Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Therapy of UTIs > Flashcards

Therapy of UTIs Flashcards

1
Q

Whata re some consequences of undiagnosed UTI?

A
  1. infertility
  2. urinary incontinence
  3. discospondylitis
  4. pyelonephritis
  5. renal failure
  6. septicemia if immunosuppressed
  7. extension to prostate gland or other accessory sex glands
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are urease producing bacteria?

A
  1. staphylococcus pseudinntermedius

2. proteus mirabilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is infection of urine with ureas producing bacteria associated with?

A

struvite uroliths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is corynebacterium urelyticum associated with?

A

alkaline ruine

struvite and calcium phosphate precipitation–bladder wall encrustations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can predispose to UTI?

A
  1. catheterization
  2. surgery
  3. other diseases of urinary tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are defense mechanisms of the urinary tract?

A
  1. normal flora
  2. microplicae of urethra/bladder
  3. secretory IgA
  4. urethral persitalsis
  5. high pressure zone mid-urethra
  6. micturition
  7. fresh urine production
  8. complete voiding
  9. pH extremes, osmolarities of urine
  10. salts, urea, organic acids in urine
    11 .urine lactoferrin
  11. tamm-horsfall protein, GAGs, uromucoid
  12. increased turnover rate with bacterial attachment
  13. neutrophil infiltratrion with intracellular invasion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why do diseases of UT like bladder atony, urolithiasis, prolonged urine retension predispose to infection?

A

presence of residual urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Why can dogs receiving corticosteroids be predisposed to UTI?

A
  1. impaired immune response

2. urine dilution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why can excessive amounts of glucose in urine predispose to UTI?

A
  1. inhibit phagocytosis

2. predispose to colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why should dogs with diabetes mellitus and / or hypoeradrenocorticism have their urine cultured?

A

becuase they have an increased risk of UTI and may have asymptomatic bacteriuria and so may not have clinical signs or significant UA findings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are defenses of the ureters?

A
  1. angle that ureter enters bladder

2. peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are renal defenses of bacterial infection?

A
  1. local and systemic immune responses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which is more susceptible to infection, the renal cortex or the renal medulla?

A 
the renal medulla likely due to 
1. decreased blood flow
2. high ammonia concentrations
3. increased osmolality
(decrease local immune response)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pyelonephritis is usually the result of what?

A

extension of a lower UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the most imporant virulence factor of uropathogenic organisms?

A

bacterial adhesion to uroepithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What organims have specific fimbriae that enhance bacterial adherence to epithelial surface of urinary tract?

A
  1. e. coli

2. proteus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What uropathogesn have resistance plasmids that confur resistance to antimicrobials?

A
  1. e coli
  2. proteus
  3. staphylococcus
  4. pseudomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can bacterial capsules inhibit immune response against them?

A
  1. limit phagocytosis
  2. antibody coating
  3. opsonization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does e. coli produce that promotes bacterial growth?

A
  1. hemolysin

2. aerobactin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most frequently isolated bacteria causing UTI in dogs, cats, horses and cattle?

A

e. cli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are bacteria other than e. coli that may be found in dogs?

A
  1. staph pseudintermedius
  2. proteus
  3. strep
  4. klebsiella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What bacteira may be isolated in recurrent or complicated UTIs?

A

pseudomonas aeruginosa

enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the second and third most prevalent bacteria in horse UTI?

A

streptococci

enterococci

24
Q

What is the second most common cause of infection in cattle?

A

corynebacterium renale

25
Q

Where are strains of uropathogenic e. coli (UPEC) often found?

A

in the faecal flora of the host

26
Q

Why may urine be culture negative for a pathogen for a long time?

A

bateria (e.g. UPEC) can form intacellualr bacterial commmunities free in cytoplasma and can bridge host cells or can remain latent in membrane bound vesicles

27
Q

Why does exofliation of infected uroepithelium and neutrophil influx work to the advntage of UPEC?

A
  1. shedding of infected cells facilitates spread into environment and leaves underlying tissue exposed
  2. influx of neutrophils compromizes integrity of uroepithelium
28
Q

How are bacterial UTIs diagnosed?

A
  1. examination and microbiological culture of urine
29
Q

What is the best method of collecting urine?

A

cystocentesis

30
Q

Why can interpretation of UA be difficult?

A

cells may not be visible below certain level
mematuria, pyuria not always present–may see bacteria without inflam
g

31
Q

Before receiving culture results, how can you inform initial antimicrobial therapy?

A

gram stain

32
Q

If urine is persistently alkaline, what should you suspect?

A

ureas producing pathogen
staph if cocci are present
proteus if rods are present

33
Q

What are the features of a simple urinary tract infection?

A
  1. due to temporary break in host defense
  2. respond quickly to appropriate therapy
  3. does not reoccur
34
Q

What is a complicated UTI?

A
  1. due to persistent underlying abnormality in urinary tract or host defenses
  2. relapse occurs when original infection not cleared despite therapy
  3. reinfection occurs when a patient is infected with a new bacterial species or strain after succcessful therapy
35
Q

What is a superinfection?

A

a different bacterial species or strain colonized the urinar y tract while the patient is still on antimicrobial therapy for original infection

36
Q

what can cyclophosphamide cause?

A

cystitis

37
Q

When will a drug most likely be effective for treatment of UTI caused by that pathogen?

A

if urine concentration is 4x MIC

38
Q

Why is amoxicillin a first line treatment even if you see R for amoxicillin for e. coli, staph pseudintermedius

A

because get extremely high urine concentrations

39
Q

Why should amoxicillin be dosing interval be decreased when treating UTI?

A

because the time above the MIC is important and dosing every 12 hrs may not be sufficient

40
Q

What are the features of amoxicillin/ampicillin for UTI treatment?

A
  1. batericidial
  2. relatively nontoxic
  3. greater spectrum than pen G
  4. oral products, injectible ampicillins for large animal
41
Q

What is amoxicillin/ampicillin good against?

A 
good initial activity against
1. staphylococci
2. streptococci
3. enterococci
4. proteus
maybe e. coli, klebsiella
42
Q

What bacteria are resistant to amoxicillin/ampicillin?

A

Pseudomonas

enterobacter

43
Q

Does amocillin/ampicillin reach therapeutic levels in the prostate?

A

no

44
Q

What are the features of amoxicillin/clavulanic acid (clavamox) for treatment of UTI

A
  1. oral use

2. increased spectrum against gram -

45
Q

What bacteria does clavamox have activity against?

A
  1. beta lactamase producing staph, e. coli, klebsiella
46
Q

What bacteria are resistant to clavamox?

A
  1. pseudomonas

2. enterobacter

47
Q

Why would you not choose clavamox over amoxicillin?

A

clavulanic acid undergoes hepatic metabolism and excretion so may not have high concentrations in urine and most activity may be due to amoxicillin

48
Q

What are features of cephalexin as UTI treatment?

A
  1. first gen
  2. cefadroxil (Cefa Tabs)
  3. greater stability to beta-lactamases so greater activity against staph and gram -
49
Q

What does cephalexin work against? (cephalosporins)

A
  1. staph
  2. strep
  3. e. coli
  4. proteus
  5. klebsiella
50
Q

What bacteria does cephalosporins not work against?

A
  1. pseudomonas
  2. enterococci
  3. enterobacter
51
Q

What are features of cefovecin (convenia)

A

aproved for UTI due to e. coli, proteus. 1 dose for 14d

3rd gen

52
Q

What are features of cefpodoxime (simplicef)?

A

oral third gen
extralabel for UTI
relatively long half life

53
Q

What are the features of ceftiofur (Excenel)

A

3rd gen injectible
approved for UTI due to e. coli, proteus
desfuroylceftiofur is in urine, good against e. coli but not as potent as ceftiofur against staph and variable against proteus.

54
Q

What bacteria are resistant to ceftiofur?

A
  1. pseudomonas
  2. enterococci
  3. enterobacter
55
Q

What adverse effect is ceftiofur associated with in dogs

A
  1. thrombocytopenia

2. anemia

Pharmacology (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions