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UTIs Flashcards

1
Q

What are symptoms of lower UTIs?

A
  1. dysuria
  2. urgency
  3. urinary frequency
  4. suprapubic pain
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2
Q

What are symptoms of upper UTIs?

A
  1. fever
  2. flank pain
  3. N/V
  4. Clinical sepsis
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3
Q

What’s the difference between an acute and chronic UTI?

A

Chronic may have high bacterial load but no symptoms

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4
Q

What factors predispose you to an ascending UTI?

A
  1. maternal hx of UTIs
  2. First UTI < 15
  3. New sex partner
  4. condom use/spermicides
  5. Bladder overdistention
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5
Q

What genetic difference would predispose you to a UTI?

A
  1. Certain HLA types

2. Short uretural length

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6
Q

How do you diagnose UTIs?

A

Gram stain and culture
Urinalaysis with 5-10 WBC/hpf
Leucocyte esterase test
nitrite test

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7
Q

What is the criteria for treating a UTI?

A

Symptomatic and > 100 organsims

Asymptomatic and 10^5 organisms

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8
Q

What would you do to treat a UTI?

A

3 days of oral antibiotics. If more than 3 re-infections in a year, consider prophylactic antibiotics

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9
Q

How do you tell whether a recurring UTi is a relapse or a reinfection?

A

Relapse if symptoms recur within 2 weeks. In this case, you want to treat with a longer course of antibiotics

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10
Q

SHould you treat asymptomatic bacteriuria?

A

NO.

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11
Q

What are your options for treating a lower UTI?

A
  1. TMP-Sulfamethoxazole
  2. Cipro
  3. Nitrofurantoin
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12
Q

What are your options for treating an upper UTi?

A

CIPRO empirically.

–Can prophylaxis with cipor, cephalex, TMP-SMX

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13
Q

How do you treat an inpatient with an upper UTI?

A

Aminoglycoside and Ampicillin
Cipro
Zosyn

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14
Q

At what age can adolescents be treated confidentially?

A

15-24

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15
Q

Clue cells=buzzword for:

A

vaginosis

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16
Q

Strawberry cervix=buzzword for

A

trichomonas

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17
Q

Genital ulcers are caused by:

A

herpes or syphilis

18
Q

Causes of vaginitis

A

candidiasis
bacterial vaginosis
trichomoniasis

19
Q

Which serovars of chlamydia trachomatis causes STD infections?

A

D-K serovars

20
Q

What forms does chlamydia take?

A

Elementary body is extracellular

Reticulate body is intracellular

21
Q

What do you need to grow chlamydia?

A

Tissue culture==it’s an INTRA cellular organism! Can’t grow on its own. It also has NO peptidoglycan wall

22
Q

How does chlamydia get into cells?

A

Receptor mediated endocytosis

23
Q

What does chlamydia cause in the neonate?

A 
Inclusion conjunctivitis (cobblestoning)
Also interstitial pneumonia
24
Q

How do you diagnose chlamydia?

A

PCR
ligase chain rxn
NAAT

25
Q

How do you treat chlamydia?

A

Azithromycin (1 dose)

Doxy (bid for 7 days)

26
Q

Who should you screen for chlamydia?

A
  1. females < 25
  2. Males < 30, military,
  3. history of STD
  4. Retest 3 months after tx
  5. HIV +
27
Q

How does N. Gonorrhea cause infection? (pathogenesis)

A

Uses pili to attach to mucosal surfaces. Also IgA protease

  • -Most women are asymptomatic
  • -BUT men are commonly symptomatic
28
Q

What are the different types of invasive gonococcal disease?

A
  1. PID
  2. Perihepatitis (Fitz-hugh-curtis)
  3. Disseminated infection
  4. septic arthritis
29
Q

How do you diagnose gonorrhea?

A

PCR, ligase, nAAT

30
Q

What can you grow gonorrhea on in culture?

A

If sterile: Chocolate agar

If NOT sterile: Thayer martin medium (Vanc, colistin, nystatin)

31
Q

How do you treat gonorrhea?

A

Ceftriaxone

ALSO concurrently treat for chlamydia with azithro/doxy

32
Q

Syphilis–how do you diagnose this?

A
  1. darkfield microscopy or direct immunofluorescence

2. VDRL (do not culture! Also cannot see under microscopy)

33
Q

What kind of a bug is chlamydia (gm pos/neg)?

A

Gram negative obligate intracellular organism. Cannot make ATP

34
Q

What can gonorrhea ferment?

A

ONLY glucose

35
Q

Which form of chlamydia is infectious?

A

The elementary body form

36
Q

Which organisms cause urethritis?

A

Gonorrhea/chlamydia

–Trichomonas causes cervicitis and epididymitis but not urethritis

37
Q

When would you want to treat an asymptomatic UTI?

A

In a pregnant woman

38
Q

What does secondary syphilis look like?

A

Rash on hands and feet

Condyloma and lymphadenopathy

39
Q

What does tertiary syphilis look like?

A
  1. Benign gammatous lesions (granulomas)
  2. Ascending aortitis
  3. Neurosyphilis
40
Q

What are the signs of neurosyphilis?

A
  1. Asymptomatic (but abnormal CSF)
  2. meningitis
  3. tabes dorsalis (demyelination of posterior columns)

ID (24 decks)

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