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22 Cards in this Set
- Front
- Back
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List 6 causes of dysuria in women
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Cystitis; urethritis; vaginitis; chemicals/irritants; estrogen deficiency; and pregnancy.
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List 3 causes of dysuria in men
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Urethritis; cystitis; and prostatitis.
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What is the most sensitive aspect of the urinalysis for diagnosing a UTI
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WBC count >5-10/HPF on/clean-void urine or leukocyte esterase on urine “dip stick”; a
microscopic examination is the most sensitive and the presence of nitrite is highly specific for diagnosing a UTI. |
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What medication is used for standard three day treatment of UTI? What about one day treatment?
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Trimethoprim-sulfamethoxazole (Bactrim DS) -1 tab twice daily
Fluoroquinolone Ciprofloxacin - 250mg twice daily Fosfomycin (Monurol) 3gm once |
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Which patients require longer therapy for UTI treatment? (There are 7 answers)
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Male
Unreliable patient Pregnant Diabetic Recent or recurrent UTI Pyelonephritis Elderly |
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Why do Fps order urine cultures for women with UTIs?
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Due to changing resistance patterns, especially
E.coli to trimethoprim-sulfamethoxazole, many providers continue the practice of culturing the urine for almost all women who present with uncomplicated UTI's. |
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In patients symptomatic for UTI, how many colonies are required to initiate treatment?
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100 colonies are needed to initiate therapy. The traditional cutoff of 100,000 colonies may miss many of these women.
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What are the three treatment options for women with recurrent UTIs?
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-patient-initiated therapy for symptomatic episodes.
-If temporally related to coitus, then post-coital prophylaxis -If no relation to coitus, then daily prophylaxis. |
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How many UTIs per year warrants the diagnosis of recurrent UTI?
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>/= to 3 UTIs yearly
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Discuss UTI diagnosis and management in men.
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1. Always do urine cultures
2. Treat urine infections for 7-10 days 3. Treat prostatitis for 4-6 weeks (suspect if patient presents with fever; rectal, lower back or perineum pain; frequency; and or signs of urinary obstruction. |
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How do you diagnose and manage UTIs in children?
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1. Under two months require hospitalization and parenteral antibiotics.
2. Urine cultures should always be obtained regardless of negative urinalysis. 3. Further imaging studies are indicated for children under 2 years of age and for children older than 2 with recurrent UTI's or an episode of pyelonepehritis. |
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How do you diagnose and manage UTIs in the elderly?
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1. Diagnosis is more difficult because older adults can be asymptomatic or present
with other manifestations of illness such as mental status changes. 2. Treat elderly women with UTI for 7 days 3. Treat older men for 10-14 days |
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How long do you treat older women with UTIs?
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7 days
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How long do you treat older men with UTIs?
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10-14 days
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How long do you treat prostatitis in a male?
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4-6 weeks
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What are three common causes of vaginitis diagnosed by wet prep?
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1. Vulvovaginal candidiasis
2. Trichomoniasis 3. Bacterial vaginosis |
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How do you treat vulvovaginal candidiasis?
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1. clotrimazole or miconazole cream by vaginal applicator h.s. x 7 days
2. If recurrent, oral one-dose fluconazole 150 mg |
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How do you treat trichomoniasis? Do you need to treat the partner?
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Metronidazole - 2 gm stat for patient and partner (“trich” is an STD)
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How do you treat bacterial vaginosis?
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1. metronidazole - 2 gm stat or 500 mg BID x 5d
2. vaginal metronidazole (Metrogel) 5 gm p.v. BID x 5d |
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How do you treat recurrent vulvovaginal candidiasis?
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One oral dose of fluconazole 150 mg
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When selecting an appropriate diagnostic test what criteria should a clinician follow?
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Identify the gold standard test and the specificity/sensitivity of the test in question.
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What does PICO stand for?
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Population, Intervention, Comparison, Outcome (used to determine the best treatment)
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