Exam #6: UTI Flashcards Preview

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Flashcards in Exam #6: UTI Deck (40):
1

What are the mechanisms that defend against UTI?

pH below 5.5
High urea
Mechanical flushing with urination

2

What is the difference between nephritis, pyelonephritis, ascending UTI, cystitis, urethrtis, prostatis?

Nephritis= inflammation of the kidney
Pyelonephritis= Inflammation of the kidney & upper urinary tract, also known as an ascending UTI
Cystitis= inflammation of the bladder
Urethritis= inflammation of the urethra
Prostatitis= inflammation of the prostate

3

What are the symptoms of uretheritis & cysititis?

Dysuria
Frequency
Urgency

*Note that there is usually no discharge with these, unlike STD

4

What are the symptoms of prostatits?

Lower back pain
Pain in perirectal area
Testicular pain

5

What are the symptoms of pyelonephritis?

Flank pain
Fever
Sx of cystitis

Diarrhea
Vomiting
Tachycardia

6

Why is pyelonephritis dangerous in pregnant women?

Can cause premature birth

7

How are UTI's diagnosed?

Symptoms
Urine dip-stick

8

What is leukocyte esterase? What is pyuria?

Presence of WBCs

>10 wbc per cubic millimeter

9

What does a positive nitrite test indicate?

Some bacteria can reduce nitrate to nitrite

10

Why is UTI more common in women than men?

Shorter urethra

*****Note that cystitis in [young] men is rare & implies a pathological process, such as renal stones, prostatitis, or chronic urinary retention

11

What increases the risk for UTI?

Sexual intercourse
CA-UTI= catheterization
BPH
GU malformation
DM
Pregnancy

12

What are community acquired UTIs associated with?

Colonization of the urinary tract by fecal flora
- E. coli
- Staphylococcus saprophyticus

13

What are hospital acquired UTIs associated with?

Catheterization

- Klebsiella, Enterobacter, Serratia, Pseudomonas aerugenosa, Enterococcus

14

What are enteric bacteria?

Bacteria routinely found in the GI tract of human or other animals
- Gram -
- LPS

15

How can the enterobacteriaceae be identified serologically?

O= polysaccharide antigens of LPS
K= capsular antigens
H= flagellar antigens

16

What are the common virulence factors associated with Enterobacteriae?

Endotoxin (LPS)
Antimicrobial resistance

17

What causes most of the community acquired UTIs?

E.coli (UPEC)

18

What else can E. coli cause?

Gastroenteritis
UTI
Spesis
Neonatal meningitis

19

What is the second most common cause of community acquired UTI?

Coagulase negative staph i.e. S. saprophyticus

20

What are the virulence factors of E. Coli?

Adhesin= attachment

Hemolysin= lyses erythrocytes --> inflammation

Endotoxin= inflammation

21

What special characteristics of UPEC allows for attachment?

- Type I pili that binds to mannose residues commonly present on epithelial surfaces
- P pili that binds sugar residues on uroepithelial cells

22

What is the difference between Staph & strep?

Catalase test

Staph = +

23

What is the difference between coagulase +/- staph?

+= epidermis
-= saprophyticus

24

What are the characteristics of S. saprophyticus?

Normal GI flora
UTIs
Novobiocin resistance (vs. epidermidis)

25

What the most common causative agents of HAC UTI?

Klebsiella
Proteus
Pseudomonas

26

List the characteristics of proteus mirabilis.

Gram negative enteric

27

What virulence factors are associated with Proteus?

Urease

- Hydrolyzes urea to ammonia & results in alkanalization of urine
- Alkalization-->precipitation of organic & inorganic compounds & real stones

28

What are the symptoms of renal stones?

Sudden onset of severe pain that radiates from side of back or abdomen & into the groin

29

How is Proteus UTI treated?

TMP-SMX

30

List the characteristics of Peudomonas aeruginosa.

Gram - rod
aerobic
motile
Minimalist

*Frequently seen in hospital UTI

31

How is pseudomonas aeruginosa diagnosed?

Blue green pigment

32

How is pseudomonas aeruginosa infection treated?

Multiple antibiotics

33

List the characteristics of Enterococcus.

Cram + cocci
Catalase negative
Group D carbohydrate
Tolerates high salt & bile
Optochin resistant

34

What risk factors are associated with enterococus?

- Hospitalization
- Treatment with broad spectrum abx

35

What other infections are associated with enterococcus?

UTI
Peritonitis
Endocarditis

36

When do you treat asymptomatic bacteriura?

Three situations:
1) Pregnant women
2) Prior to urologic surgery
3) After renal transplant

37

When do you NOT treat asymptomatic bacteriuria?

Eldery

38

How is uncomplicated cystitis treated?

TMP-SMX

39

How is pyeloephritis treated?

Gram (-)= Fluoroquinolones
Gram (+)= Amoxicillin

40

How is asymptomatic bacteriuria treated (when treating it)"

Amoxicillin
Cephalexin
Nitrofurantoin

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