UTIs

Question 1

Why should you consider the ureters as vascular structures?

Answer 1

Vasodilators help pass stones

Question 2

What is the normal level of post-void residual?

Answer 2

Less than 50ccs

Question 3

What type of bacteria usually causes sepsis 2/2 catheter placement?

Answer 3

Gram negatives (e. coli)

Question 4

What defines the upper and lower urinary tract?

Answer 4

Upper = above the vesicoureteral valves

Lower = below that

Question 5

What are complicated UTIs?

Answer 5

Involvement of tissue structures with instruments or co-morbidities

Question 6

What are uncomplicated UTIs?

Answer 6

Local effects only or upper tract without comorbidities

Question 7

What is inflammation of the glans of the penis called?

Answer 7

Balanitis

Question 8

What is a recurrence of UTIs?

Answer 8

3 or more UTIs per year

Question 9

What is a relapse of a UTI?

Answer 9

Recurrence in a month with same organism

Question 10

What is a reinfection?

Answer 10

Relapse in more than one month, but usually a difference organism

Question 11

Who usually have UTIs as neonates: males or females?

Answer 11

Males d/t urogenital malformations

Question 12

Which gender usually has UTIs in the child bearing years?

Answer 12

Women

Question 13

When does the incidence of UTIs become equal in each gender? Why?

Answer 13

Above 50 years of age d/t prostate problems

Question 14

What are the risk factors for UTIs (2)?

Answer 14

Reflux or prior h/o them

Question 15

Does circumcision increase the incidence of UTIs?

Answer 15

Yes

Question 16

Does sex increase the incidence of UTIs?

Answer 16

Yes

Question 17

What defines a UTI?

Answer 17

More than 10^5 organisms in a clean catch of urine

Question 18

What are the two usual causative agents in UTIs?

Answer 18

E. coli

S saprophyticus

Question 19

Do you treat asymptomatic UTIs?

Answer 19

If pregnant, or prior to renal transplant, but otherwise no

Question 20

What are the four different types of urine samples?

Answer 20

random
First void
Clean catch
Catheter

Question 21

Why discard the first 15-20 mL of urine with a cath?

Answer 21

Not sterile catch

Question 22

What are the bacteria findings from a urine catch reported as?

Answer 22

Yes or no, a lot or a little

Question 23

How do you determine a contaminated specimen of urine?

Answer 23

Epithelial cells = WBC

Question 24

What is the significance of pH in urine testing?

Answer 24

bacteria with urease will have high pH

Question 25

What are the 6 major components reported in a urine dipstick analysis?

Answer 25

``` pH Sp grav nitrites Leukocyte esterase WBC RBC ```

Question 26

What is the normal urine sp gravity?

Answer 26

1.010

Question 27

What is the significance of nitrites in the urine?

Answer 27

Some gram negative bacteria will convert nitrates to nitrites

Question 28

What, generally, do the first and second samples of urine represent?

Answer 28

Environment of the urethra and bladder respectively

Question 29

What STDs cause dysuria?

Answer 29

GC or Chlamydia

Question 30

What is the treatment for GC/chlamydia?

Answer 30

Ceftriaxone or Azithromycin

Question 31

Why is it important to distinguish infection from irritation with UTIs?

Answer 31

Irritation will not respond well to abx

Question 32

What are the usual infectious causes of UTIs?

Answer 32

e.coli Chlamydia Gonorrhea herpes

Question 33

Why is a wash better than a swab to diagnose UTIs?

Answer 33

wash off more than swab off

Question 34

How many days are needed for abx to work with UTIs?

Answer 34

3

Question 35

What type of abx can cause urethral candidiasis?

Answer 35

Cephalosporins

Question 36

Why get lactate with sepsis?

Answer 36

Measures tissue level perfusion

Question 37

What is emphysematous pyelonephritis?

Answer 37

kidney infection with a gas-producing bacteria

Question 38

true or false: foleys are appropriate to drain urine with a pyelonephritis pt

Answer 38

false

Question 39

Pyelonephritis with a stone = ?

Answer 39

Intrabdominal abscess