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Urinary > Lecture 18 - UTIs > Flashcards

Lecture 18 - UTIs Flashcards

1
Q

What is considered a lower urinary tract infection?

A

Infection of the bladder or urethra

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2
Q

What is considered an upper urinary tract infection?

A

Infection of the ureters or kidneys

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3
Q

What is cystitis?

A

Infection of the bladder

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4
Q

What is pyelonephritis?

A

Infection of the kidneys

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5
Q

What adaptations does the urinary tract have against bacterial colonisation?

A

Emptying of bladder in micturition (flushes bacteria)

Vesico-ureteral valves (flap sitting over entrance of ureter into bladder preventing urine backflow)

Immunological factors

Mucosal barriers

Urine acidity

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6
Q

What are some risk factors for developing a UTI?

A

Female
Obstructive causes
Neurological conditions affecting bladder emptying
Pregnancy
Abnormal renal tract
Impaired host defence

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7
Q

Why is being female a risk factor for a UTI?

A

Shorter urethra and shorter distance from rectum/anus

Shorter distance for bacteria to travel

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8
Q

Why is having obstructive pathology a risk for developing a UTI?

A

Stasis of urine occurs so reduced ability to clear bladder

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9
Q

Why is having neurological conditions affecting bladder emptying like MS or stroke a risk for developing a UTI?

A

Ineffective emptying of bladder leads to stasis of urine

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10
Q

Why is pregnancy a risk factor for a UTI?

A

Uterus can compress bladder

Muscles of ureters relax/dilate leading to stasis of urine

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11
Q

Why is having an abnormal a renal tract and having an impaired host defence a risk for UTIs?

A

Vesicles-ureteric reflux may occur allowing back flow of urine
DM or immunosuppression increases infection risk

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12
Q

Why does prevelance in UTIs in men drastically go up at around ages 50-60?

A

Men usually start to get prostate issues at this age

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13
Q

What is the main causative organism for a UTI?

A

Gram negatives:

Escherichia coli

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14
Q

How does Escherichia coli cause damage during infection?

A

Flagella allow it to move
Pili allow it to attach
Then it makes toxins that damage host membranes and causes renal damage

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15
Q

What are the signs and symptoms of cystitis (a lower UTI)?

A

Dysuria (painful voiding)
Cloudy urine
Nocturia or frequency
Urgency
Suprapubic tenderness
Mild pyrexia

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16
Q

What are the signs and symptoms of pyelonephritis (an upper UTI)?

A

High fever
Rigours
Loin pain and tenderness
Nausea and vomitting
Haematuria
Symptoms of cystitis

17
Q

What are some other causes of dysuria that’s not a UTI?

A

STIs
Post sexual intercourse
Contact with irritants
Symptoms of menopause, atrophic vaginitis or vaginal atrophy

18
Q

What is considered an uncomplicated UTI in women?

A

Infection by a usual organism in a patient with a normal urinary tract and normal urinary function `

19
Q

Why is the male defintion of an uncomplicated UTI different to women?

A

Men don’t normally get UTIs till old

So any male UTI is considered a COMPLICATED UTI

20
Q

What is considered a complicated UTI in women?

A

A UTI where there are factors that predispose to persistent infection, recurrent i nfection or treatment failure:

Impaired renal function
Suspected pyelonephritis
Impaired host defence
Virulent organism (staph a)
Abnomral urinary tract

21
Q

When is a urine culture taken with UTIs?

A

When UTI is considered complicated

22
Q

When are urine dipsticks also used to help diagnose a UTI?

A

When patients have 1 of the following:
Dysuria
New nocturia
Cloudy urine

23
Q

What patients are urine dipsticks not useful for diagnosing a UTI?

A

Older than 65
Catheterised

24
Q

What is the causative organism if the urine dipstick is NEGATIVE for nitrites but postive for LE (leukocyte esterase)?

A

Staphylococcus saprophyticus

25
Q

When is imaging of the urinary tract done with UTIs?

A

Kids with multiple UTI

Valvular in septic patients to identify renal involvement

26
Q

What are the conservative methods of treating a UTI?

A

Increase fluid intake

Regular analgesia

27
Q

What is the length of Abx course for uncomplicated and complicated UTIs?

A

3 days Abx for uncomplicated

7days Abx for complicated UTI (pregnant, male, underlying disorders)

28
Q

What antibiotics are given to a non pregnant woman with uncomplicated UTI/cystitis?

A

Nitrofurantoin
Or
Trimethoprim TWICE per day for 3 days

29
Q

What antibiotics can be given to a man with cystitis?

A

Trimethoprim
Nitrofurantoin twice a day for 7days

30
Q

What treatments can be used for pyelonephritis?

A

7-14day course of Abx

Agents with SYSTEMIC ACTIVITY

IV:
-trimethoprim/co-amoxiclav
-ciprofloxacin
-gentamicin

31
Q

Why would you not treat pyelonephritis with Nitrofurantoin?

A

Does not have systemic activity

32
Q

How can we prevent UTIs?

A

Hydration
Promote good hygiene practices
Encourage post-coital voiding
Avoid unnecessary catheterisation

33
Q

What is the function of dapagliflozin?

A

Inhibits SGLT2

Urinary (24 decks)

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