NR 507 (Advanced Pathophysiology) EXAM STUDY GUIDE LATEST
UPDATED RATED A.
1. 1. What are the two main functions 1. Filtration and collection
of the kidney Review diagram for
anatomical structures
2. Women are at a higher risk for the True
development of a UTI because of
having a shorter urethra. True/False
3. Which of the following can help to Increase water consumption
prevent a UTI?
Increase water consumption
Use spermicides during sexual in-
tercourse
Taking more Vitamin D
Douching to prevent the growth of
bacteria
4. A symptom of a lower urinary tract Urgency
infection includes:
Fever
Flank pain
Urgency
Decreased Urination
5. Which of the following is true re- Can be caused by a structural urinary
garding a complicated urinary tract tract disorder
infection?
It is usually asymptomatic
Can be caused by a structural uri-
nary tract disorder
Bacteria are located mostly in the
, NR 507 (Advanced Pathophysiology) EXAM STUDY GUIDE LATEST
UPDATED RATED A.
lower urinary tract
Is associated with young adults
8. Which of the following is a risk fac- Pregnancy
tor for the development of a urinary
tract infection (UTI)?
Perimenopause
Frequent showering
Marathon running
Pregnancy
9. 1. Where do bacteria commonly 1. Bacteria from the gut can invade
come from in UTI's the urinary epithelium to cause in-
2. Where can a UTI occur? flammation and infection
3. It is more common for women to 2. anywhere along the urinary tract
develop a UTI especially when such as the urethra, bladder, ureter,
or kidney
3. pregnant, sexually active, during
post-menopause with estrogen-defi-
ciency and when being treated with
antibiotics where the normal bacteria
flora is diminished
10. 1. Escherichia coli can bind to cells 1. A biofilm is any group of microor-
in the lower urinary tract and hide ganisms that allow them to stick to
from the immune cells. The bacteria one another and adhere to surfaces
can form biofilms-what is this? that help them survive.
2. Describe the pathophysiology of 2. First, bacteria enter and conta-
a UTI that can lead to septic shock minate the lower urinary tract. This
or bacterimia causes the colonization of bacteria in
Note the diagram btw a male & fe- the urethra and the bladder. If the UTI
male urinary tracts (who's is much progresses the bacteria can ascend
shorter) to the kidneys and colonize there. At
this point, the infection becomes an
upper UTI. From there, if left untreat-
ed, the bacteria can spread into the
circulation via the renal veins causing
bacteremia
, NR 507 (Advanced Pathophysiology) EXAM STUDY GUIDE LATEST
UPDATED RATED A.
11. UTI risk factors 1. During pregnancy, progesterone
1. For women, pregnancy is a risk relaxes smooth muscle that causes
factor. why? stasis of urine, allowing the bacteria
2. The female ureter is shorter and to colonize
3. Post-menopausal women are also 2. allows for the entrance of bacteria
at risk because into the urethra.
4. Sexual intercourse is a risk factor 3. lack of estrogen results in vaginal
especially if women use and urethral dryness promoting an
5. Indwelling urinary catheterization environment for bacteria growth.
is also a major cause of a UTI 4. spermicides
5. Fibrinogen accumulates on the
catheter which provides an ideal
environment for the attachment of
uropathogens that then form biofilms.
This results in epithelial damage
12. Lower vs. Upper Tract Disorders 1. urethra (urethritis) or bladder (cys-
1. Lower UTI's include what parts of titis). In males, the cystitis may be
the urinary tract associated with prostatitis.
2. In a lower urinary tract disorder, 2. urgency associated with burning
the individual experiences (blank) on urination. frequency, dysuria, and
Other common symptoms include suprapubic pain. The urine may also
3. initially, a urine dipstick can appear cloudy and have an odor.
be performed to identify hematuria, 3. is highly specific for bacterial infec-
proteinuria, and the presence of ni- tion
trites. The presence of nitrites 4. culture and sensitivity (C&S) test
4. an individual can have a negative and microscopy
urine dipstick but still have a UTI. 5. a white blood cell (WBC) count of
If this is the case, then the NP can greater than 5000 high power field
send the urine for a (hpf) and hematuria
5. On microscopic exam of the urine,
a patient with cystitis will have
, NR 507 (Advanced Pathophysiology) EXAM STUDY GUIDE LATEST
UPDATED RATED A.
13. 1. An infection of the lower urinary 1. pyelonephritis.
tract can progress to an upper uri- 2. all the symptoms associated with
nary tract infection if the bacteria cystitis plus fever, flank pain, cos-
ascends from the bladder to the kid- tovertebral angle (CVA) tenderness,
ney. The condition is nausea, and vomiting. Malaise is also
2. The signs and symptoms of a common complaint
pyelonephritis include 3. vomiting, flank pain and fever
3. Think of the symptoms of 4. there can also be signs of shock
pyelonephritis in a classic triad: 5. WBC casts
4. if the infection has entered the
circulation from the kidney via the
renal vein
5. For the patient with pyelonephri-
tis, the urine will present with
14. Uncomplicated vs. Complicated Uri- 1. renal function is normal, urine re-
nary Tract Infections (UTI) sults may confirm a UTI, but the pa-
1. A UTI may be classified as compli- tient denies symptoms, no antibiotic
cated or uncomplicated in terms of is prescribed
its severity. An uncomplicated UTI 2. renal function and an abnormality
indicates that in the renal tract
2. In a complicated UTI, there is de-
creased
15. Un-Complicated UTI 1. the normal urinary tract
1. Occurs in the normal urinary tract 2. a short course of antibiotic therapy
2. Responds well to 3. non-pregnant women without any
3. Ie: Simple cystitis in urologic abnormalities
Complicated UTI 4. the bladder
4. A UTI that extends beyond 5. structural or functional urinary tract
5. Caused by abnormalities or untreated UTI
6. Infants and 6. pregnant mothers & older adults
7. Associated with: affected
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