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Flashcards in UTIs Deck (26):
1

pyelonephritis symptoms

Flank/back pain

high fever, chills

headache

nausea / vomiting

spetic shock possible

+/- cystitis symptoms

2

most common pathogens in children

enterobacter spp

 

klebsiella spp

2

non-Abx prophylaxis

Methanamine salts - converted to formaldehyde and ammonia in acidic urine 

Cranberry juice - may help with prevention (block adhereance of e-coli?)

Ascorbic acid - acidifies urine (unlikely)

3

body responds to UTI via ___ and ____

exfoliation and neutrophil recruitment

3

causes of persistence

Inadequate therapy

chonic bacteria prostatitis (infxn habored in prostate)

urethral diverticula)

fistula

urinary stasis (reflux, poor emptyting)

4

Nitrate dipstick utility

detects action of bacteria on dietary nitrates via nitrate reductasse

High specitivity, LOW sensitivity

rules in UTI, but negative does not rule out

4

reinfection = 

 

persistence = 

reinfection - from bacteria outside UT (New infection)

 

peristence - bacteria focus within UT (previous infxn doesn't resolve)

5

bladder inflammation and resulting pain due to 

leukocyte infiltration of bladder

6

bood dipstick detects

peroxidase activity of erythrocytes 

(rxn catalyzed by myeoglobin and hemoglobin, possible false positives)

6

uncomplicated treatment course

 

complicated

uncomplicated - 3-5d Abx (sometimes up to 7d)

 

complicated - correct fxnl defect, Abx for 7d, often 10-14d

8

chemical strip test utitlity

urinary blood 

pus (leukocytes) 

bacteria,

pH

specific gravity

protein 

glucose

9

complicated UTI pathogens

E coli

ENterobacteriacease (Klebm enterobacter, proteus, morganell, providencia)

Gram negativs - peseudomonas, acinetobacter

Gram positives - S aurea, Coag neg staph, GBSS, eteroccoci, Corynebacterium)

Yeast and gungi (candidia torulopsis)

Parasites (schistosoma, haematobium)

10

do not treat asymptomatic bacteriruria EXCEPT in cases of 

pregnancy (prevent pre-term)

kids with reflux

12

microscopic analysis utility

definitve test for blood (RBCs) and pus (leukocytes)

 

false positives in dipsticks confirmed

13

complicated vs uncomplicated

complicated - structural or fxnl abnl of GU OR

presence of comorbidity which increases risk of infection or failure of therapy

 

 

14

imagin indicated for

complicated (some) 

predisposing factors (GU anomalies, Hx of stones)

lack of response to therapy

recurrent pyelonephritis)

(CT is best for stones)

15

risk factors for asymptomatic bacturiria

elderly women

pregnancy

diabetes

use of cathetars

spinal cord injury

(generally do not treat)

16

Adjunvant tests for UTI

Blood testing - CBC, basic chemistry (creatinine, electroyltes

 

Imaging for posible hydronephrosis, stones, abscess

18

senstivity testing for UTI treatment response (levels)

sensitive - will likely respond to typical ABx does

Intermediate - may reequire higher ABx concentrations

Resistant - response not likely at safe levels

20

uncomplicated UTI pathogens

E coli

S Saphrophyticus

Enterobacteriaceasse (Klebsiella, Enterobacter, Proteus, Salmonella, Shigella)

Gram Positives ( S aureus, GBBS, enteroccoci)

21

species of particular importance to female UT

lactobacillus

22

most common UTI pathogen in adults

 

most common nosocomial

adults - uropathogenic e-coli (UPEC)

 

nosocmial - pseudomonas aerginosa

23

descending UTI due to

hematogenous spread

24

UA dipstick LE detects

leukocyte esterae - detects pyuria (WBCs in urine)

25

in UT, luekocytes only found in ____ during times of health

urethra

26

cystitis presenting symptoms

dysuria

frequency and urgency

suprapubic pain

cloudy/smelly urine

heamturia (gross is more concerning)