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Block 10 Ellen > L10: Microbiology of the urinary tract > Flashcards

L10: Microbiology of the urinary tract Flashcards

1
Q

5 symptoms of UTI

A 
polyuria 
dysuria 
urgency 
suprapubic discomfort 
fever low grade/ absent
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2
Q

symptoms of UTI in infants (2)

A

failure to thrive

poor feeding

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3
Q

symptoms of UTI in elderly

A

absent signs

sudden confusion

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4
Q

symptoms of pyelonephritis (4)

A

loin pain
fever
rigors
renal angle tenderness

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5
Q

7 risk factors for UTI

A 
female 
anatomical abnormality 
functional abnormality 
catheterisation 
pregnancy 
foreign body
urinary tract surgery
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6
Q

why is female sex a risk factor

A

shorter urethra
urethra opens into introitus
closer to anus

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7
Q

what does catheterisation lead to

A

biofilm formation

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8
Q

what happens in pregnancy increase UTI risk (3)

A

dilated ureters
incomplete bladder emptying
gestational glycouria

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9
Q

what are UTIs in pregnancy associated with

A

low birth rate
premature
perinatal morbidity

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10
Q

what will eventually happen to all catheters

A

get colonised

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11
Q

can you have a UTI with negative urine cultures

A

YES- 50% of women

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12
Q

reasons for a negative urine culture with a UTI (4)

A
  • low bacteria count
  • fastidious bacteria don’t grow on culture
  • non-infective inflammation
  • Sexually transmitted pathogens
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13
Q

commonest bacteria cause of UTI

A

E.coli

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14
Q

where does E.coli live normally

A

in bowel

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15
Q

what E.coli can cause UTIs

A

uropathogenic E.coli (UPEC)

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16
Q

what do UPECs have to enable UTIs

A

virulence factors for urinary tract

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17
Q

3 non-bacterial cause of UTI

A

viruses
mycobacterium tuberculosis
parasitic infection

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18
Q

what are BK and JC viruses associated with

A

infection and graft failure in patients following kidney transplant

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19
Q

most common route of UTI acquisition

A

ascending from urethra to bladder to kidney

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20
Q

less common UTI acquisition route

A

haematogenous

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21
Q

UTI from urethra to bladder=

A

cystitis

22
Q

UTI from bladder to kidney=

A

pyelonephritis

23
Q

4 host defences of UTI

A

urine flow
urine osmolarity/ pH/ organic acids
secreted sIgA
mucosal defences

24
Q

3 UPEC virulence features

A

type 1 fimbriae
type p fimbriae
bacterial capsule

25
Q

what is type p fimbriae associated with

A

pyelonephritis

26
Q

what is type 1 fimbriae associate with

A

cystitis causing strains

27
Q

what is bacterial capsule associated with

A

pyelonephritis causing strains

28
Q

what does type 1 fimbriae bind to

A

mannose residue on bladder endothelial cells membrane

29
Q

what do type p fimbriae bind to

A

glycolipid residues on host cells

30
Q

E.coli gram stain=

A

negative

31
Q

other gram negative causing UTIs

A

proteus species

32
Q

commonest proteus species

A

proteus mirabilis

33
Q

how is proteus protected

A

it produces magnesium ammonium phosphate stones which surround it

34
Q

what is changed on a urinalysis with UTI

A

protein
blood
leucocyte esterase
nitrites

35
Q

most specific signs for UTI

A

nitrites

leucocyte esterase

36
Q

what is urinalysis good at

A

ruling out UTI (negative predictive value)

37
Q

what is a Negative predictive value

A

is the probability that subjects with a negative screening test truly don’t have the disease.

38
Q

what is urinalysis bad at

A

ruling in UTI

39
Q

how do you avoid urine specimen contamination

A

midstream urine specimens

40
Q

what acid is placed in urine samples

A

boric acid

41
Q

what does boric acid do

A

stuns the bacteria

42
Q

what suggests contamination in a urine sample

A

epithelial cells

43
Q

colour of E.coli in CLED agar

A

yellow

44
Q

colour of proteus in CLED agar

A

pale blue

45
Q

in children how are UTIs thought of

A

complicated

46
Q

2 managements of UTIs

A

good hydration

antibiotics (if indicated)

47
Q

antimicrobial active against most agents of uropathogens

A

Trimethoprim

48
Q

trimethoprim affect on bacteria =

A

bacteriostatic

49
Q

treatment of lower UTIs in children (3)

A

amoxicillin
trimethoprim
cephalexin

50
Q

treatment of upper UTIs in children

A

co-amoxiclav

51
Q

treatment of severe UTIs in children

A

cefotaxime

gentamicin

Block 10 Ellen (9 decks)

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