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  1. _____ is predominantly an infection of sexually active individuals, usually men.
  2. The symptoms are pain and burning during urination, and some discharge may occur at the urethral meatus
  3. Urethritis may be _____ in origin or it may be caused by Chlamydia trachomatis or Ureaplasma urealyticum
  4. Bacterial infection of the urinary bladder
  5. bacterial infection of the kidney
  6. Cystitis and pyelonephritis are more common in ____
  7. instrumentation (catheterization, cystoscopy), pregnancy, anatomic abnormalities of the genitourinary tract, and diabetes mellitus
    UTI risk factors
  8. Incidence of cystitis and pyelonephritis increase with ____
  9. Most UTI's ascend through a _____
    portal entry in the urethra
  10. ____ is the most common isolate in UTI's
    E. coli
  11. Suprapubic pain, discomfort or burning sensation on urination and frequent urination
    common symptoms of UTI
  12. Back or flank pain, or the occurrence of a fever suggests involvement of the
    kidneys, or prostate
  13. Older or debilitated patients with UTI may present with
    no symptoms referable to the urinary tract
  14. Older or debilitated patients with UTI may present with
    fever, altered mental status, hypotension
  15. UTI urinalysis may show
    WBC's, RBC's and slightly increased protein
  16. The presence of at least 10 WBC's/mm(3) of midstream urine by counting chamber is defined as pyuria
  17. the presence of WBC casts in an infected urine sample indicates the presence of
  18. Urine for culture should not be obtained from a
    catheter bag
  19. ______ tests are not essential for patients with uncomplicated cystitis unless treatment fails
    culture and sensitivity
  20. Recurrent UTI's in men should always raise the suspicion for
    anatomic alterations of the urinary tract
  21. Possible UTI organisms that will not grow on routine culture medium
    Chlamydia, N. gonorrhoeae, or Ureaplasma
  22. if a UTI is unresponsive to the first course of antibiotics patients should receive
    doxycycline or azithromycin
  23. empiric therapy for uncomplicated UTI's can be
    a short course of amoxicillin, TMP-SMZ, or ciprofloxacin
  24. short course therapy is not recommended for
    women with a history of UTI's
  25. All patients with complicated UTI's should have
    repeat urine cultures 1-2 weeks after treatment completion
  26. should be performed in all men with UTI (except those with urethritis) because of the high frequency of correctable anatomic lesions in this population
    urologic evaluation
  27. if a 6 week course of antibiotics active against the bacterial isolate is not effective then the possibility of _____ should be investigated
    structural abnormalities or prostatic infection
  28. Urine cultures showing bacterial growth in the absence of symptoms
    asymptomatic bacteriuria
  29. does not need to be treated in otherwise healthy/non-pregnant individuals
    asymptomatic bacteriuria
  30. The occurrence of pyuria in the absence of bacterial growth on culture of urine
    sterile pyuria
  31. If this condition occurs in the patient with lower UTI symptoms then chlamydia, gonococcal infections, vaginitis, or herpes simplex infection should be considered
    sterile pyuria
  32. symptoms of back or perineal pain and fever are common with
  33. Acute prostatitis may be caused by gonococcus but is most often caused by
    gram-negative bacilli
  34. Prostatic abscesses can be
    drained with ultrasound guidance
  35. Should be suggested in men with recurrent UTI
    chronic prostatitis
  36. Treatment of _____ is hampered by poor penetration by most antimicrobials
    chronic prostatitis
  37. fever, flank pain, CVA tenderness, N/V
    signs and symptoms of upper UTI
  38. dysuria, frequency, urgency, suprapubic pain, =/- hematuria
    signs and symptoms of lower UTI
  39. vaginal d/c or odor, pruritus, dyspareunia, external dysuria (labial pain with urination), but no frequency or urgency
  40. dysuria and frequency with no vaginal discharge or irritation is ___ in more than 90% of cases
  41. presence of WBC casts indicate
    upper tract infection
  42. common in UTI but not urethritis or cervicitis
  43. indicates presence of bacteria, more specific than sensitive
  44. an enzyme made by neutrophils in response to bacteria
    leukocyte esterase
  45. as a general rule ____ is a UTI occurring in a healthy young nonpregnant woman
    uncomplicated acute cystitis
  46. Septra
  47. don't give ____ for acute cystitis
  48. first line for acute uncomplicated cystitis
  49. best course length of antibiotics for uncomplicated UTI
    three day short course
  50. should be considered as and alternative to TMP-SMX in the treatment of uncomplicated acute cystitis
  51. Macrobid
  52. big guns used for complicated infections/allergy to TMP-SMX, risk factors for TMP-SMX resistance
  53. used to treat symptoms of acute cystitis-is not an antibiotic
  54. Pyridium
  55. An infection occurring in anyone OTHER than a healthy young non-pregnant woman
    complicated UTI
  56. urine culture is essential with
    complicated UTI
  57. nonsecretor phenotype
    higher risk of UTI
  58. strongest risk factor for UTI
    frequency of intercourse
  59. in postmenopausal women ____ can be an effective prophylaxis because ti leads to an increase of lactobacilli and a decrease in E. coli
    intravaginal estriol cream
  60. in recurrent UTI ___ evaluation should be done if concerned about structural or functional abnormality of GU tract
    urological evaluation
  61. when doing a urological evaluation start with
    CT or renal US
  62. treatment of cystitis in men
    7-days of TMP-SMX, trimethoprim, or FQ
  63. Normal appearance
  64. normal color
    amber yellow
  65. normal odor
  66. normal pH
    4.6-8.0 avg 6.0
  67. normal protein ___ mg/dL
  68. normal protein ___ mg/24 hr at rest
  69. normal protein ___ mg/24 hr during exercise
  70. normal specific gravity adult
  71. normal specific gravity elderly
    values decrease with age
  72. normal specific gravity newborn
  73. normal leukocyte esterase
  74. normal nitrates
  75. normal ketones
  76. normal bilirubin
  77. normal urobilinogen ___ Ehrlich unit/mL
  78. normal crystals
  79. normal casts
  80. normal glucose (fresh specimen)
  81. normal glucose (24 hr)___mg/day
  82. normal glucose (24 hr)___mmol/day (SI units)
  83. normal WBC ___ per low-power field
  84. normal WBC casts
  85. normal RBC's
    < or = 2
  86. normal RBC casts
  87. ____ infection may cause green urine
  88. patients with ____ may have the strong sweet smell of acetone
    diabetic ketoacidosis
  89. Bacteria, UTI, or a diet high in citrus fruits or vegetables may cause
    increased urine pH
  90. starvation, dehydration, or a diet high in meat products or cranberries may cause
    decreased urine pH
  91. to prevent or treat urinary calculi from xanthine, cystine, uric acid, and calcium oxalate urine pH should be kept
  92. to treat urinary calculi from calcium carbonate, calcium phosphate, and magnesium phosphate urine pH should be kept
  93. the combination of proteinuria and edema is known as
    nephrotic syndrome
  94. probably the most important indicator of kidney disease
  95. proteinuria in pregnant women can indicate
  96. a measure of the concentration of particles in the urine
    specific gravity
  97. used to evaluate the concentrating and excretory powers of the kidneys
    specific gravity
  98. high specific gravity indicates
    concentrated urine
  99. low specific gravity indicates
    dilute urine
  100. when a person is dehydrated one can expect the specific gravity of that person to be abnormally
  101. Positive results indicate UTI
    leukocyte esterase
  102. is a screening test for identification of UTI's
  103. Nitrite test is about ___% accurate
  104. leukocyte esterase is about ___% accurate
  105. _____ is usually associated with poorly controlled diabetes
  106. can be present in the following conditions; alcoholism, fasting, starvation, high protein diets, isopranol ingestion
  107. may occur in acute febrile illnesses, especially in infants and children
  108. obstruction of a bile duct by a gallstone will lead to
    elevated urine bilirubin
  109. bilirubin in the urine will color it
    dark yellow or orange
  110. by themselves, crystals cause no symptoms until
    they form stones
  111. stones only produce symptoms when they
    obstruct the urinary tract
  112. crystals may indicate
    the formation of a renal stone
  113. occur in the urine of patients with parathyroid abnormalities or malabsorption states
    phosphate and calcium oxalate crystals
  114. clumps of materials or cells that form in the renal distal and collection tubules, where material is maximally concentrated
  115. for ___ to form the pH must be acidic and the urine concentrated
  116. conglomerations of protein and are indicative of proteinuria, a few may be present after strenuous exercise
    hyaline casts
  117. sodium, potassium, chloride, carbon dioxide, BUN, creatinine, glucose, GFR
    components of the chem 7 at Duke
  118. normal sodium ____ mmol/L
  119. normal potassium ____ mmol/L
  120. normal chloride ____ mmol/L
  121. normal carbon dioxide ____ mmol/L
  122. normal urea nitrogen ___ mg/dL
  123. normal creatinine ___ mg/dL
  124. increased BUN is called
  125. decreased renal blood flow
    prerenal uremia
  126. urea backed up into blood from lower urinary obstruction
    postrenal uremia
  127. diseases or toxicities that affect glomeruli, renal microvascular or tubules
    renal uremia
  128. proportional to muscle mass, usually higher in men than women
    serum creatinine
  129. stable in health at a ratio of 1:10
    BUN:creatinine ratio
  130. lower in liver disease, starvation, acute tubular necrosis
    BUN:creatinine ratio
  131. Higher (with normal Cr) in prerenal uremia, high protein diet, GI bleed
    BUN:creatinine ratio
  132. Higher (with high Cr is called “azotemia”) in renal disease & failure
    BUN:creatinine ratio
  133. can be caused by preeclampsia, multiple myeloma, temperature extremes, fever, exercise, position, stress
  134. main cause of glycosuria
  135. product of fat breakdown
  136. product of hemoglobin breakdown
  137. a few hyaline casts on urinalysis is
  138. RBC casts
    acute glomerulonephritis
  139. WBC casts
    acute pyelonephritis
  140. epithelial casts
    tubular necrosis
  141. granular casts
    nephrotic syndrome, pyelonephritis
  142. waxy casts
    tubular atrophy, renal failure
  143. bacterial casts
  144. fatty casts
    proteinuria, nephrotic syndrome
  145. ___ can be estimated by blood level of creatinine
  146. ___ indicates level of kidney function
  147. ___ calculations do not apply in acute situations or in patients on dialysis
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