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Cards In This Set
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>90% of UTIs are caused by what type of bacteria?
*Specifically most common? *Next 4? |
Aerobic gram neg
*E.coli *Enterobacter, Klebsiella, Proteus, Pseudomonas |
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Gram + agent that may cause UTI in sexually active women?
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Staphyloccous saprophyticus
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Gram + agent that may cause UTI in men and women in indwelling urinary catheters? Another agent?
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Enterococci
Candida |
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4 virulence factors that allow some organisms to colonize the urinary tract?
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Pili/fimbriae
Hemolysin (often with strains that --> pyelonephritis) Aerobactin (an Fe-scavenging molecule) Urease |
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Risk factors that increase UTI incidence amongst women? (4)
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History of recent UTI
Sexual activity Use of diaphragm and/or spermicide failiure to void after intercourse |
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Risk factor that increases UTI incidence amongst men?
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Abnormal urinary tract, eg BPH
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3 common symptoms of lower UTIs? (cystitis) And one that's less common?
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Frequency, urgency, dysuria
gross hematuria |
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Though upper UTIs (pyelonephritis) may be present with symtpoms of bladder irritation, what distinguishs them from lower tract infections? 3
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Fever
Flank pain abodminal symptoms of pain, nausea, vomiting |
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How does physical exam differ between men and women?
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Men: base dx on hx (other than finding fever, flank tenderness)
Women: need to consider possible PID...do pelvic exam and take dx specimens if there's evdience of urethritis or vaginitis |
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DDx?
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Vulvovaginits
gonococcal or nongonoccal urethritis bladder calculi bladder tumor chemical- or drug-induced cystitis prostatits |
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Most imp lab tests to dx UTI?
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Urinalysis and urine culture
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Cover-slipped slide of unspun urine can reveal what in UTI?
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Luekocytes + organisms + WBC casts (pyelonephritis)
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What if you can't examine urine under a microscope? Look for what?
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Do urine dipstick. WBCs + nitrites correlates with UTI in 90% of cases.
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When do you not really need urine culture?
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Uncomplicated cases of lower UTI (causative agent and antibitoic susceptibility is predictable)
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When should you do a urine culture?
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* pts iwth possible upper tract disease
*pts with known or suspected anatomic abnormalities of the urinary tract *pts with recent antibiotic treatment (within 4 weeks) for UTI and recurrent symptoms following empirical tx *pts with atypical symptoms |
