Lower UTI

Question 1

lower UTI

Answer 1

• very common
• secondary to resp infections
• generally d/t bacterial infections (usually E Coli)
• normal flora in genitalia migrating to urethra = common cause
• can also arise from normal flora in gut migrating to UT
• microbes can enter the circulatory system and cause sepiticemia

Question 2

who is it more common in?

Answer 2

women d/t anatomic proximity of the vagina to the anus
urethral entry (ascending infection into the bladder)

Question 3

if it’s a lower UTI which structures does it affect and if its an upper UTI which structures does it affect?

Answer 3

lower = urethra and bladder
upper = ureter and kidney

Question 4

defenses

Answer 4

• washout
• IR
• periurethral flora in women: microbial antagonism (normal flora utilize resources and prevent establishment of invasive microbes)
• mucin layer on surface of transitional epithelium
• prostatic fluid in men: antibacterial properties

Question 5

expand on the defense of the mucin layer

Answer 5

• secreted by cells that line the bladder
• coats the bladder wall
• composed of glycoproteins
• provides a barrier between microbes and epithelial lining of bladder wall

Question 6

risks

Answer 6

• catheterization

- obstruction of urethra -> urine stasis in bladder and reflux

Question 7

manifestations

Answer 7

• acute onset
• lower back pain and abd pain
• frequency
• dysuria

Question 8

diagnosis

Answer 8

• based on manifestations
• labs but not if uncomplicated
  C&S -> identify bacteria and what Abx to use
  Urinalysis -> dipstick to look for leukocytes

Question 9

treatment

Answer 9

• Abx -> broad spectrum, alter tx once C&S is analyzed (1 wk of abx)
• fluids (helps flush out bacteria and w voiding)
• address underlying cause