Infections

Question 1

why are you more prone to infection if you have CKD

Answer 1

• immunosuppressed e.g. from transplant

- dialysis provides a route in for bacteria

Question 2

what is the most common causative organism of UTIs

Answer 2

E.coil

Question 3

what is cystitis

Answer 3

inflammation of the bladder - lower urinary tract infection

Question 4

what symptoms are seen in cystitis

Answer 4

dysuria and an increased frequency to urinate

Question 5

what is the treatment for cystitis

Answer 5

3 day course of trimethoprim

or can use nitrofurantoin

Question 6

what is an uncomplicated UTI

Answer 6

an infection caused by a usual organism in a normal urinary tract which has normal functioning

Question 7

what is a complicated UTI

Answer 7

where factors are present to predispose the patient to a UTI

Question 8

how does the treatment differ for a complicated and uncomplicated UTI

Answer 8

complicated require a longer course of antibiotics (5-7 days)

Question 9

what is asymptomatic bacteriuria

Answer 9

where there is bacteria present in the urine of elderly patient but is not causing damage

Question 10

what is the treatment for asymptomatic bacteriuria

Answer 10

no treatment - don’t want to give antibiotics as this increases the risk of resistance

Question 11

what is pyelonephritis

Answer 11

inflammation of the kidney (upper urinary tract infection)

Question 12

what are the symptoms of pyelonephritis

Answer 12

fever, loin pain, dysuria and increased frequency to urinate

Question 13

what are the causes of pyelonephritis

Answer 13

can be from the blood in a systemic infection

can ascend from the lower tract

Question 14

how is pyelonephritis treated

Answer 14

co-amoxiclav

Question 15

why is nitrofurantoin not given to treat pyelonephritis

Answer 15

this antibiotic is specific to the bladder so won’t help with systemic infections

Question 16

what investigations are carried out for a suspected UTI

Answer 16

urine dipstick, MUS culture, antibiotic sensitivity testing, visual urine inspection

Question 17

when would the leukocyte esterase be raised in a dipstick test

Answer 17

due to the presence of WBC indicating infection or inflammation

Question 18

when would the nitrites be raised in a dipstick test

Answer 18

in the presence of bacteria

Question 19

what is the sensitivity and specificity of a urine dipstick test

Answer 19

• high sensitivity as it picks up small amounts of substances
• low specificity as it can’t diagnose

Question 20

how does TB affect the urinary tract

Answer 20

goes through the blood to the kidneys where is causes calcification, formation of caseous masses and abscesses

the infection can then spread down the ureters and bladder causing fibrosis and strictures

Question 21

what does schistosomiasis do to the urinary tract

Answer 21

causes cystitis, calcification of the bladder and bladder cancer

Question 22

what systemic infections can cause glomerulonephritis

Answer 22

• post-infectous glomerulonephritis
• hepatitis
• endocarditis

Question 23

what is ureteric reflux

Answer 23

where urine goes back from the bladder into the ureters

Question 24

what neurological problems can cause an increased chance of glomerulonephritis

Answer 24

incomplete emptying of the bladder as it leads a residual urine - this stasis causes infection

Question 25

what types of obstruction could lead to a UTI

Answer 25

enlarged prostrate, pregnancy, stones, tumours

Question 26

why are women more likely to get a to get a UTI then males

Answer 26

shorter urethra