UTI

Question 1

UTI: signs and sx

Answer 1

gross hematuria

LOWER:
dysuria
urgency
frequency
nocturia
suprapubic heaviness
costovertebral tenderness

UPPER:
flank pain
fever
N/V
malaise

Question 2

UTI: laboratory test results

Answer 2

pyuria
nitrite positive urine
leukocyte esterase positive urine
antibody coated bacteria

Question 3

UTI: elderly patient presentation

Answer 3

AMS
change in eating habits
GI sx

Question 4

UTI: pts w/ indwelling catheters or neurologic disorders presentation

Answer 4

flank pain
fever

no lower tract sx

Question 5

Common Dipstick Test

Answer 5

detects nitrite in urine

false negatives common due to:

• P.aeruginosa
• low urinary pH
• frequent voiding
• dilute urine

Question 6

Leukocyte Esterase Dipstick Test

Answer 6

detects pyuria

Question 7

What is the most reliable method of diagnosing a UTI?

Answer 7

urine culture

Question 8

What microbes are associated w/ uncomplicated UTIs?

Answer 8

MC: E. coli

S. saprophyticus
K. pneumoniae
Proteus
P. aeruginosa
Enterococcus

Question 9

What microbes are associated w/ complicated UTIs?

Answer 9

gram negative organisms

enterococcus faecalis

Question 10

Recommended treatment for uncomplicated UTI

Answer 10

short course (3d) trimethroprim sulfamethoxazole
OR
1 dose fosfomycin
OR
5d nitrofurantoin

Question 11

Recommended treatment for pyelonephritis or complicated infections

Answer 11

short course (3d)

ciprofloxacin or levofloxacin (fluoroquinolones)

**moxifloxacin does NOT work in urinary tract

Question 12

Trimethoprim Sulfamethoxazole: ADEs

Answer 12

rash
steven johnson syndrome
renal failure
photosensitivity 
hematologic

Question 13

Nitrofurantoin: ADEs

Answer 13

GI intolerance
neuropathies
pulmonary reactions

Question 14

Fosfomycin Trometamol: ADEs

Answer 14

diarrhea
HA
angioedema

Question 15

Ciprofloxacin/Levofloxacin: ADEs

Answer 15

hypersensitivity
photosensitivity
GI sx
dizziness
confusion
tendonitis

Question 16

Amoxicillin Clavulanate: ADEs

Answer 16

hypersensitivity (rash, anaphylaxsis)
diarrhea
superinfection
seizure

Question 17

Cefaclor/Cefpodoxime Proxetil

Answer 17

hypersensitivity (rash, anaphylaxis)
diarrhea
superinfection
seizure

Question 18

Acute Uncomplicated Cystitis: pathogens

Answer 18

E. coli

Staph saprophyticus

Question 19

Acute Uncomplicated Cystitis: Pregnancy: treatment recommendation

Answer 19

1. AUG x 7d
2. cephalosporin x 7d
3. TMP-SMX x 7d

**avoid TMP-SMX during 3rd trimester

Question 20

Acute Pyelonephritis: Uncomplicated: pathogen and treatment

Answer 20

E. coli

1. quinolone x 7d
2. TMP-SMX x 14d

Gram (+) bacteria
1. AMOX or AUG x 14d

Question 21

Acute Pyelonephritis: Complicated: pathogens

Answer 21

E coli
P mirabilis
K pneumoniae
P aeruginosa
Enterococcus faecalis

Question 22

Acute Pyelonephritis: Complicated: treatment recommendation

Answer 22

1. quinolone x 14d

2. extended spectrum PCN + aminoglycoside

Question 23

Prostatitis: pathogens

Answer 23

E coli
K pneumoniae
Proteus
P aeruginosa

Question 24

Prostatitis: treatment recommendation

Answer 24

1. TMP-SMX x 4-6wks

2. quinolone 4-6wks

Question 25

Stevens Johnson Syndrome: clinical presentation

Answer 25

``` flu like sx facial swelling tongue swelling hives skin pain red/purple rash blisters (skin, mucous membranes of mouth nose eyes genitals) shedding of skin ```

Question 26

What component of cranberry juice can potentially aid in UTIs?

Answer 26

lactobacillus | -keeps vaginal pH in normal range

Question 27

What is a potential benefit of cranberry juice in recurrent UTIs?

Answer 27

dec adherence of bacteria to bladder epithelial cells

Question 28

Phenazopyridine HCl

Answer 28

urinary analgesic used in combination w/ abx may mask signs and sx of nonresponding UTI

Question 29

Phenazopyridine HCl: ADEs

Answer 29

``` red orange discoloration of body fluids rash anaphylaxis hemolytic anemia methemoglobinemia acute renal failure ```

Question 30

Recommended drug therapy for UTIs in pregnancy

Answer 30

7d: - cephalexin - amoxicillin - amoxicillin/clavulanate