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Y3(S) - Urology > Infections > Flashcards

Infections Flashcards

1
Q

What are the 4 classifications of UTIs?

A

Simple UTI
Complicated UTI
Upper UTI
Lower UTI

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2
Q

What is considered a complicated UTI?

A

Men
Pregnancy
Surgically altered urinary tract
Atypical organisms (proteus, pseudomonas, klebsiella)

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3
Q

What is an upper UTI?

A

Infection of:
-kidneys
-ureters

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4
Q

What is a lower UTI?

A

Infection of:
-bladder
-urethra

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5
Q

What are the 3 main symptoms of a UTI?

A

Dysuria
Frequency
Supra pubic pain

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6
Q

What are the 2 important features looked for on a urine dip when it comes to a UTI?

A

Nitrites
Leukocyte esterases

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7
Q

What is meant by a +leukocytes +nitrites?

A

Likely UTI treat if symptomatic

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8
Q

What will UTIs always be positive for on urine dip?

A

Leukocytes

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9
Q

Can a urine dip be +leukocytes -nitrites and still have a UTI?

A

Yes

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10
Q

What is the likely causative organism if a urine dip is +leukocytes - nitrites?

A

Staphylococcus saprophyticus

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11
Q

What is the significance of +leukocytes on urine dip?

A

May be a UTI
Not always indicative of a UTI (just indicates inflammation)

Look for symptoms

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12
Q

When managing a patient with a UTI, what should always be done?

A

Collect a mid stream urine smaple for Microscopy, Cultures and sensitivity in case dont respond to empirical abx

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13
Q

What is the management for an uncomplicated UTI?

A

3days oral trimethoprim or nitrofurantoin

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14
Q

What is the management of complicated UTIs?

A

7-10 days nitrofurantoin or trimethoprim

Augmentin if dont work

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15
Q

What medication given for multi drug resistant gram negative organisms (causing UTI?

A

IV meropenem

Or

Oral fosfomycin

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16
Q

What scenarios do you treat asymptomatic bacteruria?

A

Pregnancy
Before urology surgery

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17
Q

How do you manage recurrent UTIs in women without abx?

A

Exclude structural causes with Ultrasound KUB (residual volume estimate)

Can cystoscope if older

Advise fluid intake
Avoid synthetic pants
Shower rather than bath
Avoid perfumed soaps
Cranberry tablets
Topical oestrogens if post menopausal
D-mannose

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18
Q

What are the abx managements of recurrent UTIs?

A

Single dose abx post coital
Self start abx at first sign of symptoms
Low dose 3-6months prophylactic abx course

19
Q

What is pyelonephritis?

A

Infection of the kidneys

20
Q

What is pyonephrosis?

A

An infected obstructed kidney where pus builds up in the. Renal pelvis

21
Q

What is the main difference between pyelonephritis and pyonephrosis?

A

Pyelonephritis can occur without obstruction usually due to an ascending UTI and happens bilaterally

Pyonephrosis is usually always due to an obstruction so is mainly unilateral

22
Q

How does pyelonephritis present?

A

Bilateral loin pain
Fever
Chills
N+V
Tachycardia

23
Q

What is more severe pyelonephritis or pyonephrosis?

A

Pyonephrosis

24
Q

How can patients be treated in community with pyelonephritis if it’s not septic?

A

7-10 days oral ciprofloxacin or augmentin(co-amoxiclav)

25
Q

What Ix are done for men with UTI?

A

Urine dip
DRE
U+Es
Cystoscope
Flow rate

26
Q

What is a flow rate used to assess?

A

Weather theres a bladder outflow obstruction

27
Q

What flow rate is suggestive of a bladder outflow obstruction?

A

<10ml/s

28
Q

What is acute prostatitis typically caused by?

A

Infection

29
Q

What are hte causes of chronic prostatitis?

A

Bacterial

Non bacterial

30
Q

What is a non bacterial causes of chronic prostatitis?

A

Pelvic floor dysfunction

31
Q

What is the most common causative organism for acute prostatitis?

A

E.coli

32
Q

What is the most common causative organism for acute prostatitis?

A

E.coli

33
Q

What structural change can STIs cause in young men?

A

Urethral strictures

34
Q

What investigation do you send off when you suspect an STI?

A

NAAT

35
Q

What are the 2 most common organisms for STIs?

A

Chlamydia
Gonorrhoea

36
Q

What is epididymo-orchitis?

A

Acute infection oof the testis/epididymis

37
Q

What is the most common cause of epididymo-orchitis in 16-30yr olds?

A

STIs (gonorrhoea or chlamydia)

38
Q

What is the most common cause of epididymo-orchitis in 60+ year olds?

A

Bladder outflow obstruction

39
Q

What investigations are done for orchitis?

A

Mid stream urine sample and NAAT
USS to exclude abscess or Tumor

40
Q

What drugs are given for epididymo orchitis in 16-30yr olds?

A

10-14days Oral doxycycline with or without IM Ceftriaxone

41
Q

What drugs are given to 60+yr olds with epididymo orchitis?

A

10-14days ciprofloxacin

42
Q

How can you typically tell the difference between epididymo-orchitis and testicular torsion?

A

Testicular torsion = rapid onset, younger people, high lying laterally orientated testis

43
Q

How do you manage testicular torsion?

A

Emergency exploration

Y3(S) - Urology (5 decks)

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