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2013-09-15 20:30:57

Exam I UTI
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  1. bacteruria Sx
    • fever
    • frequency
    • dysuria
    • suprapubic tenderness
    • hematuria
    • foul smell
  2. Cystitis Sx
    • frequent urination
    • dysuria
    • occasional hematuria
  3. pyelonephritis Sx
    cystitis sx + flank pain, fever/chills, N/V, increased WBC, casts in urine
  4. what are the atypical Sx in the elderly
    • altered mental status
    • weakness
  5. what is a relapse
    recurrence of bacteriuria caused by same microorganism
  6. what is a reinfection
    recurrence of baceriuria with DIFFERENT organism
  7. how long does it talk for reinfection to occur
    weeks-months later
  8. how long does it take for a relapse to occur
    within weeks after previous therapy
  9. what is the most common route of UTI infection
    ascending rout
  10. what is the least common UTI route of infection
  11. what are the risk factors for UTI
    • Neurologic disorders
    • Age
    • Pregnancy
    • Others
    • Female gender
    • urologic intrumentation
    • urinary obstruction
    • DM
  12. what are the two items to look for in a urinalysis
    • leukocyte esterase
    • nitrites
  13. what are the exceptions to the > 105 CFU urine culture
    • males
    • symptomatic
    • already on antibiotics
  14. how long should you treat uncomplicated UTI
    3 days
  15. what are the drugs used to treat uncomp UTI
    • bactrim
    • quinolones
    • nitrofurantoin
  16. what drugs should be used to treat uncomp UTI in pregnant pts
    • b-lactams (amox/clavu, cephalein)
    • nitrofurantoin
  17. what drugs should be avoided in pregnant pts with uncomplicated UTI
    • quinolones
    • bactrim
    • tetracyclines
    • ampicillin PO
  18. how long is the drug therapy for nitrofurantioin in uncomplicated cystitis
    5-7 days
  19. how long should you treat uncomplicated UTI male, elderly, or recent abx use pts
    > 7 days
  20. how do you assess uncomplicated cystitis
    • allergy history
    • availability
    • tolerance
  21. what drugs are used to treat uncomp pyelonephritis and how long is the Tx
    • bactrim for 14 days (BID)
    • quinolones 5-7 days
  22. difference between complicaed and uncomplicated pyelonephritis
    pathogens similar, but possibly more hospital acquired organisms:

    • pseudomonas
    • enterobacter
    • s. aureus
  23. what are the drugs used to treat complicated pyelonephritis and how long is the Tx
    • drugs with G- coverage:
    • ceftriaxone
    • quinolones
    • aminoglycosides

    treat for longer period: 7-14 days
  24. which cephalosporin cannot be used for treating complicated pyeolonephritits but is constantly prescribed by physicians
  25. which cephalosporin can be used to treat complicated pyeolnephritis
    fortaz (ceftrazidime)
  26. when should IV therapy be used for the tx of complicated pyelonephritis
    for at least the first couple of days of therapy
  27. how long is the tx for acute prostatitis
    4 weeks
  28. how long is the tx for chronic prostatitis
    • more difficult to treat
    • treat 1 - 4 months
  29. what type of organism is found in pts infected with prostatitis
    G- organisms
  30. what type of infection occurs in pts < 35 yrs old with epididymitis
    gonoccocal/chlamydial infection
  31. what is the drug regimen for the treatment of epididymitis for pts < 35 yrs
    ceftriaxone 250 mg IM x 1 followed by dxycycline PO x 7 days
  32. what type of organisms are found in epididymitis in pts over 35 yrs
    enteric organisms
  33. how long should pts be treated for epididymitis if the pt is > 35 yrs
    10 - 28 days
  34. what is phenazopyridine
    urinary tract analgesic
  35. how is cranberries effective
    may prevent E.coli from adhering
  36. when should a pt be considered for chronic prophylaxis
    if they have > or = 3 episodes per year
  37. which drugs are used for prophylactic tx of UTI
    • low dose:
    • bactrim
    • nitrofurantoin
    • quinolones
  38. what is the most common type of hospital acquired infection
  39. CFU for CA-UTI
    103 cfu/ml
  40. tx of CA-UTI
    • remove catheter
    • 7 days for prompt response
    • 10 - 14 days for  delayed response