urinary tract infections Flashcards
(23 cards)
what is considered a lower UTI vs upper UTI ?
upper - pyelonephritis
lower - cystitis
what is the mechanism in which infection is caused in UTI ?
they ascend
what bug is the most common cause of UTI ?
E coli
staphylococcal saprphyticus
klebsiella
proteus mirabilis
what is the association with UTIs caused by proteus mirabilis ?
they cause struvite kidney stones - ammonia scent associated with the urine
what are the symptoms of UTIs ?
dysuria
frequency
urgency
suprapubic pain
what are the symptoms associated with pyelonephritis ?
costovertebral tenderness
hematuria
WBC casts
systemic symptoms
what are the differential diagnosis associated with finding white blood casts in the urine ?
tubulointerstitial inflammation
acute pyelonephritis
transplant rejection
what are the positive urine findings associated with acute cystitis ?
leukocyte estrase positive
nitrites positive
if the urine is nitrites positive what does this indicate ?
the presence of enterobacter
what does sterile pyuria indicate ?
infection by neisseria or chlamydia
where is leukocyte esterase produced from ?
WBCs in urine
what are the risk factors associated with UTIs?
more common in women
higher sexual activity
urinary catheterization
diabetes
pregnancy
what are the urinary flow associated risk factors that may cause UTIS ?
Vesicouretral reflux
urinary obstruction
what do we mean by urinary obstruction ?
enlarged prostate
anatomic abnormalities
bladder tumors
what is the treatment for UTIS ?
fluoroquinolone
nitrofurantoin
TMP-SMX
what is sterile pyuria ?
pyuria with no bacterial growth
what are the causes of chronic pyelonephritis ?
recurrent episodes of acute pyelonephritis
vesicoureteral reflux
recurrent kidney stones
thyroidization of kidney
what does thyroidization of the kidney mean ?
tubules contain eosinophilic material
what casts are seen in acute pyelonephritis ?
granular casts
if you have a patient being treated for acute pyelonephritis with a persistant fever , what should you suspect ?
perinephric abscess
what is the most common scenario associated with chronic pyelonephritis ?
almost always a child with tubular atrophy with blunting and scarring of the renal calyces
what allows for the e coli to cause cystits ?
fimbrae and pilllus protein
generally for UTIs what is the best method of prevention ?
post coital voiding
