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MHD V: Renal > 11:9: UTI > Flashcards

11:9: UTI Flashcards

1
Q

What is bacteriuria?

A
  • Bacteria in the urine

- Significant if over 10 to the fifth

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2
Q

What is cystitis?

A
  • Infection of bladder characterized by dysuria, frequency, urgency and suprapubic pain
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3
Q

What is dysuria?

A

Painful or difficult urination

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4
Q

What is urethritis?

A
  • Infection confined to urethra characterized by dysuria, and mucoid or purulent discharge from urethral meatus
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5
Q

What is acute pyelonephritis?

A
  • Infection of kidney characterized by flank pain / tenderness and fever
  • Often associated with dysuria, urgency, frequency
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6
Q

What is an uncomplicated UTI?

A
  • Dysuria, frequency, and urgency with bacteriuria and pyuria
  • Often seen in women
  • On renal or urologic dysfunction or obstruction
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7
Q

What is a complicated UTI?

A
  • Pyuria and document microbial pathogen
  • Shows local and systemic signs: fever, chills, malaise, pain
  • Occurs in presence of urinary tract abnormality
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8
Q

Most common route of UTI infection and how is it caused?

A

ASCENDING

  1. Gut flora reach bladder through urethra
  2. Perineal colonization in women
  3. Intercourse
  4. Catheterization
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9
Q

What is hematogenous route?

A
  • Bacteria reach tract through blood
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10
Q

What is hemolysin?

A
  • Enzyme produced by UTI bacteria forming pore in epithelial wall allowing bacteria to colonize
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11
Q

What does urease do?

A

Elevate urinary PH by breaking down urea making more hospitable environment for organisms

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12
Q

What is Type I (MS)?

A
  • Mannose sensitive fimbriae that attaches to D mannose on many cells of bladder and lower tract
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13
Q

What are P fimbriae?

A

Attaches to P blood group antigens on RBC and urothelium of renal pelvis and kidney

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14
Q

What does iron scavenging allow?

A
  • The UTI organism to grow and multiply
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15
Q

What causes most UTIs?

A
  1. E Coli 80%

2. Staph saprophyticus 15%

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16
Q

Risk factors for UTIs?

A
  1. Sexual intercourse
  2. Spermicide
    3, PH
  3. Voiding of urine empties bacteria
  4. Pregnancy
  5. Obstruction
  6. Catheterization
17
Q

What is vesicoureteral reflux?

A
  • Congenital condition carrying bacteria to renal pelvis

- Returns infected urine to bladder after voiding

18
Q

Risk of UTI with catheterization?

A

3% - 10% per day under catheterization

19
Q

Impact of age and sex on UTI?

A
  • Females more at risk than males

- Equal risk in both genders in elderly

20
Q

Why do elderly get UTIs?

A
  1. Bladder prolapse
  2. Prostate hypertrophy
  3. Incontinence
21
Q

Clinical features of cystitis?

A
  1. Acute dysuria, urgency, frequency
  2. Suprapubic pain and tenderness
  3. Hematuria
  4. Pyuria
  5. Positive culture even at low levels
22
Q

Risk factors for cystitis?

A
  • Young sexually active women
  • Anal sex in men
  • Lack of circumcision
23
Q

Differential diagnosis in women with dysuria?

A
  1. Cystitis
  2. Urethritis
  3. Vaginitis
24
Q

What is special about dysuria in vaginitis?

A

Pain is external and not in urethra

25
Q

What is external pain and not in urethra indicative of?

A

Vaginitis

26
Q

Where is hematuria seen in women with dysuria?

A

Cystitis

27
Q

When do we not see pyuria in women with dysuria?

A

Vaginitis

28
Q

Clinical features of pyelonephritis?

A
  1. Acute flank pain, fever, and lower tract symptoms
  2. Costovertebral tenderness
  3. Bacteremia / septic shock
  4. Papillary necrosis
  5. WBC casts
29
Q

What does WBC cast in urine tell you?

A
  • Upper urinary tract infection

- Likely pyelonephritis

30
Q

Clinical features of prostatitis?

A

1, Perineal and lower back pain

  1. Fever chills, dysuria
  2. Boggy tender prostate
31
Q

How to get clean specimen in urine sample?

A

“Clean voided midstream urine”

  • Want sample from midstream flow so it is not contaminated by organisms outside tract in genital tissue
  • Want urine from bladder
32
Q

Diagnostic definition of pyuria?

A
  • 10 WBCs per microliter

- Mainstay diagnosis for UTI

33
Q

What is leukocyte esterase?

A
  • Noted in dipstick urine test indicating pyuria
34
Q

What does nitire on dipstick test mean?

A
  • Activity of bacterial nitrate reductase which is indicative of UTI
  • May not work on some bacteria or small colony count
35
Q

How to treat UTI?

A
  1. Treat all with symptoms regardless of age

2. Bacteriostatic agents work just fine

36
Q

Treatment for acute cystitis?

A
  • Culture or urinalysis not necessary

- Antibiotic for 3 - 5 days

37
Q

Treatment for pyelonephritis?

A
  • Urinalysis and culture indicated

- Antibiotics 5 - 14 days

38
Q

Most significant risk factor for catheter associated UTI?

A

Duration of use

MHD V: Renal (28 decks)

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