Clinical UTI Flashcards
What is an infection of the kidney called?
Acute/Chronic Pyelonephritis
What is an infection of the bladder called?
Cystitis
What is an infection of the urethra called
Urethritis
Infection of prostate?
Prostatitis
Infection of testes/epididymis?
Epididymo-orchitis
What are the general predisposing factors making someone more prone to UTIS/
Immunosuppression
Steroids
Malnutrition
Diabetes
What organisms usually cause UTIs?
Usually bowel organisms
E. Coli
Proteus
Klebsiella
Enterococcus
What can cause urethra to bladder transmission of bacteria?
Intercourse for females
Catheterisation
Clinical features of UTI in kids?
Diarrhoea Excessive crying Fever Nausea and vomiting Not eating
Clinical features of UTI in adults?
Flank pain Dysuria - like passing broken glass Cloudy urine Strangury Confusion in very elderly
What is strangury ?
Severe pain and a strong desire to urinate.
Clinical features of acute pyelonephritis?
Pyrexia Poor localisation Loin tenderness (renal angle) Signs of dehydration Turbid urine
UTI investigations?
MSSU
Urine analysis in ward - blood, leukocytes, protein and nitrates
Microbiology - microscopy and gram-staining, culture and sensitivity
In children, men or when UTIs are frequent what investigations can be useful?
Ultrasound/IVU
Isotope studies to rule out reflux and scarring
Treatment?
Fluids
Antibiotics - amoxicillin
For severe infections - IV antibiotics
What is Reflux Nephropathy?
Kidney damage due to urine flowing backwards and causing repeat UTIs
Investigations for Reflux Nephropathy? Treatment?
Micturating cystogram
Assess progression by ultrasound scan & biochemistry
Treated via surgery
Indwelling Urinary Catheters considerations?
Aseptic technique
Fluid intake
Colonisation is inevitable but antibiotics only if patient symptomatic - just replace catheter
What is Bacteriuria?
Bacteria level of >10^5 in urine
But also depends on clinical symptoms as you can get asymptomatic bacteriuria and bacteriuria of pregnancy
What does chronic pyelonephritis look like radiologically? What sign will often accompany it?
Radiology - scarring and clubbing of calyces
Also has HTN and can progress to chronic renal failure