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MD3002 post MSA > cystitis > Flashcards

cystitis Flashcards

1
Q

what antibiotics are prescribed for a lower UTI

A

Trimethoprim or Nitrofurantoin

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2
Q

what does polyuria mean

A

excessive volumes of dilute urine

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3
Q

what are the symptoms of UTI

A 
suprapubic tenderness
frequency 
urgency
polyuria
haematuria 
dysuria
cloudy/smelly urine
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4
Q

what is the differential for an uncomplicated UTI

A 
chlamydia
gonorrhoea
herpes simplex
trichomonas
candidiasis
gardnerella
pylonephritis
vaginitis
cancer 
prostatitis
epididymititis
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5
Q

what can untreated STIs result in

A

infertility in women

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6
Q

why are children more likely to be referred if they have a UTI

A

often associated with a renal abnormality and recurrent infections so this must be investigated

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7
Q

what is leukocyte esterase

A

an enzyme found in white blood cells

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8
Q

what is nitrites an indication of

A

certain bacteria which are able to reduce nitrate to nitrite

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9
Q

why are mid stream samples important

A

most reliable as not contaminated with the external genitalia, prostate, urethra or the trigone of the bladder

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10
Q

what are coliforms

A

related to e. coli

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11
Q

what conditions predispose to UTIs

A 
elderly 
female
diabetes
sex and new sexual partner 
diaphragms
suppressed immune systems 
menopause 
sickle cell 
analgesic abuse 
incomplete bladder emptying
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12
Q

what are the complications of a UTI

A 
infertility 
reccurent infection 
kidney damage
stricture
low birth weight in pregnant women
sepsis/ septicaemia
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13
Q

what is gardenerella responsible for

A

BV

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14
Q

What antibiotics are commonly prescribed for a UTI

A

Trimethoprim, Nitrofurantoin

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15
Q

what age men tend to get UTIs

A

over 50s

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16
Q

what are the symptoms of pyelonephritis

A

– Loin pain & tenderness
– High fever
– Systemic upset

17
Q

what can cause complicated UTIs

A 
stones
obstruction 
PCKD
vesicouteric reflux
diabetes
sickle cell
analgesic abuse
renal calculi 
tumours
18
Q

what bacteria are usually responsible for a community UTI

A

E. coli - 80%
coagulase -ve staphylococci
other staphylococcus and enterococcus
GRAM -VE

19
Q

what are the common pathogens in nosocomal UTIs

A 
candida
gram -ves
proteues miribilis 
klebsiella
enterobacter
20
Q

what is an O serotype in E.coli

A

somatic

21
Q

what is a K serotype in E.coli

A

capsular antigens
(bad)

  • Polysaccharide
  • Forms a micro-capsule
  • Confers resistance to phagocytosis
22
Q

what virulence factors does E. coli have

A

– Fimbriae (adhesion to uroepithelia)
– K antigen
– Haemolysin

23
Q

what two types of fimbriae does E.coli have

A

type 1 -phagocytosed

type P

24
Q

what does haemolysin do

A
  • Cytolytic exo-protein
  • Damages tissue membranes in vivo
  • Causes kidney damage
25
Q

what are the features of Proteus mirabilis

A
  • Gram negative
  • Facultative anaerobe
  • Bacillus
  • Peritrichous flagellae
  • Produces urease
  • Swarming ability
26
Q

what type of fungus is candida albicans

A

diploid yeast
oppurtinistic
found in immunocompromised pts

27
Q

what are the features of Staphylococcus saprophyticus

A

• Gram positive
• Coagulase negative
• Normal microbiota of female perineum &
vagina
• Sexual activity increases risk of UTI
• Commonly causes community acquired UTIs
• Symptomatic cystitis

28
Q

what other pathogens can cause UTI

A
  • Candidia albicans
  • Trichomonas vaginalis
  • Schistosoma haematobium
  • Mycobacterium fortuitum
  • Histoplasma capsulatum
  • Polyomaviruses
  • CMV
  • Rubella
29
Q

what are the features of Trichomonas vaginalis

A
  • Protozoan
  • Pear-shaped flagellate
  • T. vaginalis is pathogenic
  • Other species are commensal
  • Prefers pH ~6.0
  • Trichomoniasis
  • Less common in males
30
Q

what are the features of Schistosoma haematobium

A
  • Trematode worm
  • Schistosomiasis (bilharzia)
  • Found in contaminated water
  • Gains access to host through skin
  • Matures in liver
  • Eggs travel to and penetrate bladder
  • Treatment with praziquantal
31
Q

what are the entry points for bacteria during catheterisation

A

junction between catheter and collection tube
connection to drainage bag
urethral meatus

32
Q

what are the host defences of the bladder

A 
urine osmolarity and pH
epithelia sloughing 
urine flow
mucus
complement
inflammatory response
immune response
commensals
33
Q

give an example of a proanthrocyanidin

A

cranberry juice

34
Q

what are some oral antibiotics for UTI

A
  • Co-trimoxazole
  • Nitrofurantoin
  • Nalidixic acid
  • Co-amoxiclav
  • Trimethoprim
  • Ciprofloxacin
35
Q

what is haemolysin

A

destroys cell membranes of red blood cells and causes tissue damage

36
Q

what is praziquantel used to treat

A

bilharzia (schisto)

37
Q

are gram negatives found in community acquired UTIs

A

yes - e.coli

other wise gram positives

MD3002 post MSA (66 decks)

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