URINARY TRACT INFECTION AND NEUROGENIC BLADDER (NGB)

danny ramos
Mind Map by danny ramos, updated more than 1 year ago
7
1
0

Description

Mind Map on URINARY TRACT INFECTION AND NEUROGENIC BLADDER (NGB), created by danny ramos on 05/01/2017.

Resource summary

URINARY TRACT INFECTION AND NEUROGENIC BLADDER (NGB)
1 INTRODUCTION
1.1 micturition
1.1.1 requires function of
1.1.1.1 bladder
1.1.1.2 urethral sphincter complex
1.1.1.3 this process
1.1.1.3.1 is coordinated by
1.1.1.3.1.1 central nervous system
1.1.1.3.1.2 peripheral nervous system
1.1.1.3.1.3 disruption here
1.1.1.3.1.3.1 caused by
1.1.1.3.1.3.1.1 diseases
1.1.1.3.1.3.1.2 damage
1.1.1.3.1.3.1.2.1 interferes
1.1.1.3.1.3.1.2.1.1 with coordinated effort
1.1.1.3.1.3.1.2.1.1.1 neurogenic bladder
1.1.1.3.1.3.1.2.1.1.1.1 abnormal storage
1.1.1.3.1.3.1.2.1.1.1.2 abnormal emptying
1.1.1.3.1.3.1.2.1.1.1.3 improper management
1.1.1.3.1.3.1.2.1.1.1.3.1 renal injury
1.1.1.3.1.3.1.2.1.1.1.3.2 renal failure
1.1.1.3.1.3.1.2.1.1.1.3.3 pyelonephritis
1.1.1.3.1.3.1.2.1.1.1.3.3.1 kidney deterioration
2 EPIDEMIOLOGY
2.1 estimates NGB in USA
2.1.1 approximately
2.1.1.1 400,000 people
2.1.1.1.1 are diagnosed with
2.1.1.1.1.1 spina bifida
2.1.1.1.1.1.1 UTI
2.1.1.1.1.1.1.1 most common
2.1.1.1.1.1.1.1.1 in emergency room
2.1.1.1.1.2 spinal cord injury
2.1.1.1.1.2.1 31% were diagnosed
2.1.1.1.1.2.1.1 first year
2.1.1.1.1.2.1.1.1 21% = hospitalization
2.1.1.1.1.2.2 2.5 symptomatic UTI
2.1.1.1.1.2.2.1 per year
2.1.1.1.1.3 cerebral palsy
2.1.1.1.1.4 multiple esclerosis
2.1.1.1.1.5 parkinson disease
2.2 increased
2.2.1 frequency and severity of
2.2.1.1 higher risk of
2.2.1.1.1 morbidity
2.2.1.1.2 mortality
2.2.1.1.3 secondary to
2.2.1.1.3.1 urosepsis
2.2.1.1.3.2 end-stage renal disease
3 PATHOGENESIS
3.1 bladder dysfunction
3.1.1 abnormal urodynamic parameters
3.1.1.1 in patients with NGB
3.1.1.1.1 increased rick of UTI
3.1.2 detrusor overactivity
3.1.2.1 decreased
3.1.2.1.1 bladder compliance
3.1.2.2
3.1.3 vesicoureteral reflux
3.1.3.1 febrile UTI
3.1.3.1.1 spinal dysraphism
3.1.4 increased intravesical pressure
3.1.4.1 bladder ischemia
3.1.4.1.1 delayed or deficient
3.1.4.1.1.1 inmune response to pathogen
3.1.4.2 in
3.1.4.2.1 distendent
3.1.4.2.1.1
3.1.4.2.2 empty
3.1.4.2.2.1 bladder
3.1.4.2.2.1.1 suggest dysfunction
3.2 URINARY STASIS / INCREASED POSTVOID RESIDUAL
3.2.1 normal voiding
3.2.1.1 protects against UTI
3.2.1.1.1 99.9% of bacteria are removed by voiding
3.2.2 inefficient voiding
3.2.2.1 with residual urine
3.2.2.1.1 development of UTI
3.2.3 association between
3.2.3.1 PVR urine / UTI
3.2.3.1.1 among patients with spinal cord injury and NGB
3.2.3.1.1.1 PVR > 300 mL
3.2.3.1.1.1.1 4 to 5 times more UTI
3.2.4 2 studies of patients
3.2.4.1 after stroke
3.2.4.1.1 PVR after 150 mL
3.2.4.1.1.1 risk factor
3.2.4.1.1.1.1 UTI
3.2.4.1.2 PVR after 100 mL
3.2.4.1.2.1 4.9 - fold increased
3.2.4.1.2.1.1 UTI
3.2.4.1.2.1.2 from those with
3.2.4.1.2.1.2.1 PVR < than 100 mL
3.3 CATHETER USE
3.3.1 urinary catheters
3.3.1.1 mainstay management strategy
3.3.1.1.1 patients with NGB
3.3.1.2 clean intermittent catheterization
3.3.1.2.1 preferred method to
3.3.1.2.1.1 drainage in patients with NGB
3.3.1.2.2 increased risk of
3.3.1.2.2.1 UTI
3.3.1.2.2.1.1 caused by
3.3.1.2.2.1.1.1 catheter contamination
3.3.1.2.2.1.1.2 introduction of
3.3.1.2.2.1.1.2.1 external microorganisms
3.3.2 are usually made of
3.3.2.1 silicone
3.3.2.1.1
3.3.2.2 other soft rubbers
3.3.2.2.1 to avoid trauma
3.4 IMMUNE DYSFUNTION
3.4.1 decreased
3.4.1.1 proinflammatory and inflammatory responses
3.4.1.1.1 to
3.4.1.1.1.1 uropathogenic Escherichia Coli
3.4.1.1.1.1.1 inflammation was not
3.4.1.1.1.1.1.1 suppressed after
3.4.1.1.1.1.1.1.1 infection
3.4.2 may redisponse
3.4.2.1 to infection
3.4.2.2 hinder bacterial eradication
3.4.3 urine and urinary tract luminal space
3.4.3.1 contains
3.4.3.1.1 Escherichia Coli
3.4.3.1.1.1
3.4.3.1.2 Klebsiella Pneumoniae
3.4.3.1.2.1 invade urothelial cells
3.4.3.1.2.1.1 can proliferate within urothelium
3.4.3.1.2.1.1.1 not be easily eradicate with
3.4.3.1.2.1.1.1.1 antibiotics treatment
3.4.3.1.2.1.1.1.1.1 nidus of reinfection
3.4.4 pharmacology immunosuppression
3.4.4.1 further risk of recurrent UTI
4 DIAGNOSIS
4.1 a key factor complicating study and treatment
4.1.1 in UTI and NGB is
4.1.1.1 lack of consensus definition of infection
4.1.1.1.1 in study population
4.1.1.1.2 in clinical practice
4.2 impaired sensations
4.2.1 with non-specific symptoms
4.2.2 bacterial colonization in
4.2.2.1 bladder in patients with NGB
4.2.2.1.1 unclear clinical picture
5 MONITORING FOR INFECTION
5.1 universal agreement in NGB
5.1.1 renal
5.1.1.1 should be monitored
5.1.2 bladder
5.1.2.1
6 DEFINITIONS
6.1 UTI in pediatrics with spina bifida
6.1.1 equal or > 2 symptoms
6.1.1.1 fever > 38 C
6.1.1.2 abdominal pain
6.1.1.3 new back pain
6.1.1.4 new or worse incontinente
6.1.1.5 pain with catherization or urination
6.1.1.6 cloudy urine
6.1.2 > 100,000 colony forming units
6.1.2.1 single organism
6.1.3 > 10 white blood cells
6.2 UTI in patients with Spinal Cord Injury
6.2.1 > than 1000
6.2.1.1 intermittent catheterized specimen
6.2.2 > 100.000 CFU/mL from condon catheter
6.2.3 any value of
6.2.3.1 inderweiling suprapubic catheters
6.2.3.2 along with
6.2.3.2.1 piuria
6.2.3.2.2 signs and symptoms
6.2.3.2.2.1 of UTI
7 SYMPTOMS
7.1 typical symptoms
7.1.1 general population
7.1.1.1 disuria
7.1.1.2 urgency
7.1.1.3 frecuency
7.1.1.4 rarely present in
7.1.1.4.1 NGB population
7.2 symptoms in Spinal Cord Injury
7.2.1 autonomic disrreflexia
7.2.2 increased spasticity
7.2.3 urinary incontinence
7.2.4 vague back / abdominal pain
7.2.5 foul smelling urine
8 TREATMENT
8.1 urine cultures
8.1.1 must be obtained
8.1.1.1 before antibiotics
8.2 antibiotics choice
8.2.1 should be tailored
8.2.1.1 specific pathogen
8.2.1.1.1 sensitive trends in NGB population
8.2.1.1.1.1 differ from general population
8.3 recurrent courses of
8.3.1 antibiotics
8.3.1.1 results in
8.3.1.1.1 higher rates of
8.3.1.1.1.1 antibiotic-resistance
8.3.1.1.2 antibiotic prophylaxis
8.3.1.1.2.1 limited efficacy
8.3.1.1.2.1.1 related to
8.3.1.1.2.1.1.1 antibiotic resistance
8.4 duration
8.4.1 based on provider evxperience
8.4.1.1 few data supporting atb duration
9 ETIOLOGY
9.1 E. Coli
9.1.1 primary cause
9.1.1.1 in 18% of symptomatic patients
9.1.1.1.1 compared with 75 - 90% popular population
Show full summary Hide full summary

Similar

To Kill A Mockingbird Complete Notes
jessica.moscrip
GCSE Maths Quiz
Andrea Leyden
PE 1 Multi Choice Questions
Cath Warriner
Of Mice and Men
amyk4321
An Inspector Calls - Inspector Goole
Rattan Bhorjee
AQA GCSE Chemistry Unit 2
Gabi Germain
CHARACTERS IN OF MICE AND MEN
jessicasusanevans
Junior Cert Physics formulas
Sarah Egan
Highway Code Road Signs for Driving Test
Sarah Egan
Cells and the Immune System
Eleanor H
SFDC App Builder Quizlet
Parker Webb-Mitchell