Common childhood rashes

Question 1

Define cystitis

Answer 1

Term used to describe a collection of urinary symptoms - dysuria, frequency and urgency

Question 2

Define dysuria

Answer 2

Pain on passing urine

Question 3

Cystitis self-limiting?

Answer 3

Yes

Half of cases will resolve within 3 days WITHOUT treatment

Question 4

Cystitis male/female incidence

Answer 4

Common in women due to shorter passage of bacteria via the shorter urethra into the bladder
Men’s prostatic fluid has antibacterial properties which act as a defence against infection

Question 5

What is honeymoon cystitis?

Answer 5

Where sexual intercourse causes minor trauma or pushing in of bacteria along the urethra - can lead to cystitis

Question 6

Examples of a disease which can give symptoms of cystitis but it isn’t cystitis?

Answer 6

-Chlamydia in women - can have symptoms of cystitis, alterations in vaginal discharge and lower abdominal pain.
However chlamydia usually asymptomatic

• may be due to other precipitating factors such as irritant effects of toiletries and other chemicals like spermacides and disinfectants
• NOT due to lack of hygiene

Question 7

Postmenopausal women and cystis

Answer 7

Post menopausal women have thinning of lining of vagina and less lubrication. This means they can be more vulnerable to trauma and irritation, so more susceptible to cystitis.
May have pain on intercourse- can give OTC lubricant or oestrogen creams.

Question 8

Treatment timescale of cystitis

Answer 8

Within treatment should resolve within 5 days

Question 9

Symptoms of cystitis

Answer 9

• itching, pricking sensation in urethra
• increased desire to pass urine, becomes more frequent and urgent, but will only pass a few burning, painful drops
• dysuria
• bladder may not feel completely empty
• urine may be cloudy and strong-smelling (sign of infection, source is often GI tract)
• lower abdominal pain

Question 10

Referral criteria for cystitis

Answer 10

• Failed medication
• Diabetes
• all men and children (to exclude kidney, bladder or prostate problems, sign of abuse in children and recurrent)
• fever, nausea/vomiting (upper UTI)
• loin pain/tenderness (upper UTI-kidney and ureters)
• haematuria (too much cystitis inflammatiomn but could also be kidney stone, kidney/bladder cancer)
• vaginal discharge
• pregnancy
• recurrent cystitis of >2-3 times a year
• no improvement within 7 days

Question 11

Lifestyle advice for cystitis

Answer 11

• drink plenty of fluid to allow emptying of bladder and to flush away any infections as a result - but may cause discomfort via dysuria
• after urination, wait 20 more seconds after emptying and straining to clear away last drops
• wiping front to back after bowel movement
• reduced coffee and alcohol intake as these may dehydrate and be irritant
• avoid sex

Question 12

Drugs causing cystitis

Answer 12

Cystitis may be caused by cytotoxic drugs e.g.
Cyclophosphamide
Methenamine hippurate

Question 13

Treatment options for cystitis

Answer 13

Analgesics

Cystopurin (no good evidence for effectivensss)