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26 Cards in this Set
- Front
- Back
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What types of infections are considered UTIs?
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Lower tract infection(acute cystitis, or upper tract infection(acute pyelonephritis, kidney)
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What is the major mode of bacterial entry in the genitourinary tract?
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Ascending periurethral infection. Hematogenous spread is also seen in immunocompromised patients and neonates.
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What are common symptoms of uncomplicated acute cystitis?
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Dysuria, increased urinary urgency and suprapubic pain.
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What is the ost common cause of uncomplicated acute cystitis?
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E. coli causes 80-85% of all uncomplicated acute cystitis.
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Which family of bacteria that causes UTIs is known for reducing nitrates to nitites?
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Enterobacteriacae, which includes the bacteria E. coli, causes nitrites to appear in urine analysis.
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What is an important cause of uncomplicated acute cystitis in newly sexually active females?
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Staph. saprophyticus, although E. coli is still more common.
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Why are females more susceptible to UTIs than males?
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Females have a shorter urethra, which is in close proximity to the rectum.
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Why are certain females more susceptible to recurrent UTIs?
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A subset of females experience recurrent UTIs due to increased mucosal receptivity to bacterial adhesion.
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What is the treatment of choice for uncomplicated acute cystitis?
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Three day treatment with TMP-SMX or fluoroquinolones. Single dose therapy sterilizes the urine but allows a recrudescent infection from periurethral tissue.
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What are complicated UTIs?
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Complicated UTIs are associated with UTI, diabees, male sex, pregnancy, hospital or catheter related infections, and anatomical/surgical variants.
Bacterial resistance is more common and requires prolonged treatment with broad spectrum antibiotics. Uncomplicated UTIs are limited to simple cystitis in healthy women. |
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Why does a UTI in a male warant further workup including imaging studies of the urinary tract?
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In males, UTIs(especially recurrent UTIs) are frequently associated with anatomical abnormalities such as urinary obstruction due to benign prostatic hyperplasia and urethral stricture.
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What common cause of UTIs is known to have swarming motility?
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Proteus mirabilis
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What bacteria are associated with struvite(staghorn renal calculi)?
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Ureaplasma urealyticum, P. mirabilis, Corynebacterium urealyticum, pseudomonas, Klebsiella, Staph, and Mycoplasma.
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What enzyme allows them to form struvite stones?
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Urease which cleaves urea forming ammonia, which raises the pH leading to precipitation of phosphate, carbonate and magnesium.
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What enzyme allows them to form struvite stones?
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Urease which cleaves urea forming ammonia, which raises the pH leading to precipitation of phosphate, carbonate and magnesium.
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What are common causes of catheter related acute cystitis?
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E.coli, Serratia marcesens, Enterobacter cloacae, Klebsiella pneumonia, P. mirabilis and Pseudomonas aeruginosa
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What is the treatment of choice for complicated acute cystitis?
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Minimum 7-14 days treatment with fluoroquinolones.
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What are common symptoms and findings of upper tract infection?
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Fevers, chills, flank pain and costovertebral angle(CVA) tenderness. Additionally, the presence of white cell casts on urinalysis supports a diagnosis of pyelonephritis. Sometimes, these features are absent and upper tract infection is diagnosed after failure of short course therapy for apparant lower tract infection.
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What is the most common cause of acute pyelonephritis?
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E. coli>70%(second most common S. saprophyticus.
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What is an important virulence factor for E. coli that enables it to cause acute cystitis and acute pyelonephritis
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P. pili, which help E. coli bind to uroepithelial cells. Almost all E. coli, which cause acute pyelonephritis have P-pili.
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How is acute pyelonephritis treated?
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Commonly with oral fluoroquinolones or parental ceftriaxone for 14 days. However, therapy should be based on results of urine culture with sensitivities.
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What are the signa and symptoms of acute prostatitis?
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Fever, chills, malaise, obstructive symptoms, dysuria.
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What are common causes of acute prostatis?
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Same organisms that cause acute cystitis, mainly, E. coli and proteus.
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How is acute prostatitis treated?
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Patients require long term therapy that should be organism directed. If possible, TMP-SMX or quinolones should be used because of better penetration into the prostate.
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How does chronic prostatitis present?
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Many are asymptomatic or havesigns of a lower UTI.
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How is chronic prostatitis treated?
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Minimum 6 weeks of fluoroquinolones(ideally guided by sensitivities from urine or semen culture).
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