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Nyeri saat berkemih - Coggle Diagram
Nyeri saat berkemih
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Clinical manifestations
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A frequent or intense urge to pee, even though little comes out when you do
Cloudy, dark, bloody, or strange-smelling pee
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Prevention
Drink plenty of liquids, especially water
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Complications
Recurrent infections, especially in women who experience two or more UTIs in a six-month period or four or more within a year.
Permanent kidney damage from an acute or chronic kidney infection (pyelonephritis) due to an untreated UTI.
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Urethral narrowing (stricture) in men from recurrent urethritis, previously seen with gonococcal urethritis.
Sepsis, a potentially life-threatening complication of an infection, especially if the infection works its way up your urinary tract to your kidneys.
Treatment
Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
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Nitrofurantoin (Macrodantin, Macrobid)
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Patogenesis ISK
Ascending infection
berasal dari flora normal usus dan hidup secara komensal introitus vagina, preposium penis, kulit perineum, dan sekitar anus
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Limfogen
jika masuknya mikroorganisme melalui sistem limfatik yang menghubungkan kandung kemih dengan ginjal namun ini jarang terjadi
Langsung dari organ sekitar yang sebelumnya sudah terinfeksi atau eksogen sebagai akibat dari pemakaian kateter
Risk Factors of UTIs
Iatrogenic/drug
Catheter, antibiotics, spermicides
Behavioural
Voiding dysfunction, frequent or recent sexual intercourse
Anatomic/physiologic
Vesicoureteral reflux, pregnancy
Genetic
Familial tendency, susceptible uroepithelial cells
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Diagnosis
Penunjang
Darah lengkap
peningkatan leukosit, neutrofil, laju endap darah (biasanya >30 mm.jam) dan C-reactive protein positif (>20 mg/dL) yang mengindikasikan respon inflamasi
Kultur urin
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bakteriuria bermakna jika terdapat berapa pun jumlah bakteri jika urin diambil dengan aspirasi supra pubik; atau jumlah bakteri >50.000 cfu/mL jika urin diambil dengan kateterisasi urin; atau jumlah bakteri >100.000 cfu/ mL jika urin diambil dengan cara pancar tengah atau dengan urine collector
Anamnesis & pemfis
Dysuria, pollakisuria, nycturia (↑) Present or increased incontinence (↑) Macrohematuria (↑) Suprapubic pain (↑) “Offensive” smell, turbid urine (↑) Prior infections of the urinary tract (↑) Changed or new discharge, vaginal irritation (↓).
Fisiologi berkemih
Function of Renal
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Regulation of electrolyte balance (e.g., sodium, potassium, and calcium).
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Blood pressure homeostasis: The renal system alters water retention and thirst to slowly change blood volume and keep blood pressure in a normal range.
Regulation of acid-base homeostasis and blood pH, a function shared with the respiratory system.
Definition
An uncomplicated urinary tract infection (UTI) is a bacterial infection of the bladder and associated structures. These are patients with no structural abnormality and no comorbidities, such as diabetes, immunocompromised state, or pregnancy.
Etiology
Most cases of urinary tract infections are due to the colonization of the urogenital tract with rectal and perineal flora. The most common organisms include Escherichia coli, Enterococcus, Klebsiella, Pseudomonas, and other Enterococcus or Staphylococcus species. Residential care patients, diabetics and those with indwelling catheters or any form of immunocompromise can also colonize with Candida.
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