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Pharm Pro and Epid
Pharm - II
| Question | Answer |
|---|---|
| Two types of bacterial prostatitis | acute and chronic |
| What is commonly associated with prostatitis | recurrent infections in men > 30 |
| Patho of prostatitis | refluc of infected or sterile urine (chemical prostatitis, non-bacterial, sexual intercourse, indwelling and condom catherization, any urethral instrumentation |
| What is TURP | transurethral prostate resection |
| What are MC prostatis bacteria in ABP, CBP | A: Gm- enteric organsims most frequent (E. coli) B: E. coli |
| CP of ABP | high fever, chills, malaise, myalgia, localized pain, Freq, urg, dys, noct, retention |
| What is contraindicated in ABP | prostatic massage will express a purulent discharge will spread to systemic infection |
| How do we dz CBP | more difficult diagnose, recurrent UTIs w/ same pathogen |
| Presenting sx of CBP | voiding difficulties (freq, urg,dyrs) LBP, perineal and suprapubic pain many adults asymptomatic |
| Dx of ABP | CP, ↑ bacteriuria, midstream specimen cultre |
| Dx of CBP | urinary tract localization, sequential cultures |
| What are sequential cultures | VB1: 1st voided 10ml, 200ml later VB2: midstream culture→prostatic message EPS: prostatic secretions void: VBs: 1st voided 10 mil after message |
| Two abx classes to tx prostatitis | FQs and Bactrim |
| Why only two abx classes to tx prostatitis | hard to get to the prostate to tx |
| What ↑ the rate/amount of tx | ↑ inflammation, the more inflammation the more the abx can get to it like meningitis |
| What type of prostatitis is more easily tx | acute, d/t ↑ inflammation |
| Two MC pathogens for ABP <35yo | gonorrhorah and chlamydia |
| Which abx txs G and C | G: 3rd gen ceph C: doxy |
| What other things do we need to test in this category | tx partners, test for HIV |
| What is no longer recommended for gonococcal infx | FQs |
| MC pathogen for APB >35 | Enterobacteriaceae (GI) |
| Tx for uncomplicated ABP | FQ or Bactrim |
| What are adjunctive measures for ABP | analgesics, stool softners, adequate hydration and bed rest |
| If uncertain of pathogen, what should we do | do a C and a G test |
| Length of tx for UAPB, CAPC, and CPB | UAPB: 10 days, CABP: 10-14days, CBP: 4-6 and 4 weeks and Bactrim for 1-3m |
| Etiology of epididymitis | trauma, but usually 2 to infx (STD) |
| Where do non STD infx occur and likely pathogens | middle-aged men or older men, usually coliform or psedudomonas |
| CP of epididymitis | unilateral pain and swelling of scrotum, fever, urethral discharge, urinary sxs (prostatitis can be present as well) |
| Dx of epididymitis | culture voided urethral and midstream specimens |
| Supportive care for epididymitis | analgesics, bed rest with legs apart, elevate testes on a towel, scrotal support, non-constrictive lightweight clothing |
| What is PDPT | patient delievered partner therapy for G and C |
| Pros for PDPT | controlling occurrence of STIs, AMA states is can be done |
| Cons for PDPT | 1) potential liablility in tx for unseen pts 2) no screening for other STDs and prevention counseling 3) legality is not consistent in all states (is in MN) |
Created by:
becker15
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