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What are the patient characteristics associated with Acute uncomplicated cystitis/urethritis (lower tract infection)?
- typically women
- 18-menopause
- non-pregnant
- often related to sexual intercourse
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What are the symptoms of acute uncomplicated cystitis/uretrhitis (lower tract infection)?
- dysuria
- urgency
- frequency
- nocturia
- suprapubic heaviness
- gross hematuria
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What pathogens cause Acute uncomplicated urethritis/cystitis (lower tract infections)?
- E. coli (85%)
- Staph saprophyticus (10%)(peds)
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What is the treatment for Acute uncomplicated urethritis/cystitis (lower tract infection)?
- Bactrim x 3d (short-course tx)
- FQ x 3d
- Nitrofurantoin x 7d
- B-lactams (Cephs really) x 3d
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What are the symptoms associated with Acute uncomplicated pyelonephritis (upper tract infection)?
- flank pain
- fever
- nausea
- vomiting
- malaise
- gross hematuria
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What are the patient characteristics associated with Acute uncomplicated pyelonephritis (upper tract infection)?
- Male or female
- mild-moderate (uncomplicated)
- severe (complicated)
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What pathogens cause Acute uncomplicated pyelonephritis?
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What is the treatment for Acute uncomplicated pyelontphritis?
- FQ x 14d
- Bactrim x 14d
- Amoxicillin x 14d
- Amoxicillin clavulanate x 14d
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What pathogens cause Acute complicated pyelonephritis?
- E. coli
- P. mirabilis
- K. pneumoniae
- P. aeruginosa
- E. faecalis
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What is the treatment for Acute complicated pyelonephritis?
- FQ x 14d
- Extended spectrum pen + AG (Amp, Amox, Carbenicillin, Ticarcillin, Pip)
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What is considered recurrent UTI?
at least 3 episodes/yr
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What is the treatment for recurrent UTI?
- Bactrim 1 SS qd
- Bactrim 2 DS upon onset
- Bactrim 1 DS post coitus
- topical estrogens (women >65)
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What are the patient characteristics associated with asymptomatic bacteriuria?
- pregnant
- diabetes
- catheterized
- elderly
- children
- Not always an infection
- "hold the Foley"
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What are the patient characteristics associated with symptomatic abacteriuria?
NOT a UTI!!!!
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What is the treatment for UTI in pregnant patients?
- Amox-Clav x 7d (not really)
- Ceph x 7d
- Bactrim x 7d (not 3rd trimester)
- Nitrofurantoin x 7d
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What are the patient characteristics associated with prostatitis?
- men 35-64yo
- typically after instrumentation (scope, biopsy, Foley) or anal intercourse
- complications: bacteremia, abscess, chronic prostatitis, urine obstruction
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What are the symptoms associated with prostatitis?
- UTI
- abd/lowback/penile/perirectal/perineal pain
- warm, swollen, tender
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What pathogens cause prostatitis?
- E. coli
- K. pneumonia
- Proteus spp
- P. aeruginosa
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What is the treatment for prostatitis?
- FQ x 4-6wks
- Bactrim x 4-6wks (not very good)
- Acute prostatitis may require IV tx initially
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