1. UTI

Question 1

How common is it?

Answer 1

Very - one of the most common presentations in primary care

1 in 3 women by 24 y/o

Question 2

What causes it?

Answer 2

Invading bacteria from other sites eg perineum, gut

Common causative organisms = E. coli, Staph saprophyticus, Proteus mirabilis

Question 3

What risk factors are there?

Answer 3

Urinary stasis (pregnancy, prostatic hypertrophy, stones, neoplasia)
Catheters
Sex
Fistulae
Congenital abnormalities eg vesico-ureteric reflux

Question 4

How does it present?

Answer 4

Upper = dysuria, frequency, urgency, supra-pubic pain, haematuria, nocturia
Lower = (upper symptoms +) loin / abdo pain, fever, systemic signs of infection

Question 5

How would you investigate?

Answer 5

Urinalysis
Urine and blood culture
Microscopy, culture and sensitivity
Renal tract USS, isotope scans in special cases

Question 6

What signs may the patient have on examination?

Answer 6

Tenderness on palpation of abdomen

Cloudy, foul-smelling urine, haematuria

Question 7

What other conditions might present similarly?

Answer 7

(Acute pyelonephritis)
Interstitial cystitis
Ectopic pregnancy
Gynaecological / urological malignancy
STI
Adverse drug effects (eg opioids)
BPH

Question 8

What complications are there?

Answer 8

Ascending infection –> pyelonephritis

In pregnancy - pre-term delivery and low birth weight