Urinary tract infections

Question 1

Escherichia coli (E.coli)

Answer 1

most common pathogen

Question 2

if lower urinary infection, it’s called

Answer 2

cystitis

Question 3

if upper urinary infection, it’s called

Answer 3

nephritis

Question 4

lower UTI symptoms

Answer 4

inflammation of bladder, prostate, or urethra. pain.

Question 5

upper UTI symptoms

Answer 5

fever, chills, flank pain. can seem like back pain.

Question 6

Pyelonephritis: acute or chronic?

Answer 6

both

Question 7

Urosepsis

Answer 7

UTI that has spread systemically. can lead to death.

Question 8

who is at risk for UTI?

Answer 8

immunosuppressed
Diabetic
Have kidney problems
Have undergone multiple antibiotic courses
Have traveled to developing countries

Question 9

exam will usually be

Answer 9

benign

Question 10

who is at higher risk for UTI?

Answer 10

Alteration of defense mechanisms increases risk for contracting UTI
Compromising immune response factors
Age, HIV, diabetes
Predisposing factors
Factors increasing urinary stasis
BPH, tumor, neurogenic bladder
Foreign bodies
Catheters, calculi, instrumentation
Anatomic factors
Obesity, congenital defects, fistula
Functional disorders
Constipation
Other
Pregnancy, multiple sex partners (women)

Question 11

older age - do kidneys get smaller?

Answer 11

kidney gets smaller, loss of muscle tone. decrease in bladder capacity.

Question 12

UTI - Bladder storage - Nocturia and Nocturnal enuresis

Answer 12

Nocturia- waking up 2 or more times to void
Nocturnal enuresis- loss of urine during sleep

Question 13

how many ppl have incontenence?

Answer 13

15 - 35% over 60

Question 14

Older adults - UTI

Answer 14

Symptoms often absent
Non localized abdominal discomfort rather than dysuria
Cognitive impairment possible
Change in behavior, confusion or agitation possible
Fever less likely

Question 15

Dipstick urinalysis (dip into the night with white and luke)

Answer 15

Identify presence of nitrites, WBCs, and leukocyte esterase

Question 16

objective signs of UTI

Answer 16

fever
Hematuria, foul smelling urine, tender/enlarged kidney
Leukocytosis, + bacteria, WBCs, RBCs, pyuria, ultrasound, CT scan, IVP

Question 17

pylonephritis - palpation?

Answer 17

Costovertebral tenderness to percussion on affected side

Question 18

pylonephritis relapses

Answer 18

Relapses are treated with 6 weeks of antibiotics

Question 19

stress incontinence (the pregnancy is stressing me so I smoke and I’m obese)

Answer 19

pregnancy big one, post-menoupausal. smoking and obesity.

Question 20

urge incontinence

Answer 20

from caffeine, nicotine, artificial sweeteners

Question 21

mixed incontinence

Answer 21

stress and urged mixed

Question 22

laterogenic incontinence

Answer 22

drug induced, muscle relaxants. pee all of the time.

Question 23

Adults 60 years and older - residual, and how much?

Answer 23

50 to 100 mL of residual urine remaining in the bladder after voiding

Question 24

kidney stone - how to diagnose? (cutie kidney stone)

Answer 24

CT scan w/out contrast. very specific. looking for swelling in kidneys. KUB - not as good.

Question 25

stones larger than 10 mm

Answer 25

need surgery. under 5 mm can pass on their own.

Question 26

prevent stones

Answer 26

lemons, lemonade, decrease sodium, no chocolate, rhubarb.

Question 27

need 80 MAP for

Answer 27

good perfusion

Question 28

pre-renal

Answer 28

blood not getting to kidney with enough pressure, hypovolemia, clot, anything obstructing the blood flow

Question 29

blood supply to the kidneys

Answer 29

The kidneys receive unfiltered blood directly from the heart through the abdominal aorta which then branches to the left and right renal arteries. Filtered blood then returns by the left and right renal veins to the inferior vena cava and then the heart

Question 30

elderly hang onto

Answer 30

CO2 more.

Question 31

have to know lab values

Answer 31

in renal function lab values

Question 32

BUN

Answer 32

8-25

Question 33

creatinine (creatinine, the number of the beast)

Answer 33

.6 - 1.5 mg dl

Question 34

bun/cr ratio

Answer 34

10:1 - 20:1

Question 35

GFR normal

Answer 35

100 - 125

Question 36

if rapid change in GFR, do (rapidly 24)

Answer 36

a 24 hour test

Question 37

does GFR change with age?

Answer 37

goes down a tiny bit.

Question 38

check

Answer 38

how to do JVD

Question 39

where to listen for plural friction

Answer 39

rub

Question 40

is age a high risk for UTIs?

Answer 40

yes

Question 41

obese higher risk for UTIs?

Answer 41

yes