Infections Lecture 6: Renal + GI Infections and management

Question 1

What are the causes of lower urinary tract infection?

Answer 1

Commonly bacteria from E.Coli in the urethra

Question 2

What are the risk factors of UTI?

Answer 2

1. Females
2. Post menopause
3. Sexual activity
4. Pregnancy

Question 3

What are the symptoms of UTI?

Answer 3

1. Polyuria (increased urination)
2. Dysuria (pain whilst urination)
3. Increased urgency
4. Lower abdominal discomfort
5. Lower backpain
6. Cloudy or bloody urine
7. Strong smelling urine

Question 4

How do you test for UTI?

Answer 4

1. Dipstick test
2. Urinanalysis
3. Culture if required

Question 5

What are the treatment options for uncomplicated UTI?

Answer 5

1. Short course of nitrofurantoin or Trimethoprim for 3 days or 7 days
2. Cefalexin (3 days)
3. Amoxicillin
4. Co-amoxiclav (5 days)

Question 6

How do you treat uncomplicated UTIs in pregnancy?

Answer 6

1. Cephalosporins
2. Penicillins
3. Nitrofurantoin
4. Trimethoprim

Question 7

What are the symptoms of UTI in children?

Answer 7

1. Painful
2. Frequent
3. Foul smelling
4. Cloudy urine
5. Poor control over urination
6. Back pain and abdominal pain
7. Fever and vomiting

Question 8

What are the treatment options available for UTI in children?

Answer 8

1. Nitrofurantoin
2. Trimethoprim
3. 1st generation cephalosporin
   Co-amoxiclav for 7 to 10 days

Question 9

How do you treat recurring UTI?

Answer 9

1. Trimethoprim
2. Nitrofuratoin
3. Cefalexin (low dose at night)

Question 10

How does trimethoprim work?

Answer 10

1. Broad spectrum antibiotic most UTI causing organisms
2. Inhibits folate synthesis
3. Rapidly absorbed with high bioavailability

Question 11

Describe how Nitrofurantoin works?

Answer 11

1. Broad spectrum bactericidal
2. Only used in UTI infections as it doesn’t penetrate into tissues
3. Works by inhibiting cell wall, bacterial proteins and DNA
4. Highly soluble in urine (bioavailability increases food)

Question 12

Describe what complicated UTI is and the treatment options?

Answer 12

1. Occurs due to structural abnormality, blockage in urinary system and any other underlaying health conditions
2. Treatment: Hospitalisation
3. Empirical:
   - Fluroquinolone
   - Cephalosporin
   - IV aminoglycoside
   Duration: 7 to 14 days

Question 13

What are the symptoms of prostatitis (bacterial)?

Answer 13

1. Pain problems
2. Urinating and ejaculation problems
3. Discomfort in the lower back, pelvis and genitals
4. With acute prostatitis it’s usually very sudden

Question 14

What is prostatitis?

Answer 14

Enlargement of the prostate which causes the blockage of the ureter

Question 15

How do you test for prostatitis?

Answer 15

1. Dipstick
2. Labtesting urine
3. Scans

Question 16

How do you treat prostatitis?

Answer 16

1. 28 day course antibiotic started straight away
2. Ciproflaxacin 500mg twice daily for 28 days
3. Orfloaxin 200mg twice daily for 28 days

Question 17

What are the risk factors of pyelonephritis?

Answer 17

1. Women
2. Obstruction in the urinary tract
3. Immuno compromisation
4. Pregnancy
5. Catheter
6. Diabetes

Question 18

What are the symptoms of pyelonephritis?

Answer 18

1. Fever
2. Increased heart rate
3. Painful urination
4. Abdominal pain
5. Nausea
6. Tenderness of affected side and others if more serious

Question 19

How do you treat pyelonephritis?

Answer 19

Broad spectrum cephalosporin or quinolone for 14 days