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Urology NP
Info & Q: NP EXAM
| Question | Answer |
|---|---|
| Most bugs that cause UTIs are what type? | Gram Neg |
| What UTI bug is Gram Pos? | Staph saprophyticus |
| What is the story with UTI caused by S. saprophyticus (Gram +)? | The only Gram Pos UTI organism; seen in pts that are sexually active with multiple partners |
| Dx UA with >10,000 bacteria, NO urinary tract discomfort? | asymptomatic bacteriuria |
| Manage asymptomatic bacteriuria? | encourage fluids (in most Healthy inds, consider co-morbids) |
| How much bacteria for Dx: In/Out Cath? Midstream clean catch? | In/Out Cath - 1000 Midstream Clean Catch - 100,000 |
| What lab do we get with pt that has freq UTI? | Urine Culture |
| Who produces Nitrates? | Humans - from protein metabolism |
| Who produces Nitrites? | Bacteria - from eating Nitrates and spitting out Nitrites (typically E. coli) |
| What are Leukocyte Esterase? | an enzyme found in WBC |
| What does positve Leukocytes in urine mean? | infection in the bladder or "nearby" |
| Interpret UA: +Bld, +Nitrite, +Leuko | UTI with hematuria |
| Interpret UA: -Bld, -Nitrite, +Leuko | 1. UTI but from bug that does not eat Nitrates (note lack of Nitrites seen with E. Coli) ie; 2. Might be infection NOT in bladder but "nearby" ie: STD 3. Had bladder infection and increase fluids; speciman dilute |
| Interpret UA: +Bld, -Nitrite, -Leuko | Neg for UTI |
| Interpret UA: -Bld, -Nitrite, -Leuko but C/O freq and urge | 1. check sugar 2. UPT 3. STD, vaginitis 4. Dilute urine thus neg 5. ANTIBIOTIC - watch those old meds at home |
| Name 3 antibiotics to tx UTIs: | 1. Bactrim DS (Sulfa) 2. Macrodantin (Nitrofurantoin) 3. Ciprofloxacin (Quinolone) |
| What pts do we avoid giving quinolones and why? | 1. Age <18 (achilles tendon rupture; disrupt bone and cart form) 2. Pregnant |
| How long do we tx UTI with antibiotics? | 1. Women uncomplicated: 3 days 2. Women complicated or co-morbid: 7-10 days 3. Men: 7-10 days |
| What is the significance of an Antispasmotic for UTI? | Bacteria cling to wall of bladder and cause erosion (hematuria) thus bladder contraction which is "spasm" of bladder; helps with comfort when C/O freq, urge, burn |
| Name 2 Antispasmotics used for UTI? | 1. Pyridium 2. Urispas |
| What is SE of Pyridum? | Turns urine orange or red |
| What are drugs of choice (2) for tx UTI in pregancy? | 1. Macrodantin 2. Cefuroxime |
| When you see CVA tenderness think? | Acute Pyelonephritis |
| What lab MUST you get with Pyelonephritis? | Urine "CULTURE"; don't want to guess the bug |
| Antibiotic of choice to tx Pyelonephritis? | 1. Quinolone (don't start with Bactrim) 2. Augmentin (amoxicillin-clavulanate) |
| Stress incontinence is caused by (2)? | 1. age 2. decrease estrogen |
| Kegel exercises and a "voiding" diary are used in pt with what type of urinary incontinece? | Stress incontinence |
| When you see back or flank pain that "WAXES & WANES" think? | Kidstone (urolithiasis) |
| Trick to pass kidney stone? | Fluids and Flomax (Alpha Blocker) |
Created by:
dprest
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