12. UTI Diagnosis Flashcards
What tissues and organs make up the Upper Urinary Tract?
- Kidney
- Renal Pelvis
- Ureter
What tissues and organs make up the Lower Urinary Tract?
- Bladder
2. Urethra
What does the Urothelium lining consist of?
- Transitional Epithelium in Upper Tract and Bladder
2. Pseudostratified Columnar in Membranous/Spongy Urethra
What is the route of infection for UTIs?
Ascending
- Retrograde ascent of bacteria up the urethra
- Travels towards the kidney via ureter
What can increase the risk of UTIs?
- Vesicoureteric Reflux
- Impaired ureteric peristalsis
- Previous UTI
- Female
- Congenital Abnormality
- Reflux Nephropathy
What symptoms are generally seen in diagnosis of UTI?
- Frequency
- Urgency
- Dysuria
- Suprapubic Pain
- Haematuria
- STI Symptom similarities
What additional symptoms can be seen in Acute Pyelonephritis?
- Sweating
- Fever
- Loin Pain
- Nausea and Vomiting
For a patient with suspected UTI, what should be asked in the history?
- Previous UTI
- Sexual history
- Renal tract issues (Stones/Congenital Abnormalities)
- Bladder cancer symptoms
What major investigations can be done to diagnose UTIs?
- Urine Dipstick: Leukocytes/Nitrites/Protein
- Midstream Urine (MSU): Microscopy/Culture/Sensitivity
- Tests for E.coli, Pseudomonas, Proteus, Gram + - Recurrent UTI:
- USS the reanl tract
- CT the KUB
If there is Nitrite in urine, what is the sensitivity for UTI?
90% sensitive
35-85% specific for UTI
How do we manage Uncomplicated Cystitis?
- 3-5 day course of standard antibiotics
- Trimethoprim/Nitrofurantoin
- Second-Line:
- Co-Amoxiclav
- Cephalosporin
- Ciprofloxacin - ESBLs to counter Antimicrobial Resistance
How do we manage Pyelonephritis?
- May need IV Therapy with Co-Amoxiclav
2. Stable: Out-patient antibiotic therapy (OPAT)
How do we manage Recurrent UTI?
Rotating Antiibotics and post-coital antibiotics
