Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Renal 21 UTI
Dugan: Urinary Tract Infections
| Question | Answer |
|---|---|
| Urinary Tract Infection Epidemiology | Community More common in women, particularly pregnant women In elderly: 15% females 10% males |
| Urinary Tract Infection Epidemiology | Nosocomial Instrumentation and catherization Up to 10% of hospitalized pts develop UTI |
| Normal Flora in Women | Lactobacillus Coag - Staph Streptococcus Mycoplasma Enteric Gram- |
| Normal Flora in Men | Coag - Staph Streptococcus Mycoplasma |
| Community Acquired Infections (Agents) | E.coli 80% Proteus-Morganella Klebsiella Staph. saprophyticus Enterococcus |
| Nosocomial Infections (Agents) | E. Coli 20% Entercoccus Pseudomonas Proteus Klebsiella Staphlococcus coag- |
| Escherichia coli | Most commonly isolated organism Called coliforms as they live in the colon Biochem: Indole+, Lactose fermentation+, Voges-Proskauer-, Lysine decarboxy+ |
| Host defenses | Micturition pH of urine Phagocytosis Urinary secretory IgA Prostatic secretions |
| Entry of Pathogens | Ascending 95-99% Descending Rare |
| Bacterial Virulence Factors | Adherence- P&type1 Hemolysins Aerobactin Capsular polysac K antigen (E.coli) Lipopolysaccharide |
| Female predisposing factors | Anatomy Pregnancy Sex Nonsecretor status Diaphragm/spermicide use Increase cellular adherence |
| Other Predisposing Factors for Males and Females | Stones/calculi Urethral strictures Bladder tumor Instrumentation Systemic disease |
| Classifications of Symptomatic Infections | Urethritis: dysuria and mucopurilent discharge-STI Cystitis: dysuria, frequency and urgency from enteric organisms Pyelonephritis: fever, flank pain, systemic signs (WBC casts) |
| Asymptomatic Infections | Bacteruria >10^5 30-40% of all elderly pts Generally don't treat Treat before Sx and during pregnancy Treat in presence of WBCs |
| Uncomplicated UTI | Pt has normal UT w/o underlying disease 80-90% E.coli Most are relatively sensitive to antimicrobioal agents Most common: Sex. act. women |
| Complicated UTI | Pt has functionally, metabolically, anatomically abnormal UT Broad range of bacteria Many are MDR Maybe >1 organism |
| Complicated UTI Suspect Populations | Young child/neonate Young adult male Pregnant female Catheterized pt Elderly |
| Localization of Infections | Good H&P Selective uretheral catheterization with quantitative culture |
| Spectrum Collection | *Clean catch midstream* Indwelling cath Bilateral urethral cath Suprapubic aspiration |
| Specimen Transport | Refrigeration @ 4C Commercial kits: -Boric acid -Sodium formate |
| Quantitative Culture Media | Blood agar (red) MacConkey Agar (pink) |
| Microorganisms that don't grow on BAP or MAC | Anaerobes, Chlamydia Gardnerella, Herpes Haemophilus, Mycoplasma Neisseria, Most yeasts |
| Treatment Acute Uncomplicated Cystitis | 3 day TMP/SMX Nitrofurantion If recurrent, eliminate infxn first then TMP/SMX |
| Treatment Child <5 y/o | 7 day TMP/SMX Nitrofurantion |
| Treatment Acute Uncpomplicated Pyelonephritis | Mild/mod: 7 days TMP/SMX Fluoroquinolone Severe: PE until fever is gone Fluro, or Gent+Amp Piper-tazobactam, ect Followed by 14-21 days oral |
| Prevention | Urinate frequently Drink plenty of liquids Wipe front to back Cotton underwear Showers Empty bladder after sex |
Created by:
bcriss
Popular Medical sets