Flashcards in Genitourinary Deck (378)
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361
Treatment of urethritis?
mainly STI causes so managed by GUM
362
What causes epididymoorchitis?
chlamydia if
363
Symptoms of epididymoorchitis?
hot, red swollen testicular pain
364
Treatment of epididymoorchitis?
GUM if STI
quinolone if >35 or no STI
Deoxycycline and azithromycin if STI likely as it can lead to infertlity
supportive underwear
NSAIDs
drainage of abscess
ceftriaxone is gonorrhoea suspected
365
What is pyelonephritis?
infection of the renal parenchyma and soft tissues of the renal pelvis/upper ureter with neutrophil infiltration
366
How does pyelonephritis present?
tender loin pain, fever, pyuria, small cortical abscessses and streaks of pus in renal medulla
367
Who does pyelonephritis affect?
women
368
Treatment of pyelonephritis?
IV Gentamicin/co amoxicillin +/- HDU, increase fluid intake, drain obstructed kidney, catheter is compromised, analgesics, oral antibiotics once well, complete 10-14 days of antibiotics
369
What can pyelonephritis lead to?
renal abscess and emphysematous pyelonephritis
370
What is vesicouretic reflux?
incompetent valve between bladder and ureter, allowing reflux or urine during bladder contraction and voiding, causing dmaage of scarring and hypertension
371
Who is most likely to get reflux?
children, caused by structural or functional abnormalities
372
What is the general treatment for lower UTI?
nitrofurantoin or trimethoprim, increase fluid intake
373
What added investigations would you want to do in a complication UTI?
renal US, cystoscopy, KUB-XR
374
Treatment of an upper UTI?
ABCDE, rehydration, IV antibiotics, drain hydronephrosis, catheter, percutaneous nephrostomy
coamoxiclav, ciprofloxacin, OR gentamycin and cefuroxime IV
375
DD of acute pyelonephritis?
acute appendicitis, diverticulitis, cholecystitis, ruptured ovarian cyst, ectopic pregnancy
376
What protein inhibits bacterial adhesion in the urinary tract?
Tamm-Horsfall protein
377
Host factors against UTI?
urinary IgA, vaccine therapy, antegrade flushing of urine, gag layer resists adhesion, low urine pH, high osmolality
378
