Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
18 Cards in this Set
- Front
- Back
|
Define "Recurrent UTI"
|
2 uncomplicated UTI <= 6 months
3 + urine cultures <= 12 months affects 25% of women with UTIs |
|
|
For recurrent UTI define:
1) Relpase 2) Reinfection |
1) infection with different organism
2) infection with previous organism despite a) negative interval culture b) >=2wk time period. |
|
|
List some other organisms/infections that might mimic acute UTI
|
gonorrhea
Chlamydia BV genital HSV Candida |
|
|
List the primary and then secondary organisms involved in recurrent UTI
|
E. coli (80%)
S. saprophyticus K. pneumoniae Proteus rarely: enterococci, citrobacter |
|
|
How might uropathogenic E. coli avoid host immune responses and antibiotic therapy?
(i.e. where could a reservoir be?) |
intracellular
|
|
|
List RFs for recurrent UTI for:
a) premenopausal women b) postmenopausal women |
a)
frequency of intercourse, use of a spermicide new sexual partners increased tone of the external sphincter history of UTI <15a maternal history of UTI b) POP (prolapse) Incontinence high PVR DM History of UTI |
|
|
List factors in evaluating a women with recurrent UTI
|
Anatomical exam
?prolapse Estrogenization of tissues PVR ?DM --> random glucose |
|
|
In the presence of symptoms, what CFU should be used to assess for UTI?
What number of epithelial cells suggest vaginal contamination? |
1000 (10^3)
>= 20 |
|
|
True or False:
ampicillin or amoxicillin is a reasonable first-line empiric choic for antibiotic treatment of UTI/recurrent UTI? |
False
~20% of E. coli is resistant to these meds |
|
|
List 2 regimens for treatment of acute uncomplicated UTI.
|
Septra x 3d
unless DM, recent UTI, recent Septra Macrobid x >=7d Fluoroquinolone x 3d Fosfomycin x 1 dose |
|
|
List strategies (behavioural, medical, diet) to reduce/prevent recurrent UTI
|
No spermicidal lubricant
Vaginal estrogen Cranberry pills/juice Antibiotic prophylaxis Accupuncture |
|
|
What women should receive further urological workup?
e.g. cytso, imaging |
Persistent hematuria
Persistent non-E.coli |
|
|
List options for long-term antibiotic prophylaxis of recurrent UTI
|
Nitrofurantoin (50-100mg OD)
Cephalexin (125-250mg OD) Norfloxacin (200mg OD) Ciprofloxacin 125mg OD Septra 40/200mg OD |
|
|
List 3 strategies for antibiotic prophylaxis of recurrent UTI
|
1) continuous (6-12 months)
2) post-coital 3) self-diagnosis |
|
|
What percentage of women with recurrent UTI are able to self-diagnose?
(i.e. based on comparing to culturing?) |
85%
|
|
|
List so adverse effects of continuous nitrofurantoin use
|
aplastic anemia
polyneuritis acute liver damage pulmonary toxicity |
|
|
When should continuous antibiotic prophylaxis of recurrent UTI be offered, and for what duration?
|
2 UTI <= 6 months
3 UTI <= 12 months duration: 6- to 12-month |
|
|
What agents are recommended for continuous prophylaxis in pregnancy?
|
Nitrofurantoin 50mg OD
Cephalexin 250mg OD |
