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Duke PA Urinary Tract Infections

_____ is predominantly an infection of sexually active individuals, usually men. urethritis
The symptoms are pain and burning during urination, and some discharge may occur at the urethral meatus urethritis
Urethritis may be _____ in origin or it may be caused by Chlamydia trachomatis or Ureaplasma urealyticum gonococcal
Bacterial infection of the urinary bladder cystitis
bacterial infection of teh kidney pyelonephritis
Cystitis and pyelonephritis are more common in ____ women
instrumentation (catheterization, cystoscopy), pregnancy, anatomic abnormalities of the genitourinary tract, and diabetes mellitus UTI risk factors
Incidence of cystitis and pyelonephritis increase with ____ age
Most UTI's ascend through a _____ portal entry in the urethra
____ is the most common isolate in UTI's E. coli
Suprapubic pain, discomfort or burning sensation on urination and frequent urination common symptoms of UTI
Back or flank pain, or the occurance of a fever suggests involvement of the kidneys, or prostate
Older or debilitated patients with UTI may present with no symptoms referable to the urinary tract
Older or debilitated patients with UTI may present with fever, altered mental status, hypotension
UTI urinalysis may show WBC's, RBC's and slightly increased protein
The presence of at least 10 WBC's/mm(3) of midstream urine by counting chamber is defined as pyuria pyuria
the presence of WBC casts in an infected urine sample indicates the presence of pyelonephritis
Urine for culture should not be obtained from a catheter bag
______ tests are not essential for patients with uncomplicated cystitis unless treatment fails culture and sensitivity
Recurrent UTI's in men should always raise the suspicion for anatomic alterations of the urinary tract
Possible UTI organisms that will not grow on routine culture medium Chlamydia, N. gonorrhoeae, or Ureaplasma
if a UTI is unresponsive to the first course of antibiotics patients should receive doxycycline or azithromycin
empiric therapy for uncomplicated UTI's can be a short course of amoxicillin, TMP-SMZ, or ciprofloxacin
short course therapy is not recommended for women with a history of UTI's
All patients with complicated UTI's should have repeat urine cultures 1-2 weeks after treatement completion
should be performed in all men with UTI (escept those with urethritis) because of the hight frequency of correctable anatomic lesions in this population urologic evaluation
if a 6 week course of antibiotics active against the bacterial isolate is not effective then the possiblility of _____ should be investigated structural abnormalities or prostatic infection
Urine cultures showing bacterial growth in the absence of symptoms asymptomatic bacteriuria
does not need to be treated in otherwise healthy/non-pregnant individuals asymptomatic bacteriuria
The occurence of pyuria in the abscence of bacterial growth on culture of urine sterile pyuria
If this condition occurs in the patient with lower UTI symptoms then chlamydia, gonoccocal infections, vaginitis, or herpes simplex infection shoulb be considered sterile pyuria
symptoms of back or perineal pain and fever are common with prostatitis
Acute prostatitis may be caused by gonococcus but is most often caused by gram-negative bacilli
Prostatic abscesses can be drained with ultrasound guidance
Should be suggested in men with recurrent UTI chronic prostatitis
Treatment of _____ is hampered by poor penetration by most antimicrobials chronic prostatitis
fever, flank pain, CVA tenderness, N/V signs and symptoms of upper UTI
dysuria, frequency, urgency, suprapubic pain, =/- hematuria signs and symptoms of lower UTI
vaginal d/c or odor, pruritis, dyspareunia, external dysuria (labial pain with urination), but no frequency or urgency vaginitis
dysuria and frequency with no vaginal disharge or irritation is ___ in more than 90% of cases cystitis
presence of WBC casts indicate upper tract infection
common in UTI but not urethritis or cervicitis hematuria
indicates presence of bacteria, more specific than sensitive nitrites
an enzyme made by neutrophils in response to bacteria leukocyte esterase
as a general rule ____ is a UTI occuring in a healthy young nonpregnant woman uncomplicated acute cystitis
septra TMP-SMX
don't give ____ for acute cystitis amox-clav
first line for acute uncomplicated cystitis TMP-SMX
best course length of antibiotics for uncomplicated UTI three day short course
should be considered as and alternative to TMP-SMX in the treatment of uncomplicated acute cystitis nitrofurantoin
macrobid nitrofurantoin
big guns used for complicated infections/allergy to TMP-SMX, risk factors for TMP-SMX resistance fluoroquinolones
used to treat symptoms of acute cystitis-is not an antibiotic phenazopyridine
Pyridium phenazopyridine
An infection occurring in anyone OTHER than a healthy young non-pregnant woman complicated UTI
urine culture is essential with complicated UTI
nonsecretor phenotype higher risk of UTI
strongest risk factor for UTI frequency of intercourse
in postmenopausal women ____ can be an effective prophylaxis because ti leads to an increase of lactobacilli and a decrease in E. coli intravaginal estriol cream
in recurrent UTI ___ evaluation should be done if concerned about structural or functional abnormality of GU tract urological evaluation
when doing a urological evaluation start with CT or renal US
treatment of cystitis in men 7-days of TMP-SMX, trimethoprim, or FQ
Created by: bwyche