Without treatment, 25% to 42% of uncomplicated acute cystitis (UTI) cases in women will resolve spontaneously. Even without effective treatment, the likelihood that uncomplicated acute cystitis will progress to pyelonephritis is only around 2%

The preferred agents for empiric therapy of acute simple cystitis are:
• Nitrofurantoin
• Trimethoprim-sulfamethoxazole (TMP-SMX)
• Fosfomycin

Antimicrobial selection for acute simple cystitis depends on the risk of infection with a multidrug-resistant (MDR) gram-negative infection.
We generally consider patients to be at risk for an MDR gram-negative infection if they have any of the following within the prior 3 months:


• An MDR gram-negative urinary isolate or a fluoroquinolone-resistant Pseudomonas aeruginosa urinary isolate.

• Inpatient stay at a health care facility (eg, hospital, nursing home, long-term acute care facility).

• Use of a fluoroquinolone, trimethoprim-sulfamethoxazole, or broad-spectrum beta-lactam (eg, third- or later-generation cephalosporin).

• Travel to parts of the world with high rates of MDR organisms.

Diabetic foot ulcer (DFU)

It's caused by a combination of peripheral neuropathy & peripheral artery disease (PAD)

الفكرة هي أنّ السكري يسبب neuropathy وهذا الشي يخلي الشخص يفقد إحساسه برجله ومفاصله، وممكن يدوس عليها ويأذيها بشكل طفيف وية كل حركة بدون ما يشعر causing micro-trauma (بالإضافة لأشياء أُخرى). هاي الإصابات الصغيرة لما تتجمع تدريجيًا، رح تؤدي لتشوه مفاصل وعظام الرجل (charcot joints).

وبنفس الوقت السكّري يسبب PAD اللي ممكن نعرّفه ببساطة على أنّه:
Narrowing/occlusion of peripheral vessels due to atherosclerosis (or other causes such as spasm).
بحالة السكّري فالـ PAD يصير بسبب الـ atherosclerosis (لأن كل السكر الزايد رح يتحول لدهون تتجمع بالجسم وبالأوعية الدموية) وهالشي رح يقلل وصول الدم للأطراف وبالأخص للقدم ويسبب ischemia.
كل هالعوامل تزيد إحتمالية الإصابة بتقرحات القدم السكّرية diabetic foot ulcer.

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تبقى ملاحظة: أغلب الـ DFU سببها الرئيسي هو الـ neuropathy (ومرات مزيج من الإثنين). بنسبة قليلة فقط يكون السبب هو الـ PAD

Here's a case:

A 65-year-old man presents with an ulcer on the dorsum of his right foot. He noticed a sore area on the right foot 3 weeks ago and this has extended to an ulcerated lesion which is not painful. He has complained of pain in the legs for some months. This pain comes on when he walks and settles down when he stops.
He had an inguinal hernia repaired 2 years ago and he stopped smoking then on the advice of the anaesthetist. Previously he smoked 20 cigarettes per day. He drinks four pints of beer at weekends. His father died of a myocardial infarction aged 58 years.

On examination, his blood pressure is 136/84 mmHg. The respiratory, cardiovascular and abdominal systems are normal. There is a 3cm ulcerated area with a well-demarcated edge on the dorsum of the right foot. The posterior tibial pulses are palpable on both feet, and the dorsalis pedis on the left. The capillary return time is 4s. On neurological examination there is some loss of light touch sensation in the toes. Varicose veins are present in the long saphenous distribution on both legs.
His blood glucose is 6.4 mmol/L (115 mg/dL) and his HbA1c is 9.1%. Otherwise, his lab tests were normal.

Discussion:
The diagnosis is most likely to be diabetic foot ulcer.

Venous ulcers are usually found around the medial malleolus and are often associated with skin changes of chronic venous insufficiency. This has the features of an ulcer caused by arterial rather than venous ulceration or a mixed aetiology.
Arterial ulcers are often on the dorsum of the foot. The position and nature of ulcers provide clues to their cause.
The story of pain in the legs on walking requires a little more detail but it is suggestive of intermittent claudication related to insufficient blood supply to the exercising calf muscles.

The raised HbA1csuggests diabetes and prolonged hyperglycaemia.

Btw, diabetic neuropathy (DN) can cause a wide range of presentations. Most commonly, it causes peripheral sensory neuropathy in a glove & stocking manner (hands & feet). But it can cause cranial nerve neuropathy, autonomic, or motor neuropathy. And in a lot of cases, it's a mix of many types.

Poikilothermia:
differing temperatures between limbs with the affected side being cooler.

Cooper's ligaments (Retinacula cutis)

These are the ones responsible for giving the breast its (widely beloved and appreciated) shape

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In anemia of chronic disease, usually:
Serum iron & TIBC are low
Ferritin is high

While in iron-deficiency anemia:
Serum iron & ferritin are low
TIBC is high

Here's why aortic regurgitation (AR) can be such a pain in the ass:

It causes a murmur best heard on the lower left sternal edge, which is about the same place for hearing tricuspid sounds like tricuspid stenosis (TS).