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40 Cards in this Set
- Front
- Back
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why do men end up getting more UTIs after 50
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prostate enlargement
and kidney stones :( |
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Nosocomial UTI are often caused by what?
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Catheterization
10% increase chance each day |
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community acquired infections that cause UTI are normally due to what bug?
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E. Coli
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what other bugs make up the remaining 20% of community acquired UTI (just take a look)
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Proteus-Morganella
Klebsiella-Enterobacter Staphylococcus saprophyticus Enterococcus (Grp D strep) |
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what are 2 important biochemical characteristics about E. Coli
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Indole positive
ferment lactose |
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Enterococcus (Grp D strep)
Pseudomonas aeruginosa Proteus-Morganella Klebsiella-Enterobacter Staphylococcus coag neg make up the majority of what type of UTI? |
nosocomial infections
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what is one of the most common causes of nosocomial infections (bug)? how does it occur
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pseudomonas
catheterization |
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What is one of the reason biggest reasons for the start of UTI?
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blocking micturition
normally you slough off some of the cells to stop bacterial |
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what is normal pH of urine? what pH does bacteria like to grow in?
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normal: 5
bacteria grow in: 7 |
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what Ig is a host defense for UTI?
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Secretory IgA
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most commonly how do pathogens end up causing infection? from what?
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Ascending pathway (usually feces)
goes up |
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This is not normal, but if you have an infection in your urinary pathway that was descending (aka coming from an infected body site) what would be the cause?
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Staph
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most important bacterial virulence factor for UTI?
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Adherence!
P and type 1 fimbriae |
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The more compromised the host defenses, the ____ _____ required of E. coli to cause an infection
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less virulence
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what is nonsecretor status? who is this likely in?
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ABO antigens are not present in secretion... which lowers the host defense against UTI
likley in Biddies |
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most common cause of urethritis?
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Trichomonas
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dysuria and mucopurulent discharge caused by sexually transmitted agents =
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Urethritis
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dysuria, frequency, and urgency caused by multiplication of enteric organisms within the bladder
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Cystitis
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what are often used as a rapid screening test in office for cystitis?
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LN Strip (nitrite and leukocyte esterase)
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A positive LN strip is indicative of what normally?
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E. coli
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fever, flank pain, and systemic signs caused by invasion of the kidney tissue by enteric organisms, would see white blood cell casts
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Pyelonephritis
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Cystitis vs Pyelonephritis?
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Cystitis: lower UTI-- dysuria, frequency, and urgency caused by multiplication of enteric organisms within the bladder
Pyelonephritis -- upper UTI--fever, flank pain, and systemic signs caused by invasion of the kidney tissue by enteric organisms, would see white blood cell casts |
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Patient has normal urinary tract without underlying disease =
how many organisms present? what is it/are they? typical pt? |
Uncomplicated Urinary Tract Infections
1 organism E. coli Sexually active WOMAN |
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Patient has functionally, metabolically, or anatomically abnormal urinary tract =
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Complicated Urinary Tract Infections
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the following are pts that you are likely to see what in?
Young child or neonate Young adult male Pregnant female Catheterized patients Elderly |
Complicated Urinary Tract Infections
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will you see pseduomonas for a normal uncomplicated UTI?
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shit naw!
look for E.coli in that |
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Upper urinary tract stones that involve the renal pelvis and extend into at least 2 calyces are classified as....
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Staghorn Calculi
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What are staghorn calculi composed of?
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75% are composed of a struvite-carbonate-apatite matrix
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What accounts for 10 to 15 % of all stones?
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Struvite stones (staghorn calculi)
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Struvite stones are most often caused by?
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Proteus
(can also be Klebsiella) |
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what are 2 important ways to prevent your urine specimen from being altered
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Refrigeration at 4oC
Commercial urine transport kit (contains boric acid and sodium formate) |
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Blood agar is used to grow?
MacConkey agar is used to grow? |
Blood agar= G+
MacConkey=G- |
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how does cranberry juice help prevent UTI?
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Cranberries contain 2 compounds with anti-adherence properties that prevent fimbriated E. coli from adhering to uroepithelial cells:
Fructose Proanthocyanidin |
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Tx for Acute uncomplicated cystitis in women (non recurrent)
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Short course (3 da) oral TMP/SMX1 or Nitrofurantoin 1o Fluoroquinolone 2nd
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Tx for Acute uncomplicated cystitis in women (recurrent)
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Eradicate infection then TMP/SMX
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tx for acute cystitis in child < 5
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TMP/SMX
Nitrofurantoin |
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tx for Acute uncomplicated pyelonephitis (mild-moderate)
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7 days oral
TMP/SMX Fluoroquinolone |
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tx for Acute uncomplicated pyelonephitis (severe hospitalized)
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Parenteral until fever gone Fluoroquinilone or Genta+amp Ceftriaxone Piperacillin
Followed by 14 days oral |
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tx for Complicated UTI mild-mod
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10-14 days oral Fluoroquinolone
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tx for Complicated UTI severe
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Parenteral till fever gone Amp + gentamicin Piperacillin-tazobactam Ticarcillin-clavulanate Imipenem-cilastin Fluoroquinolone Followed by 14-21 days oral
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