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Flashcards in GU Deck (18)
1

pathogen responsible 85-90% of time for UTI

E Coli

2

UTI s/s

frequency, urgency, dysuria (suprapubic discomfort)
- physical exam unremarkable

3

UTI aka

acute cystitis

4

UTI labs

UA: pyuria gt 10 leukocytes/ml & bacteriuria 102 - 105 cfu/ml

degree of each doesn't correlate with infection severity

5

UTI treatment: 1st line, alt, 2nd line

Bactrim (trimethoprim-sulfamethoxazole)
-- 3 days uncomplicated
-- 7-10 days if complicated

- if resistant to Bactrim & F: Macrobid (nitrofurantoin)
- 2nd line: Keflex, Cipro

6

acute pyelonephritis definition

renal parenchyma and pelvis

causative: E Coli or Klebsiella

can lead to sepsis

7

acute pyelonephritis : s/s

TOXIC: fever, shaking, chills, tachycardia

flank or back pain, FUD, CVA tenderness

8

acute pyelonephritis: tx stable vs unstable

stable: Bactrim x 14 days

unstable: ampicillin or Gentamicin

repeat culture

9

renal calculi: s/s

acute colic (sudden onset flank pain, migrates to groin as stone moves, restless)

N, V (ddx: appendicitis)

hx: diet, hydration, environment, habits

10

renal calculi labs:

serum Ca, PO4, lytes, uric acid

UA: microscopic hematuria (r/t calculi trauma)

urine pH:
- lt 5 = uric acid or cystine calc
- gt 7.5 = struvite or staghorn

11

renal calculi: urine pH
lt 5
gt 7.5

5 = uric acid or cystine calc

gt 7.5 = struvite or staghorn

12

renal calculi: tx

fever + pain = admit to prevent staghorn

13

staghorn calculi: what is it and what's the most common agent?

infectious renal calculi, usually proteus, assoc with urease-producing bacteria (E Coli usually doesn't do this.)

14

renal calculi: labs

CBC
PTT
serum lytes
creatinine

15

renal calculi: tx

- push fluids
- observe + 6 wks pain meds
- intervention: ureteroscopic stone extraction, lithotripsy

16

benign prostatic hyperplasia s/s

s/s of chronic obstruction! (difficulty urinating/emptying bladder)
- Obstructive symptoms
- Decrease force or caliber of stream, dribbling
- Intermittent stream or hesitancy
- Irritative symptoms
- Urgency
- Irritative: Frequency, nocturia, urgency

17

benign prostatic hyperplasia: PE

- Rectal exam: enlarged prostate, smooth. rubbery
- Abd exam: assess for distended bladder, mass, neoplasm, cystic dz, tenderness=infection
- Neuro exam: Rectal tone, genital/perineal sensation motor & sensory & DTRs (r/o r/t nerve impingement on enervation of bladder)

18

benign prostatic hyperplasia: dx/labs

uroflometry (assess degree obstruction)

BUN, Cr, UA (hematuria), PSA: assess for cancer