Pathophysiology 1 Flashcards Preview

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Flashcards in Pathophysiology 1 Deck (29)
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1
Q

Bacteriuria

A

-bacteria in urine (UTI or colonization)

2
Q

Pyuria

A

-pus in urine (WBC)

3
Q

“significant” bacteriuria

A

-10^5 colonie forming units per mL

4
Q

Dysuria

A

-pain/burning on urination

5
Q

Lower Urinary Tract Infection

A

-bladder infection (cystitis)

6
Q

Urethritis

A

-inflammation of urethra, trauma, chemical hurt (dysuria)

7
Q

Pyelonephritis

A

-infection of renal pelvis, kidney collecting system

8
Q

Acute Urethra Syndrome

A
  • frequent urination, urgency, burning, dysuria

- can happen if no infection

9
Q

Causes of Dysuria

A
  • 50% clasic cystitis >10^5
  • 10% herpes urethritis
  • 14% unknown
  • 8% chlamydia
  • bacterial lower UTI 10^2-4/mL
10
Q

UTI Epidemiology

A
  • most common bacterial infection
  • infants: males>females
  • years 3-50: females»>males
  • elderly >65 increased bacteriuria, multiple factors
  • greater with intercourse
  • greater with pregnancy (4-10% all women), 25% progression
11
Q

Bacteria that cause UTIs

A
  • 95% from GI tract
  • E. coli is most common
  • staph. saprophyticus
  • other “niche” organisms
12
Q

Does the type of birth control matter with UTIs?

A
  • yes
  • diaphragm changes angle of urethra
  • spermicidal changes flora of vagina
  • oral pill is best for lowest bacteria
13
Q

Route of Infection of UTIs

A

-ascending 95%
urethral trauma, intercourse, instrumentation, diaphragm
-hematogenous <5% (endocarditis, etc.)

14
Q

Mechanisms of UTIs

A
  • adhesion: fimbrie to stick to uroendothelial cells
  • colonization: replicate in urinary tract
  • invasion: evade host defense, go to soft tissue
  • phase variation: shift antigens/virulence factors
15
Q

Type 1 Fimbriae

A

-mano sensitive (blocked by adding manose, b/c it will bind to the manose)

16
Q

P-fimbriae

A
  • named for P antigen of blood group

- causes pyelonephritis

17
Q

Do bacteria need Fe?

A
  • yes, rate limiting step of growth

- will lyse RBC if needed

18
Q

Host Defense Mechanisms for UTIs

A
  • bacterial growth inhibition
  • urine flow
  • epithelial cell turnover (sloughed off)
  • antibodies (target bacteria)
19
Q

Factors that predispose to UTIs

A
  • urine flow obstruction
  • female factors
  • abnormal urine flow
  • urethral trauma
  • vesiculo-ureteral reflux
  • instrumentation
  • general health (bad hygiene)
20
Q

Hydroureter

A

-ureter dilates because urine flow is blocked

21
Q

Symptoms of Lower UTI

A
  • frequency of urination
  • dysuria
  • turbid urine
  • suprapubic discomfort
  • hematuria
  • asymptomatic cystitis
22
Q

Symptoms of Upper UTI

A
  • fever
  • chills
  • flank pain & “CVAT” costovertebral angle tenderness
  • asymptomatic pyelonephritis
23
Q

Diagnosis of UTI

A
  • microscopic urinalysis (screening)
  • gram stain of urine
  • urine culture
  • blood cultures for pyelonephritis
  • screening tests
24
Q

Complications of UTI

A
  • gram - sepsis
  • intrarenal or extrarenal abscess
  • chronic renal insufficiency
  • struvite renal calculi (infections not Ca)
  • recurrent infection
25
Q

Prevention of UTI

A
  • proper use of urinary catheterization
  • correction of anatomic abnormalities
  • prophylactic antibiotics (rare)
26
Q

Treatment of UTI

A

Lower: men - 1 week (prostitis)
women - 1-3 days (longer if complicated)
Upper: 1-6 weeks, IV & oral combo
don’t treat asymptomatic bacteriuria unless pregnant

27
Q

Treat Upper UTI

A

-ceftriaxones

28
Q

What gets UTI drug in prostate?

A

-ciprofloxacin

29
Q

Treat Pyelonephritis?

A

-fluoroquinalones