Unit 7: GU

Question 1

Most common pathogen for UTI

Answer 1

E coli

Question 2

Complicated UTIs may be due to

Answer 2

Pseudomonas, enterococcus, staphylococcus, serratia, providencia, fungi

Question 3

Urine culture for UTI

Answer 3

> 10^5/mL

Question 4

Urinary analgesics for UTI

Answer 4

Methenamine, phenazopyridine, flavoxate
used to treat urgency, frequency, burning, and discomfort
Should not be used for more than 2 days

Question 5

First line antibiotics for UTI

Answer 5

Trimethoprim-Sulfametaxazole (Bactrim)
Nitrofurantoin
Fluoroquinolones (Cipro)

Question 6

Second line antibiotics for UTI

Answer 6

Cipro–usually reserved for complicated UTI and pyelonephritis

Question 7

Antibiotics safe for UTI in pregnancy

Answer 7

Amoxicillin, cephalexin, nitrofurantoin (only 1st and 2nd trimester)

Question 8

Prostatitis categories

Answer 8

Acute bacterial
chronic bacterial
chronic nonbacterial and pelvic pain syndrome
asymptomatic inflammatory

Question 9

Main organism in acute bacterial prostatitis

Answer 9

E coli and pseudomonas

Question 10

Main organisms in chronic bacterial prostatitis

Answer 10

pseudomonas, E Coli, proteus mirabilis, klebsiella pneumoniae, enterococcus

Question 11

Most accurate method of prostatitis diagnosis

Answer 11

culture isolation of prostatic urine

Question 12

1st line therapy for bacterial prostatitis

Answer 12

Fluoroquinolone for 4-6 weeks

Oral

Question 13

Other antibiotics for bacterial prostatitis

Answer 13

Bactrim, doxycycline, azithromycin, clarithromycin

Question 14

BPH causes

Answer 14

may be due to higher amounts of estrogen in the gland that increases activity of substances that promote cell growth; or increase in DHT levels
Increased smooth muscle tone in lower urinary tract due to stimulation of alpha 1 receptors

Question 15

Main class of drugs for BPH

Answer 15

a1 blockers

Question 16

5-a-reductase inhibitors for BPH

Answer 16

Finasteride + Dutasteride
Decrease levels of intracellular DHT without reducing testosterone levels
Most men achieve 20-40% reduction after 6 months of use

Question 17

a-adrenergic blockers

Answer 17

-zosin, tamsulosin (flomax)
Relax smooth muscle of prostate and bladder neck without interfering with bladder contractility
May take weeks to months to see effects
May cause hypotension

Question 18

Erection

Answer 18

Release of NO following PANS stimulation –> causes smooth muscle relaxation that permits inflow of blood
Vasoactive intestinal peptide and prostaglandins E1 + E2 also contribute to vasodilation

Question 19

Phosphodiesterase 5 inhibitors

Answer 19

Sildenafil (viagra)
Inhibit breakdown of one of messengers required for erection
Reinforce the normal cellular signals that increase cAMP

Question 20

Phosphodiesterase 5 inhibitors CI in

Answer 20

use of nitrates, unstable angina, systolic BP <90, alpha blockers, recent MI

Question 21

Overactive bladder

Answer 21

urinary urgency + frequency, nocturia, with or without urge urinary incontinence
SANS stimulates urethral sphincter closure and detrusor relaxation during filling
PANS influences contraction of detrusor and relaxation of sphincter during emptying

Question 22

Predominant mediator of detrusor contraction

Answer 22

ACh mediated activation of muscarinic receptors–more so M3

Question 23

Drug target for treatment of OAB

Answer 23

M3 receptor blockage

Question 24

First line tx of OAB

Answer 24

Anticholinergics/antimuscarinics

Question 25

Anticholinergics for OAB

Answer 25

Oxybutynin, tolterodine, trospium, solifenacin, fesoterodine Increase bladder capacity, decrease intensity and frequency of bladder contractions and delay initial urge to void

Question 26

Beta adrenergic agonists for OAB

Answer 26

Mirabegron Selective B3 agonist Increases cAMP which causes smooth muscle relaxation and increased urine storage space

Question 27

Onabotulinumtoxin A (Botox) for OAB

Answer 27

Reserved for patients who have failed other treatments Injected into detrusor muscle, inhibits Ca dependent release of ACh, ATP and substance P and desensitizes motor neurons UTI is a common SE

Question 28

Alpha adrenergic antagonists for OAB

Answer 28

-Zosin | Decrease sympathetic mediated stricture

Question 29

Antidiuretic drugs for OAB

Answer 29

Desmopressin | Can cause diuresis without impacting BP

Question 30

Causative organism for chlamydia

Answer 30

Chlamydia trachomatis

Question 31

First line therapy for chlamydia

Answer 31

Azithromycin single dose | Doxycycline

Question 32

Causative organism for gonorrhea

Answer 32

N. Gonorrhoeae

Question 33

First line treatment for gonorrhea

Answer 33

Single dose ceftriaxone + single dose of azithromycin

Question 34

Causative organism for syphilis

Answer 34

Spirochete trepenema pallidum

Question 35

First line treatment for syphilis

Answer 35

Penicilin G | If allergic treat with doxycyline or tetracycline

Question 36

Antivirals for genital herpes

Answer 36

Acyclovir, famciclovir, valacyclovir | CI in breastfeeding

Question 37

Most common pathogens for pelvic inflammatory disease

Answer 37

N. Gonorrheoeae and C. Trachomatis

Question 38

TX for PID

Answer 38

Usually same as gonorrhea or chlamydia | Cefoxitin, doxycycline, clindamycin, ofloxacin, metronidazole, ceftriaxone

Question 39

Therapy for HPV

Answer 39

Podofilox and Podophyllin Resin--self applied gel | Trichloroacetic acid and bichloroacetic acid--applied by healthcare professional