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Flashcards in Urosepsis Deck (18):
0

Most common infections in patients older than 65 years?

Pneumonia >UTIs

1

Risk factors for UTIs?

Incontinence, prior UTIs, neurologic impairment, anti-cholinergics

2

In symptomatic patients how much bacteria is typically found in the urine?

10^5 colony forming units from a clean catch specimen

10^2 from catheterization

3

Leukocyte esterase versus nitrites?

Pyuria versus bacteriuria

4

Clinical syndromes of UTIs?

Acute uncomplicated cystitis – lower tract infection

Acute uncomplicated pyelonephritis – upper tract infection

Complicated UTI – associated with urinary catheter or functional abnormalities

5

Symptoms of cystitis Versus pyelonephritis?

Dysuria, frequency, urgency, hematuria versus Fevers, chills, and nausea, with or without symptoms of cystitis

6

Suspected UTI, begin treatment when?

Immediately (before results of cultures)

7

Treatment for uncomplicated UTIs? In patients presenting with clinical picture of sepsis?

Fluoroquinolones (ciprofloxacin and gatifloxacin)

Gentamicin, imipenem, Bactrim

8

Hypovolemic shock results with how much loss of fluid?

20 to 40% blood volume

9

Treatment of cardiogenic shock?

1. Maintain blood pressure dopamine or norepinephrine
2. Relieve pulmonary edema with diuretics
3. Reduce cardiac afterload with intrathoracic balloon pump

10

Distributive shock?

Increase in cardiac output with inability to maintain vascular resistance (inappropriately vasodilation)

11

Phases of distributive shock?

1. Initially, extremities are warm and well perfused
2. Cardiac output falls causing intense vasoconstriction (cold things)

12

Causes of distributive shock?

1. Septic shock
2. Neurogenic shock from spinal cord injury or adrenal crisis

13

Treatment of Distributive shock?

1. Isotonic volume repletion
2. Vasopressors support (dopamine)
3. Mechanical ventilation

14

Mortality from all types of shock?

50%

15

Only type of patient to benefit from asymptomatic bacteriuria? Why?

Pregnant patients. Prevents upper tract infection, preterm delivery, fetal loss

16

Dose regimens for UTIs?

Acute uncomplicated cystitis – Single-dose ciprofloxacin or 3 Day dose bactrim useful

Pyelonephritis – 14 day course of IV then oral gatifloxacin

17

Ways to increase BP in shock?

1. Volume resuscitation
2. Dopamine/norepinephrine
3. Corticosteroids

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