx
How to treat UTIs in catheterised adults or >65 years old?
No dipstick as unreliable (don’t want to start unnecessary antibiotics)
Most likely asymptomatic
Check for UTI symptoms —> send culture if appropriate
When to test for H pylori?
Pts with uncomplicated dyspepsia (lifestyle and PPIs not helping)
Pts with gastric or duodenal ulcer bleed
Pts with unexplained iron deficiency
What are tests for H pylori?
Urea breath test - most accurate
Stool Helicobacter antigen test
Serology - IgG antibody
Endoscopy, culture and susceptibility tests if pt still HP pos after 2 rounds Abx
What would it mean if bilirubin or urobilinogen is present in urine?
Issues with bile ducts or liver damage
(Bilirubin is a by product of RBC death. Bilirubin is converted to urobilinogen. Most absorbed by liver, rest excreted)
Meaning if ketones present in urine?
Produced When fat is broken down, not carbs
Uncontrolled diabetes (diabetic ketoacidosis)
And others
Meaning of glucose in urine?
Diabetes/ kidney disease?
Meaning if protein in the urine?
Kidney disease (kidneys are good at keeping protein)
Meaning of blood and ethrocytes in the urine?
UTI or tumour
Or just vigorous exercise
pH range of normal urine?
5-5-6.5
Meaning if nitrites in urine ?
Could suggest a UTI
Gram neg Bacteria can convert nitrates into nitrite
Not reliable test for infection though
Meaning is leukocytes are present in Urine?
Detects leukocyte esterase (produced by WBCs)
Suggests UTI if raised but could be contaminant vaginal discharge
What is specific gravity for urine ?
Measures urine solute conc
Low SG = excessive fluid uptake
High SG = kidney actively restored water, Heart failure eg
