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What results would make you suspect UTI? - Answer--
cloudy urine clarity
-positive leukocytes esterase
-positive nitrites (signals gram - organism, may have false
-)
-Protein: 1+-4+ (kidney problems)
-Alkaline urine (PH 6.5-8)
-RBCs may be present
Who should receive prophylaxis for recurrent UTI? -
Answer--2 or more symptomatic UTIs w/in 6 months
-3 or > within 12 months
When should prophylaxis for recurrent UTI be intiated? -
Answer-After previous UTI resolution is confirmed
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Antibiotic regimin for recurrent UTI prophylaxis. - Answer--
Daily dosing for 6 months
-Post-coital prophylaxis
-self medication (3-4 days of therapy when symptoms
being
What is the clinical presentation of uncomplicated UTI? -
Answer--Dysuria
-urinary frequency & urgency
-hematuria
-low back or suprapubic pain/tenderness
-elderly=AMS
WHat is the oral treatment for acute uncomplicated UTI? -
Answer--Bactrim 1 DS BID x 3
-Cefdinir 500 mg BID x 5
-Nitrofurantoin 100 mg BID x 5
Patient education for uncomplicated UTI - Answer-
•Complete the antibiotic regimen
•Proper hygiene
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•Drink plenty of water (8 - 8oz glasses)
•Cotton undergarments
•Empty bladder after sexual intercourse
•Empty bladder frequently
•No tub baths or bubble baths
Non-cyclic pain of 6 or more months duration that is
localized to the pelvis and is sufficient severity to cause
functional disability - Answer-Chronic Pelvic Pain
3 most common disorders causing Chronic pelvic pain? -
Answer-Endometriosis
Intersitial cystitis
IBS
Chronic inflammatory condition of the bladder clinically
characterized by irritable voiding symptoms or urgency
and frequency, in the absence of objective evidence of
another disease. - Answer-Interstitial cystitis (IC)
What worsens IC related CPP? - Answer-Intercouse and
perimentrual status.
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Pathogenesis of IC - Answer-Dysfunction of the GAG layer
What is the diagnostic criteria for IC? - Answer--diagnosis
of exclusion
-gyn
-ultrasound
-IVP
-cystoscopy
-PUF scale (>5, likely IC)
-intravesical potassium sensitivity test
What are potential causes of chronic infection/UTI? -
Answer--obstructions
-antibiotic-resistant bacteria ---- presence of multiple
strains of bacteria
What additional HPI questions would you want to ask a
patient with urinary complaints (dyuria, urgency, etc.)? -
Answer--fever
-N/V
-Pain (abdominal, pelvic, back)