UTI and prostatitis Flashcards

(36 cards)

1
Q

what is UTI or prostatitis?

A

infection in any part of the urinary system (kidney, urther, bladder, urethra)

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2
Q

What are examples of bladder infections?

A

lower UTI or cystitis

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3
Q

what are examples of kidney infections?

A

pyelonephritis, or upper UTI

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4
Q

Asymptomatic bacterimia

A

a significant amount of bacteria in urine without any signs and symptoms

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5
Q

uncomplicated UTI

A

lower tract (cystitis) that presents with dysuria, urgency, frequency, and suprapubic tenderness

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6
Q

complicated UTI

A

metabolic, functional, and structural abnormality that may involve both the upper and lower tracts. increased rate of treatment failure

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7
Q

What does catherization put u at risk fro?

A

cathertization in the last 48 hours puts you at risk for developing a UTI

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8
Q

what is pyelonephritis and what’s it due to?

A

inflammation of the renal parenchym, calcies, and pelvis
infection due to bacteremia

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9
Q

what is urosepsis due to?

A

reuslts from infection of extravasated urine or the obstruction of infected urine

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10
Q

HOw do we test for these conditons?

A

Via urinalysis

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11
Q

what tests does urinalysis include?

A

lots

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12
Q

how do we collect urinalalysi samples?

A

midstream catch

catheter (note on label)

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13
Q

what can we expect to see in a UTI urinalysis?

A
  1. bacteremia
  2. hematuria
  3. Nitrites ( presence of bacteria that convert nitrates to nitrites (ex: E.coli)
  4. Pyuria (WBC) indicative of inflammation (including infection)
  5. WBC casts - indicative of renal origin leukocytes
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14
Q

what does WBC on a gram stain mean?

A

indicative of infection

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15
Q

what do epithelial cells on a gram stain mean?

A

contamination

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16
Q

what are coliforms?

A

part of normal intestinal flora of humans and animals that can be isolated from a variety of environmental sources

17
Q

what grousp can I isloate coliforms from?

A

escherichia
klebisella
enterobacter
serratia
citrobacter

  • all are gram negative baccili
18
Q

what is a coagulase test (coagulase negative staphyloccocus)

A

differentiate S.aurea from this group (S. epidermis, s.saprophyticus, s.hemolticus)

relatively low virulence but often resistant to antibiotics

19
Q

when should we treat asymptomatic bacteremia?

A

-we don’t treat unless:

  • pregnant
  • before TURP or urological procedures where mucosal bleeding is anticipated
    -bacteremia persists fro 48 hours after removing cathether
20
Q

treatment of asymptomatic bacteriemia before and after invasive urological intervention

A
  • aerobic gram-negative bacilli
  • TMP-SMX for 3 days
21
Q

treatment of asymptomatic bacteriemia pregnancy and why

A
  • increased risk of pyelonitis, preterm labor and low infant birthweight
  • aerobic gram-neg bacilli and coagulare-negative Staph
  • amoxicillin, clavulanic, cephalexin, fosfomycin
  • duration for 3- 7 days
22
Q

what are some Symptoms of uncomplicated cystitis

A
  • usual: dysuria, frequency, urgency, suprapubic pain
  • delirium (elderly, rule out other causes)
  • fever (uncommon, if present treat like pyelonephritis and get blood cultures_
23
Q

usual pathogens for uncomplicated cystitis

A

e.coli and entererobacteriases
coagulase-negative staph
enterococcus

24
Q

tx of uncomplicated cystsiis

A

first -line (problem with these is minimual tissue penetration)
- nitrofurantoin (5 days)
- fosfomycin (1 dose)

second-line
- TMP -SMX (3 days)
- Cipro (3days) ( this can cause lots of damge to flora of gut

25
pregnancy uncomplicated cystitis
avoid Tmx-SMX in the start and towards the end - avoid nitrofurantoin near-term - do not use cipro - treat for 7 days - cefixime for 7 days
26
Prphylaxis - when is it needed? what should we do befreo starting tx
when 3 or more episodes per year pretreatment urine culture is recommended
27
prophylaxis related to coitus
TMP-SMX Nitrofuratoin - both PO pericoitus
28
prophylaxis unrelated to coitus
TMP - SMX ( 1 before bedtime, or 3 times a week for 6 months) Trimethoprim (PO for 6 months)
29
complicated UTI
functional or anatomical abnormality ( obstructive uropathy, recent instrumentation, delayed/ impaired voiding, metabolic abnormality, immunocompromised) - males - S and s siislar to usual - can include systemic (fever, increased LKC, decreased BP)
30
what increase risks of complicated UTI?
catheters
31
when should we treat complicated uti and why?
only if UTI symptoms or systemic infection b/c there is potential for abx misuse
32
complicated uti afebrile, systemically well tx
cefixime, amox/clav, cipro, tmp-smx
33
complicated uti febrile, systemically unwell tx
ampicillin - gentmicin and ceftriaxone
34
complicated uti hemodynamically unstable
pip/tazo gentamicin
35
duration of theroay for complicated uti
7-14 days
36
what step dwon from IV to po should we consider
FQ or TMP-SMX