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Micro Exam VI > UrinaryTractInfections > Flashcards

Flashcards in UrinaryTractInfections Deck (38)
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1
Q

Host defenses in the urinary tract

A

pH < 5.5, High urea, Flushing mechanisms of urine

2
Q

Cystitis Definition

A

infection of the bladder

3
Q

Urethritis Definition

A

infection of the urethra

4
Q

Prostatitis Definition

A

infection of the prostate

5
Q

Pyelonephritis

A

infection of the kidney (“upper UTI”)

6
Q

Symptoms of urethritis and cystitis (LOWER UTIs)

A

BIG 3 Dysuria, frequency and urgency, Urine may be cloudy or hematuria, USUALLY NO DISCHARGE (differential from STD)

7
Q

Symptoms of prostatitis

A

Lower back, perirectal and testicular pain

8
Q

Symptoms of pyelonephritis

A

Pain in FLANKS + FEVER, Also frequency, urgency, dysuria precede

9
Q

Pyuria

A

more than 10 wbc per cubic millimeter of urine

10
Q

Dip Stick Components (2)

A

Test for ESTERASE (pyuria) and NITRITE (E. Coli)

11
Q

Indication of Significant Bacteriuria

A

Presence of at least one bacterium per microscopic oil-immersion field (100,000 Colony Forming Units/mL), culture to find causative agent

12
Q

How much more common are UTIs in women than men?

A

Ten times more common due to shorter urethras

13
Q

Most common type of health care associated infection

A

UTI due to cath

14
Q

Community-acquired UTI is largely due to what

A

Colonization of the urinary tract by fecal flora by E. Coli

15
Q

E. Coli found within what family

A

Enterobacteriacea

16
Q

**Features of E. Coli

A

Gram (-) rod, Part of normal flora of colon, Ferments lactose (red on MCA), Oxidase (-)

17
Q

Most common Gram negative rod associated with sepsis

A

E. Coli

18
Q

What is the most common cause of community acquired UTIs and what is its reservoir?

A

E. Coli (80-95%), Reservoir = intestinal tract

19
Q

Virulence Factors associated with E. Coli

A

Adhesins +Pili (binding), Hemolysin (lysis > inflammatory response), Endotoxin (inflammation)

20
Q

Type I Pili

A

Attachment pili expressed by MOST E coli > bind to mannose residues on epithelial surfaces, Will be FLUSHED out with urine

21
Q

Type P Pili

A

Expressed by UPEC of E. Coli > binds to sugars residues SPECIFICALLY on UROEPITHELIAL CELLS, Does NOT get flushed out with urine

22
Q

2 Cause of UTI

A

Staphylococcus

23
Q

**Features of Staphylococcus

A

Gram + clusters (cocci), Catalase +, Non-flagellate, motile or spore forming

24
Q

**Two groups of Staphylococci and what they are differentiated by:

A

S. Aureus (coagulase +, Coagulase Negative Staph (Saprophyticus + Epidermis)

25
Q

**Coagulase Negative Staph Saprophyticus Features:

A

Normal in GI tract, SECOND leading cause of UTIs, **NOVOBIOCIN RESISTANT (unlike Staph Epidermidis)

26
Q

**Features and Prevalence of Proteus Mirabilis:

A

Gram negative enteric, high prevalence in chronically catheterized patients

27
Q

Virulence Factor of Proteus:

A

Produces urease > breaks down urea in urine > creates alkaline environment

28
Q

Implication of Alkaline Environment set up by Proteus:

A

Promotes precipitation of magnesium and calcium > formation of kidney stones

29
Q

**Pseudomonoas Aeruginosa features:

A

Gram (-) rod, oxidase (+), Have pyocyanin/pyoveridin (blue/green pigment), Primarily a nosocomial +opportunistic infection

30
Q

Pseudomonoas Aeruginosa UTI:

A

Primarily seen in patients with long-term indwelling urinary catheters or patients who have been treated with multiple courses of Abx

31
Q

**Enterococcus features

A

G + cocci, catalase (-), (just like S Pneumoniae)

32
Q

**How to differentiate Enterococcus from S. Pneumoniae:

A

Enterococcus tolerates high salt/bile and is NOT SENSITIVE to OPTOCHIN

33
Q

Risk Factors for Enterococcus infection:

A

Treatment with broad spectrum Abx and catheterization

34
Q

Asymptomatic Bacteriuria:

A

Significant bacteria on two successive cultures in asymptomatic patient Common in older men and women.

35
Q

**Cases to treat asymptomatic Bacteriuria:

A

Pregnant women, prior to urologic surgery, after renal transplant

36
Q

**Treatment for uncomplicated cystitis:

A

Trimethoprim/Sulfamethoxazole

37
Q

**Treatment for Pyelonephritis

A

Fluoroquinolones for G (-), Amoxicillin for G (+)

38
Q

Treatment for Asymptomatic Bacteriuria

A

No treatment, or in 3 cases– Amoxicillin, cephalexin or nitrofurantoin