infection of UTI

Question 1

what kind of flora is in the urogenital system

Answer 1

perineal flora
kidneys and ureters are sterile sites
mainly coagulate negative such as S epidermis

Question 2

what are the features and causes of UTI

Answer 2

dysuria, frequency and urgency, tenderness

causes - E coli mainly

Question 3

what is pyelonephritis

Answer 3

upper UTI - kidneys or renal pelvis
systemic infection - rigour vomiting, diarrhoea
lower pain and tenderness

Question 4

what mis urethral syndrome

Answer 4

abacterial cystitis
mainly affected by 30-50 yo women
symptoms of lower UTI

Question 5

what is significant bacteriuria

Answer 5

kass criteria - levels of bacteria high enough to cause systematic infection more than 10^5 cfu/mL

Question 6

what are the imitations of the kass criteria

Answer 6

women can have over 10^5 bacterial counts
many symptomatic have less than 10^5
lower counts in males are significant

Question 7

what is asymptomatic bacteriuria and who are commonly affected

Answer 7

no symptoms but cultured urine

cathaters, harm-dialysis, diabetic, pregnant women

Question 8

what is sterile pyuria and its causes

Answer 8

pus cells in urine

inhibition of bacterial growth, fastidious/hard to grow organisms, UT inflammation, urethritis - STI

Question 9

what are the risk factors for UTI

Answer 9

female 
urinary stasis 
instrumentation 
sexual intercourse 
fistulae 
congenital abnormalities

Question 10

what are the characteristics of complicated UTI

Answer 10

underlyng abnormiality - structural or functional
presence of foreign body (catheter)
children under 10-12 and men over 65

Question 11

what are the top 3 casues of UTI from bacteria

Answer 11

gut bacteria
e coli
staphylococcus saprophytic
proteus mirabilis

Question 12

what is the difference in perineum and fistulae movement of bacteria in UTI

Answer 12

p - ascending movement of bacteria along a lumen

F - movement of bacterial from genial to urinary tract

Question 13

what causes haematogenous UTI infection

Answer 13

descending seeding form blood (s. aureus)

Question 14

what are the complications of catheter associated UTI

Answer 14

bacteraemia

colonisation

Question 15

what are the three methods of UTI investigation

Answer 15

dipstick
microbiological investigations
further investigations (CT scan, renal tract ultra sound)

Question 16

how does a dipstick test for UTI and when should you not use it

Answer 16

blood, protein, nitrites, WBC

do not use in over 65’s, less than 3 months, more reliable over 3 yo

Question 17

what microbiological investigations can be done for a UTI

Answer 17

MSU
CSU - catheter urine 
clean catch in children 
SPA - supra-pubic aspirate 
microscopy and culture

Question 18

what are non-antimicrobial treatment of UTI

Answer 18

fluid intake, anti-inflammatories, cranberry juice

Question 19

what antibiotics are used in UTI

Answer 19

nitrofuratonin, pivecillinam and trimethoprim

Question 20

what is the treatment or pyelonephritis

Answer 20

empiric therapy - cefuroixme, ciprofloxacin or piperacillian tazobatcam

Question 21

what are the two types of abscess associated with UTI

Answer 21

perinephric

infrarenal - classic acute pyelonephritis

Question 22

what is prostatitis and what is the treatment

Answer 22

inflammation of prostate
acute bacterial cause with lower UTi symps and e coli cause
can be chronic
quinolones - ciprofloxcin or trimethoprim