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Urinary Tract Infections > Learning Objectives - UTI > Flashcards

Learning Objectives - UTI Flashcards

1
Q

Clinical Manifestations of Lower UTIs (Cystitis)

A

Dysuria (Painfuly urination)
Increased Urinary Frequency + Urgency
Suprapubic Discomfort
Possible Haematuria (Blood in Urine)

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2
Q

Clinical Manifestations of Upper UTIs (pyelonephritis)

A

Systemic symptoms
Fever
Chills
Flank Pain
Nausea
Vomiting
Malaise

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3
Q

Definition of Lower UTI

A

Infection of the bladder (cystitis)

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4
Q

Definition of Upper UTI

A

Infection of ureters and Kidneys (Pyelonephritis)

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5
Q

Urinary Tract Infection (UTI) definitions

A

An infection occurring in any part of the urinary system: kidneys, ureters, bladder or urethra

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6
Q

Uncomplicated UTI definitions

A

Refers to infection in a structurally and neurologically normal urinary tract of adult females
- Premenopausal
-Non-pregnant with no known relevant anatomical + functional abnormalities within the urinary tract or comorbidities

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7
Q

Uncomplicated UTI occur in which demographic

A

Premenopausal
Non pregnant women with no known relevant anatomical + functional abnormalities within the urinary tract or comorbidities

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8
Q

Complicated UTIs definition

A

An infection of the urinary tract in the presence of factors that can predispose patient to either persistent or relapsing infection(s)

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9
Q

Complicated UTIs include which demographic

A
  • Male (treat for minimum 7 days)
  • Pregnant Women
  • Post menopausal females
  • Children
  • Diabetes
  • Foreign body (catheter, other)
  • Obstruction
  • Immunosuppression
  • Renal failure
  • Renal Transplantation
  • Urinary Retention - Neurological
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10
Q

Asymptomatic bacteriuria

A

Considerable bacteriuria in a patient without symptoms. No adverse consequences + service no benefit from antibiotic therapy

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11
Q

Problems associated with urinary tract infections in non-pregnant women

A

Recurrent Infections
Renal Damage
Urosepsis

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12
Q

Problems associated with Urinary Tract Infections in pregnant women

A

Increased risk of pre-term labour
Low birth weight infants

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13
Q

Pathophysiology of Urinary Tract Infections

A

Ascending bacterial infection; pathogens enter the urinary tract via the urethra and colonise the bladder

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14
Q

Pathophysiology of urinary tract infections. What factors facilitate colonisation?

A

Bacterial virulence factors, such as adhesions + biofilm formation facilitate colonisation + persistence

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15
Q

Pathophysiology of urinary tract infections. What are the host defences?

A

Urinary flow
Mucosal Immunity
Antimicrobial properties of urine

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16
Q

Epidemiology of UTIs in Women

A

Shorter female urethra (4cm vs 20 in men)
Proximity to the anus
Hormonal changes
Sexual activity

17
Q

How does age affect the incidence of UTIs? Women

A

More common in sexually active young women and increase post-menopause due to changes in vaginal flora + oestrogen levels

18
Q

How does age affect the incidence of UTIs? Men

A

Prostate enlargement can lead to urinary retention -> increased infection risk

19
Q

Epidemiology of UTIs Men Over 50

A

UTIs in men are rare but increase in incidence after age 50 due to prostate enlargement

20
Q

Common Causative Pathogens

A

E.coli (70%-95% of cases) of uncomplicated UTIs
Staphylococcus saprophyticus
Klebsiella pneumoniae

21
Q

Causative pathogens in Hospital-Acquired infections

A

May involves more resistant organisms :
Pseudomonas aeruginosa
Enterococcus species

22
Q

What virulence factors enable uropathogenic E.coli to cause UTIs?

A

E.coli has adhesins, such as P fimbriae, to attach to the bladder lining. It produces toxins like hemolysin; damages host tissues. Biofilms protecting it from the immune response + antibiotics

23
Q

How do uncomplicated and complicated UTIs differ?

A

Uncomplicated UTIs occur in structurally normal urinary tract, typically in healthy non pregnant women. Complicated UTIs involve underlying conditions like anatomical abnormalities, urinary retention or immunosuppression

24
Q

Clinical Decision rules for differentiating UTIs?

A

Symptoms assessment
History
Diagnostic tests
Laboratory tests: Urine Dipstick
Urine Culture

25
Q

Risk factors for Minor UTIs?

A

Female sex
Sexual activity
Use of spermicides
History of previous UTIs
Frequent sexual intercourse

26
Q

Risk factors of Major UTIs or complicated infections

A

Structural abnormalities (e.g kidney stones)
Immunocompromised states
Pregnancy
Diabetes
Use of in dwelling catheters
Men x>50 prostatic hypertrophy

27
Q

First-Line Treatment for Uncomplicated UTIs in Non-Pregnant Women

A

Nitrofurantoin: 100mg modified-release BD for 3 days (if estimated glomerular filtration rate >45ml/min)

28
Q

Alternative First-Line Treatment for Uncomplicated UTIs in Non-pregnant Women.

A

If nitrofurantoin is unsuitable
Trimethoprim: 200mg BD for 3 days (if low risk of resistance)

29
Q

Second-Line Treatment for Uncomplicated UTIs in Non-Pregnant Women

A

Pivmecillinam: 400mg initial dose, then 200mg TDS for a total of three days
Fosfomycin: 3g single dose sachet

30
Q

Treatment for Uncomplicated UTIs in Pregnant Women

A

Nitrofurantoin: 100mg modified-release BD for 7 days (avoid at term)
Amoxicillin: 500mg TDS for 7 days (if culture results confirm susceptibility)
Cefalexin: 500mg BD for 7 days

31
Q

Treatment for Uncomplicated UTIs in Men

A

Nitrofurantoin: 100mg modified-release BD for 7 days
Trimethoprim: 200mg BD for 7 days

32
Q

Treatment for Complicated UTIs

A

Treatment should be guided by urine culture + sensitivity results. Options may include:
Ciprofloxacin: 500mg BD for 7 days
Co-amoxiclav: 500/125mg TDS for 7 days
Trimethoprim: 200mg BD for 14 days (if culture results confirm susceptibility.)

33
Q

Treatment for Catheter- Associated UTIs

A

Nitrofurantoin: 100mg modified release BD for 7 days ( if no upper UTI symptoms)
Trimethoprim: 200mg BD for 7 days (if no upper UTI symptoms
Cefalexin: 500mg BD/TDS for 7 days (if upper UTI symptoms)

34
Q

Treatment for Recurrent UTIs

A

Antibiotic Prophylaxis: e.g Nitrofurantoin 50 mg or 100mg at night for 6 months with regular review
Self-care measures: Personal hygiene measures; increased fluid intake + post-coital voiding

35
Q

Treatment of Asymptomatic Bacteriuria in Pregnancy

A

Nitrofurantoin: 100mg modified release BD for 7 days (avoid at term)
Amoxicillin: 500mg TDS for 7 days (if culture results confirm susceptibility)
Cefalexin: 500mg BD for 7 days Trimethoprim

Urinary Tract Infections (1 decks)

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