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Micro Exam VI > UrinaryTractInfections > Flashcards

Flashcards in UrinaryTractInfections Deck (38):
1

Host defenses in the urinary tract

pH < 5.5, High urea, Flushing mechanisms of urine

2

Cystitis Definition

infection of the bladder

3

Urethritis Definition

infection of the urethra

4

Prostatitis Definition

infection of the prostate

5

Pyelonephritis

infection of the kidney ("upper UTI")

6

Symptoms of urethritis and cystitis (LOWER UTIs)

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

7

Symptoms of prostatitis

Lower back, perirectal and testicular pain

8

Symptoms of pyelonephritis

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

9

Pyuria

more than 10 wbc per cubic millimeter of urine

10

Dip Stick Components (2)

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

11

Indication of Significant Bacteriuria

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

12

How much more common are UTIs in women than men?

Ten times more common due to shorter urethras

13

Most common type of health care associated infection

UTI due to cath

14

Community-acquired UTI is largely due to what

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

15

E. Coli found within what family

Enterobacteriacea

16

**Features of E. Coli

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

17

Most common Gram negative rod associated with sepsis

E. Coli

18

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

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

19

Virulence Factors associated with E. Coli

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

20

Type I Pili

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

21

Type P Pili

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

22

#2 Cause of UTI

Staphylococcus

23

**Features of Staphylococcus

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

24

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

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

25

**Coagulase Negative Staph Saprophyticus Features:

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

26

**Features and Prevalence of Proteus Mirabilis:

Gram negative enteric, high prevalence in chronically catheterized patients

27

Virulence Factor of Proteus:

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

28

Implication of Alkaline Environment set up by Proteus:

Promotes precipitation of magnesium and calcium > formation of kidney stones

29

**Pseudomonoas Aeruginosa features:

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

30

Pseudomonoas Aeruginosa UTI:

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

31

**Enterococcus features

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

32

**How to differentiate Enterococcus from S. Pneumoniae:

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

33

Risk Factors for Enterococcus infection:

Treatment with broad spectrum Abx and catheterization

34

Asymptomatic Bacteriuria:

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

35

**Cases to treat asymptomatic Bacteriuria:

Pregnant women, prior to urologic surgery, after renal transplant

36

**Treatment for uncomplicated cystitis:

Trimethoprim/Sulfamethoxazole

37

**Treatment for Pyelonephritis

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

38

Treatment for Asymptomatic Bacteriuria

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