N6637 Week 6 Reproductive; STIs, women's health|Clinical
Assessment of Urinary, Genitourinary, and Sexually Transmitted
Infections: High-Yield Diagnostic, Pathophysiologic, and
Therapeutic Concepts in UTIs, Pyelonephritis, Hematuria,
Urolithiasis, Epididymitis, Testicular Torsion, Cervical Dysplasia,
HPV, Gonorrhea, Chlamydia, Trichomoniasis, Herpes, Syphilis,
Chancroid, LGV, PID, Bacterial Vaginosis, and Vulvovaginal
Candidiasis Exam Questions Verified and Provided with Complete
A+ Graded Rationales Latest Updated 2026
UTIs
One of the most common disorders seen in primary care.
◦Women > men due to anatomic proximity to perianal area
More common in women with a life time probability of 50%
3-5% of women will have multiple recurrences
One of the leading causes of gram-negative bacteremia
Etiologic agents in UTI
Escherichia coli (80%), Women
Proteus, men
Gram-positive organisms only account for about 5-10% of uncomplicated UTI.
Staphylococcus saprophyticus common in young women.
symptoms of UTI
Frequency of urination and dysuria.
Urgency with possible minor leakage or complete incontinence.
,Urine is commonly cloudy and foul smelling.
Suprapubic pressure or pain.
Hematuria in a severe infection.
Foul smelling urine
UTI risk factors women
◦History of recent UTI,
◦Increased sexual activity,
◦Use of a diaphragm and a spermacide,
◦Failure to void after intercourse.
◦Catherizations
◦Diabetes
◦Pregnancy
◦Retaining urine despite urge to void
UTI risk factors men
◦Residual urine (prostate enlargement)
◦Neurogenic bladder
◦Calculi
◦Prostatitis
◦Catherizations
◦Anal intercourse
◦Diabetes
◦Immunosuppression
Classification of UTIs
,Uncomplicated
Recurrent
Complicated
Asymptomatic bacteriuria*
Pyelonephritis
UTI differential diagnosis
Vaginal infection (gardenerella, candida)
Prostatitis (men)
Cervicitis
Herpes
STI or PID (chlamydia or GC)
Urethritis
Acute urethral syndrome
Interstitial cystitis
Epididymitis
physical findings: uncomplicated UTI
Urinary meatus erythematous/edematous
Negative costovertebral angle tenderness
Negative pelvic or prostate exam
May have suprapubic tenderness on palpation
UTI diagnostics
Complete urinalysis or urine dip
, Urine culture should be obtained in those who have been recently hospitalized, are seriously ill or
febrile, pregnant and male patients.
Bacteria count over 100,000 per ml
Leukocyte esterase dipstick-positive
Urine dipstick positive for leukocytes, suggestive UTI (correlate with symptoms)
If urine pH is elevated, proteus may be the causative agent
UTI diagnostics: imaging
Usually not necessary for uncomplicated UTI's that respond to treatment.
Ultrasound: Quick and safe. Detects kidney scars, cortical scars, stones and hydronephrosis.
CT: Good for detecting perinephric abscess and as a prelude to operations of the kidney.
Treatment for uncomplicated (3 day regiment): women UTI
1.Nitrofurantoin ER: 100mg BID x5 days
2.TMP-SMX 160/800 (Bactrim DS): one tablet Q12 x 3 days.
3.Beta-lactam coverage if above are not options (amox-clavulanate)
4.Quinolone(Cipro): 250mg BID x 3 days
1.Fluroquinolone if beta-lactam not an option
Pregnancy treatment UTI
◦Nitrofurantoin 100 mg bid for 7-10 days (1st trimester)
◦Amoxicillin 250-500 mg tid-qid for 7-10 days
◦Cephalosporin (Keflex) 500 mg qid for 7-10 days
men treatment UTI
Assessment of Urinary, Genitourinary, and Sexually Transmitted
Infections: High-Yield Diagnostic, Pathophysiologic, and
Therapeutic Concepts in UTIs, Pyelonephritis, Hematuria,
Urolithiasis, Epididymitis, Testicular Torsion, Cervical Dysplasia,
HPV, Gonorrhea, Chlamydia, Trichomoniasis, Herpes, Syphilis,
Chancroid, LGV, PID, Bacterial Vaginosis, and Vulvovaginal
Candidiasis Exam Questions Verified and Provided with Complete
A+ Graded Rationales Latest Updated 2026
UTIs
One of the most common disorders seen in primary care.
◦Women > men due to anatomic proximity to perianal area
More common in women with a life time probability of 50%
3-5% of women will have multiple recurrences
One of the leading causes of gram-negative bacteremia
Etiologic agents in UTI
Escherichia coli (80%), Women
Proteus, men
Gram-positive organisms only account for about 5-10% of uncomplicated UTI.
Staphylococcus saprophyticus common in young women.
symptoms of UTI
Frequency of urination and dysuria.
Urgency with possible minor leakage or complete incontinence.
,Urine is commonly cloudy and foul smelling.
Suprapubic pressure or pain.
Hematuria in a severe infection.
Foul smelling urine
UTI risk factors women
◦History of recent UTI,
◦Increased sexual activity,
◦Use of a diaphragm and a spermacide,
◦Failure to void after intercourse.
◦Catherizations
◦Diabetes
◦Pregnancy
◦Retaining urine despite urge to void
UTI risk factors men
◦Residual urine (prostate enlargement)
◦Neurogenic bladder
◦Calculi
◦Prostatitis
◦Catherizations
◦Anal intercourse
◦Diabetes
◦Immunosuppression
Classification of UTIs
,Uncomplicated
Recurrent
Complicated
Asymptomatic bacteriuria*
Pyelonephritis
UTI differential diagnosis
Vaginal infection (gardenerella, candida)
Prostatitis (men)
Cervicitis
Herpes
STI or PID (chlamydia or GC)
Urethritis
Acute urethral syndrome
Interstitial cystitis
Epididymitis
physical findings: uncomplicated UTI
Urinary meatus erythematous/edematous
Negative costovertebral angle tenderness
Negative pelvic or prostate exam
May have suprapubic tenderness on palpation
UTI diagnostics
Complete urinalysis or urine dip
, Urine culture should be obtained in those who have been recently hospitalized, are seriously ill or
febrile, pregnant and male patients.
Bacteria count over 100,000 per ml
Leukocyte esterase dipstick-positive
Urine dipstick positive for leukocytes, suggestive UTI (correlate with symptoms)
If urine pH is elevated, proteus may be the causative agent
UTI diagnostics: imaging
Usually not necessary for uncomplicated UTI's that respond to treatment.
Ultrasound: Quick and safe. Detects kidney scars, cortical scars, stones and hydronephrosis.
CT: Good for detecting perinephric abscess and as a prelude to operations of the kidney.
Treatment for uncomplicated (3 day regiment): women UTI
1.Nitrofurantoin ER: 100mg BID x5 days
2.TMP-SMX 160/800 (Bactrim DS): one tablet Q12 x 3 days.
3.Beta-lactam coverage if above are not options (amox-clavulanate)
4.Quinolone(Cipro): 250mg BID x 3 days
1.Fluroquinolone if beta-lactam not an option
Pregnancy treatment UTI
◦Nitrofurantoin 100 mg bid for 7-10 days (1st trimester)
◦Amoxicillin 250-500 mg tid-qid for 7-10 days
◦Cephalosporin (Keflex) 500 mg qid for 7-10 days
men treatment UTI
