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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

Bacterial factors that increase UTI risk?

capusule, toxins, enzymes, urease to make the urine more alkaline, a fimbril attachments, fimbriae/pili