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How does bacterial contamination of urine usually occur
retrograde movement of microorgamisms
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what is an ascending UTI infection
Pathogen-urethra-bladder-ureter-kidney
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enters the kidneys through blood and may cause pyelonephritis
blood-borne infection
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What is the most common cause of UTI
E. coli from fecal contamination
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Describe E. coli
- gram-negative bacilli
- normal intestinal flora
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What helps prevent one from getting a UTI
- washout phenomenon
- bactericidal effect of urea and low pH
- ureterovesical junction closes bladder(no reflux)
- prostate secreations-antimicrobial
- mucin layer- has mucopolysaccaride
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What increases ones chances of a UTI
- preagnancy
- scar tissue
- congenital defects
- reanal calculi
- vesicoureteral relux
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Why are women more commonly infected with UTI
- shorter urethra
- easy for fecal contaminents to enter
- frequent irritation-tampons,hygeine deodorants
- sexually active
- elderly & postmenopausal= less mucin
- estrogen decreases-mucin decreases
- changes in periurethral envirment-antibiotics
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How does mucin play a role in protecitng form UTI
provides a barrier between transitional epithelium and bacteria
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what is found in the normal female flora of the periurethral
lactobacillus
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What causes UTI in males
- older males w/prostatic hypertrophy and retention of urine
- teste or prostate infections that have spread
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What are common causes of UTI for both sexes
- incontinence-urine retention
- stasis of urine-urine obstruction
- immunosuppresion-decreased resistence
- diabetes-glycosuria, glucose=food for bacteria
- noscomial infections-cystoscopy, catheters
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inflammation of the bladder
most common UTI
cystitis
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what is the patho of cystitis
- bladder wall and urethra are inflammed
- bladder capacity reduced
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what are the signs of cystitis
- lower abdominal pain
- frequent and urgent urination
- dysuria-pain
- bacteriuria,hematuria,pyuria
- cloudy urine-leukocytes
- foul smell
- fever,maliase,nausea
- leukocytosis
- bladder spasms
- asymptomatic
- pelvic & lower back pain=ascending infection
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what are the diagnostic test for cystitis
- History
- Urinalysis-C&S, RBC, WBC
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How are infections diagnosed by a culture
specific organism counts of 100,000 bacteria/ml of urine
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What are the complications of cystitis
re-infection
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What is the treatment for cystitis
- antibiotics
- fluid increase
- prophylactic measure-cranberry juice
- follow up urinalysis
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what is the treatment for cystitis that most people fail to do
follow up urinalysis
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what is the prognosis for cystitis
good
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What is a warning sign of an ascending infection
pelvic and lower pack pain
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