L 33 Renal Flashcards
Is the urinary tract sterile?
Usually
What are the defense mechanisms of Urinary tract infection ?
Immune system and passing urine
What is the proportion of UTI for women?
Common in female around 50%
Womens are 30x more likely get a UTI
Why women has higher infection rate of UTI than male?
Shorter urethra,Opening near vagina and anas.
Predisposing factors for UTIs?
- Gender (women)
- Age like below 1yr of age why ? cause of napkin
- Obstructions of UT (e.g by using catheter,)
- Pregnancy (hormone alteration)
- Diabetes (increased glucose and micorbes like it)
- Immunocompromisation
- Urine composition (microbes present?)
- Vaginal and faecal microflora (protective)
Types of UTI?
Uncomplicated & complicated
Uncomplicated UTIs occur in people with …. and they respond to….
Recurrence is due to a …..
Uncomplicated UTIs occur in people with normal immunity and normal urinary tracts and they respond to antibiotic therapy.
Recurrence is due to a new infection.
Complicated UTIs occur in people with …. and they …. respond to….
Recurrence is due to a …..
Complicated UTIs occur in people with abnormal immunity and abnormal urinary tracts, and they do not respond to antibiotics.
Recurrence is due to a relapse of earlier infection (not cleared well enough/at all)
What is urethritis?
Infection of the urethra causing inflammation
What are the common infectious causes of urethritis? What would be 2x examples of a non-infectious cuase?
- From Sexually Transmitted disease (chlamydia, gonorrhoea)
- GI oragnisms (e.g E.coli)
- Candida infections
Non infectious: trauma, washing detergents/irritants,
What are the Symptoms of urethritis?
Dysuria, increased urination urgency and frequency
- None of these are particularly unusual symptoms)
What is cystitis?
Infection of the bladder (leading to inflammation)
What are the most common causes of cystitis? x4
- E.coli
- Uropathogenic E.coli (UPEC) for recurrent infections
- Other GI organisms (Staph, Enterobacter)
- Fungal (candida), or viral (adenovirus)
What are the risk factors for cystitis?
Same as urethritis/other UTIs
What is UPEC?
Uropathogenic E. coli
Where do UPEC normally come from? How can UPEC survive in the UT? (Specialised factors x5)
UPEC are usually from the GIT.
Specialised factors:
1. Adhesion factors -pili/fimbriae (help to stick)
2. Toxins - haemolysin, cytotoxic factor (peak immune system and damage walls)
3. Capsules (help evade immune response)
4. Iron acquisition (nutrients to grow in urine (urine = nutrient-lacking environment for bacteria)
5. Urease activity (accumulates ammonia to change pH of urine, and can lead to kidney stones = decreased flow)
Symptoms of cystitis (uncomplicated and complicated)?
Uncomplicated: dysuria, urine urgency or frequency
Complicated: dysuria, urine urgency or frequency, incontinence, abdominal pain, low grade fever, foul smelling, discharge (blood or pus)
Recurrent cystitis is usually due to…
Recurrences are linked to host…..?
Usually due to a new organism
Recurrences are linked to host risk factors
Treatment aim for recurrent cystitis?
To keep patient symptom free and prevent renal damage
How do you diagnose UTIs?
How do you diagnose recurrent UTIs?
UTIs: symptomatic diagnosis (e.g dysuria, urgency/frequency, no discharge)
Recurrent UTIs: Self diagnosis has over 90% accuracy. Very reliable.