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Flashcards in Infectious Diseases Deck (30)
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1

classic sxs of UTI

- dysuria- frequency- urgency

2

sx and sign seen in about 1/2 of pts w/ pyelonephritis

- flank pain- fever

3

risk factors for UTIs in WOMEN

- DM- sexual activity- diaphragm use- vaginal atrophy- genetic predisposition

4

when is sexual activity a risk factor in MEN?

MSM

5

risk factors for UTIs in HETEROSEXUAL MEN

- obstruction- ureterovesical reflux- prostatic hypertrophy

6

what are the MOST COMMON nosocomial infections?

UTIs

7

risk factors for UTIs in EITHER gender

- DM- SCD- renal stones

8

what bug is specifically associated w/ urinary stones?

Proteus

9

when Proteus is identified in the urine (UTI), what should be done next?

imaging test to look for stones

10

group B strep (S. agalactiae) UTI is seen in

pregnancy

11

diagnosis for UTI

- urine culture growing 100,000 or more of gram-negative organisms- gram-positive organisms or yeast can cause infection with lower colony counts

12

what is a positive urine culture in the absence of sxs called?

NOT a UTI; asymptomatic bacteriuria

13

MC gram-negative organism causing UTI

E. coli

14

MC gram-positive organism causing UTI

Enterococcus

15

uncommon cause for UTI if NO urinary catheter, and should raise concern for what?

- Staphylococcus aureus- bacteremia from another source seeding to the kidney

16

what is the FIRST step in evaluating whether to treat a positive urine culture?

determine if the pt has SIGNS or SYMPTOMS of infection

17

treat ASYMPTOMATIC bacteriuria under ONLY 3 circumstances

1. pregnant women2. pts about to undergo a urologic procedure3. renal transplant recipients w/i the first 3 mos

18

why do you treat asymptomatic bacteriuria in pregnant women?

- prevent progression to pyelonephritis- decrease maternal and fetal morbidity and mortality

19

treatment for asymptomatic bacteriuria in pregnant women

- TMP/SMX during weeks 12-36 ONLY x 3 days- nitrofurantoin x 3 days- cephalexin x 3 days

20

why do you treat asymptomatic bacteriuria in renal transplant recipients?

- decrease r/o a SYMPTOMATIC UTI, which increases risk of rejection

21

w/ SYMPTOMATIC UTIs, what is the next step?

determine if LOWER tract (cystitis), or UPPER tract (pyelonephritis)

22

w/ SYMPTOMATIC UTIs, what is the next step after determining if lower vs upper tract?

complicated or not

23

definition of complicated UTI

- DM- structural anomalies- foreign bodies- prior resistant organisms- immunocompromised- male

24

when do you NOT need a urine culture?

uncomplicated UTI

25

when should imaging be performed in pyelonephritis?

ONLY if sxs PERSIST after 72 hours of culture-guided therapy

26

treatment for uncomplicated cystitis

- 3-day course of:- TMP/SMX- fluoroquinolone- cephalexin

27

treatment for complicated cystitis or UNcomplicated pyelonephritis

- fluoroquinolone- TMP/SMX- beta-lactam- depending on C+S data

28

treatment for complicated pyelonephritis and/or hospitalized pts

- 7-10 days unless bacteremic- fluoroquinolone- ceftriaxone- beta-lactam + beta-lactamase inhibitor- ampicillin + aminoglycoside

29

when should a urinary catheter be changed in UTI?

ONLY if symptomatic

30

recurrent UTIs can be differentiated into what 2 types?

1. RELAPSE (same strain w/i 2 weeks of the end of previous tx)2. REINFECTION (different strain than the initial infection)