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renal - mine > Infections > Flashcards

Infections Flashcards

1
Q

what is an UTI

A

presence of micro-organism in the urinary tract that are causing clinical infections

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2
Q

where is bacteria found in the urinary system, what types

A

lower end of the urethra

coliforms and enterococci from large bowel

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3
Q

what are the gram negative causes of UTI

A 
e.coli
klebsiella
enterobacter
pseudomonas 
proteus
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4
Q

what is pathogen causes UTI in catheters

A

pseudomonas

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5
Q

what does proteus produce, what does this result in

A

urease which breaks down urea to ammonia causing increased urinary pH resulting in precipitation of salts (urolithiasis)

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6
Q

what are the gram positive causes of UTI

A

enterococcus faecalis
enterococcus faceium
staph saphrophytics
staph aureus (rare)

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7
Q

what pathogen is associated with bacteraemia

A

staph aureus

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8
Q

what is pathogen has the buzzword urolithiasis

A

proteus

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9
Q

what is a lower tract UTI, what is it also known as

A

infection confined to the bladder

cystitis

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10
Q

what is a upper tract UTI, what is it also known as

A

infection involving the ureters ± the kidney

pyelonephritis

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11
Q

what is a complicated UTI

A

UTI complicated by systemic symptoms of urinary structural abnormalities/stones

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12
Q

what are the symptoms of an UTI

A

pain/dysuria
frequency
nocturia
haematuria

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13
Q

what are the symptoms of an upper tract UTI

A

fever/chills
back/flank/loin pain
rigors

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14
Q

what are the investigations of an UTI

A

urine sample
dipstick
microscopy
culture

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15
Q

who would you not dipstick if UTI was suspected

A

elderly

catheterised

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16
Q

what would you expect to find on dipstick in UTI, what do they indicate

A

leukocyte esterase = WBC

nitrites = coliform bacteria

17
Q

what organisms don’t produce nitrites

A

enterococcus
staph
pseudomonas

18
Q

what quantity of bacteria signals a probable UTI

A

> 10 organisms/ml

19
Q

what is the treatment of a lower female UTI

A

trimethorpim OR nitrofurantoin 3 day oral course

20
Q

what is the treatment of a male UTI

A

trimethorpim OR nitrofurantoin 7 day oral course

21
Q

what is the treatment of a complicated UTI or pyelonephritis in the community

A

Co-amoxiclav OR co-trimoxazole 14 days

22
Q

what is the treatment of a complicated UTI or pyelonephritis in hospital

A

amoxicillin/co-trimoxazole and gentamicin IV for 3 days

23
Q

what is the treatment of a UTI with catheter

A

no antibiotics unless symptoms are present

24
Q

what investigation must be done in a male UTI

A

culture

25
Q

what is the treatment of a coliform

A

Gentamicin IV
Amoxicillin (40%)
Trimethoprim = lower tract
If resistant = aztreonam

26
Q

what is the treatment of enterococci

A

Amoxicillin IV
Co-trimoxazole
If resistant = vancomycin

27
Q

what is abacterial cystitis, what is it also known as

A

patient has symptoms of uTI and pus cells in urine but no growth on culture

urethral syndrome

28
Q

what are the causes of abacterial cystitis

A 
early phase of UTI
urethral trauma (honeymoon cystitis)
STI = chlamydia, gonorrhoea
29
Q

what is asymptomatic bacteriuria

A

significant bacteriuria (>10) but patient is asymptomatic

30
Q

what is the treatment of asymptomatic bacteriuria

A

none

pregnant - antibiotics due to risk of complications

31
Q

what is emphysematous pyelonephritis

A

acute necrotising parenchymal and peirirenal infection usually occurring in diabetes

32
Q

what causes emphysematous pyelonephritis

A

gas-formic uropathogens (e.coli)

33
Q

what are the symptoms of emphysematous pyelonephritis

A

fever
vomiting
flank pain
often associated with ureteric obstruction

34
Q

what are the investigations of emphysematous pyelonephritis, what would you expect to find

A

kidney, ureter, and bladder Xray = gas

CT

35
Q

what is the treatment of emphysematous pyelonephritis

A

emergency nephrectomy

36
Q

what causes a perinephric abscess

A

rupture of acte cortical abscess

haematogenous seeding from site of infection

37
Q

what are the symptoms of perinephric abscess

A

insidious onset
may be pyrexial
mass in flank (50%)

38
Q

what are the investigations of perinephric abscess

A

CT
high WCC
high serum CK

39
Q

what is the treatment of perinephric abscess

A

antibiotics + percutaneous/surgical drainage

renal - mine (8 decks)

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