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