Dysuria and UTI Flashcards

1
Q

Dysuria what further questions do you ask?

A

Check for bladder dysfunction

frequency, urgency, cramping or pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How will you diagnose cystitis?

A

Urine dipstick - WBC / leukocyte esterase

Midstream urine - microscopy, culture, susceptibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A common demographic for cystitis?

A

post menopausal women, lack of oestrogen to promote growth of good flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Male and female factors that can contribute to a UTI?

A
Females 
- Past UTI 
- Sexual intercourse 
- diaphragm use 
- pregnancy 
- diabetes 
- instrumentation 
males 
- lack of circumcision 
- AIDS 
- MSM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A common sense cost saving approach to diagnosis and treatment

A

Typical symptoms? dipstick shows pyuria? = TREAT

Further problems? = reassess and send MSU to lab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Other features in older people that cause UTIs

A
Females: 
- Post menopause 
- UT abnormalities 
- neurological disease 
- incomplete bladder emptying 
Male 
- strictures 
- stones 
- prostatic disease 
- neurological disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The bacteria that cause cystitis

A

E. coli = 80%
Staphylococcus saprophyticus - quite common in young women

other enterobacteriaceae
e.g. candid albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Features of uropathogenic E.coli that help it evade out immune system

A

Sequesters iron to help it evade our immune system
Fimbriae to anchor bladder to wall
Alpha haemolysin damages epithelial cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Commonly used antibiotics to treat said infections

A

trimethoprim - antidote drug, bacteria do folate synthesis to produce nucleotides, BUT avoid in pregnancy, and in patients recovering form chemo treatment for leukaemia
ALLERGY: rash, can be severe, sevens-Johnson syndrome
co-trimoxazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Human defences against uropathogenic E.coli

A

Microbial flora
Urine - inhospitable to bacterial growth
Urination - important to fully empty bladder
Tamm- horsfall protein - formed in loop of Henle binds to bacteria
Prostatic fluid
Innate and adaptive immunity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment regimes?

A

although most cases will resolve after a few months they’re very discomforting, so treat with antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of pyelonephritis

A

IV then rapid change to oral treatment when responds

gentamicin 5mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Possible reasons for recurring cystitis?

A

intercourse
form of contraception
abnormal urinary tract or urodynamics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly