3. TOPIC: Signs & Symptoms Explain the cause of each of the following common sig

Question

3. TOPIC: Signs & Symptoms Explain the cause of each of the following common signs and symptoms of a UTI: A. pain with urination B. constant sensation of the need to urinate C. orange to red color of urine 4. TOPIC: Diagnosis and Treatment A. Name 2 diagnostic tests used in the clinic to diagnose a UTI. What is the purpose of each test? What kind of information does each test provide? B. Name 2 common medications prescribed to treat UTis. Describe how each medication works to treat the infection or relieve signs & symptoms?

Explanation / Answer

3.

a) pain in urination could be due to following causes

Urinary tract infection (infection in any part of urinary system)

Kidney infection

   Urethritis

   Kidney stone (hard deposits)

  

   b)

UTI is the most common cause behind the symptoms like inc in urge to urinate

Also it could be some specific diseases like painful bladdder syndrome, benign prostatic hyperplasia, overeactive bladder or diabetes insipidus

c) foods like blackberries etc. and some medications for tuberculosis may turn urine to reddish in colour

Though in severe glomerular injuries there’d colour may be due to rbc in blood but that would be considered with other symptoms and history

   a). urine analysis(with urine The threshold for establishing true UTI includes finding 2-5 or more white blood cells (WBCs) or 15 bacteria per high-power field (HPF) in a centrifuged urine sediment.

As with females, a positive nitrite test is poorly sensitive but highly specific for UTI, and false-positives are uncommon.

Bacteriuria without pyuria suggests contamination or colonization. Pyuria without bacteriuria suggests nongonococcal urethritis (NGU), genitourinary tuberculosis, stone disease, or malignancy.

Gram stain of an uncentrifuged clean-catch midstream urine sample reveals the presence of 1 bacterium per oil-immersion field, this represents 10,000 bacteria/mL of urine. A specimen (5mL) that has been centrifuged for 5 minutes at 2000 revolutions per minute (rpm) and examined under high power after Gram staining allows for the identification of bacteria in lower numbers. In general, Gram staining has a sensitivity of 90% and a specificity of 88%.

The older patient who appears toxic, has diabetes, or is immunocompromised may be at risk for emphysematous pyelonephritis; radiographic studies (eg, kidney, ureters, bladder [KUB]) may be necessary to exclude this possibility.

b)

Fluroquinolones (eg ciprofloxacin)

Ciprofloxacin is a fluoroquinolone with activity against pseudomonads, streptococci, methicillin-resistant S aureus (MRSA), S epidermidis, and most gram-negative organisms, but it has no activity against anaerobes. This agent inhibits bacterial deoxyribonucleic acid (DNA) synthesis and growth. Ciprofloxacin is indicated for urinary tract infections (UTIs) and chronic bacterial prostatitis.

Trimethoprim-sulfamethoxazole

Trimethoprim -sulfamethoxazole (TMP-SMZ) is a combination antimicrobial agent designed to take advantage of synergy between TMP and sulfonamides. The antibacterial activity of TMP-SMZ includes common urinary tract pathogens, except Pseudomonas aeruginosa.

SMZ inhibits dihydropteroate synthetase, preventing incorporation of para-aminobenzoic acid (PABA) into dihydrofolate and subsequent synthesis of tetrahydrofolate. This agent has broad bacteriostatic activity against aerobic gram-positive and gram-negative organisms, with little activity against anaerobes; unfortunately, SMZ does not penetrate well into the kidney.

Ampicillin is an aminopenicillin beta lactam that impairs cell wall synthesis in actively dividing bacteria by binding to and inhibiting penicillin-binding proteins in the cell wall. This agent has enhanced activity against anaerobes and gram-negative aerobes and is generally used in combination with an aminoglycoside for empiric or directed activity against E faecalis urinary tract infections (UTIs).

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