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Pathology > M - UTIs > Flashcards

M - UTIs Flashcards

1
Q

Define uncomplicated UTI

A

Infection of the urinary tract without any structural or functional abnormality

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2
Q

Define complicated UTI

A

infection of the urinary tract with functional or structural abnormalities

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3
Q

Complicated UTI is generally an infection in which kind of patients?

A

Male
pregnant
Indwelling catheters
Children

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4
Q

Prevalence of bacteriuria in young non-pregnant women?

A

1-3%

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5
Q

List the 4 most common bacterial causes of UTI

A

E. Coli
Staph. Saprophyticus
Proteus
Klebsiella

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6
Q

Clinical features of lower UTI in diff patients?

A

Generally: dysuria, frequency, urgency, haematuria

Children - vague (fever, irritability, vomiting,FTT)

Elderly - asymptomatic

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7
Q

Clinical features of pyelonephritis

A

Fever
Rigors
Flank pain

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8
Q

Gram +ve, coagulase -ve, UTI

  • name 2 common causes
A

S. Saprophyticus
S. Epidermis (prostheses)

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9
Q

Extra renal causes of urinary tract obstruction

A

BPH, Calculi

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10
Q

Intrarenal causes of urinary tract obstruction

A

PCKD
SCD
Hypokalemic nephropathy?!

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11
Q

Neurogenic causes of renal tract obstruction

A

Poliomyelitis
Diabetic neuropathy
Spinal cord injury

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12
Q

Haematogenous route of UTI - what tends to cause this?

A

S. aureus bacteremia or endocarditis

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13
Q

If urine dip shows +ve leukocytes alone, what step should you take next?

A

Urine culture
Treat if severe Sx

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14
Q

what culture result is diagnostic of UTI?

^exception to this rule?

A

Culture of single organisms >10^4 colony forming units/mL

Accept lower number if E.Coli or S. saprophyticus

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15
Q

Urine microscopy - which cells, if you saw them, would be indicative of sample contamination

A

squamous epithelial cells

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16
Q

Causes of sterile pyuria (WBCs present and nothing on culture)

A

Prior treatment with Abx = top cause

calculi
catheterisation
bladder ca
TB or STD (not grown in normal culture)

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17
Q

Tx of pyelonephritis

A

Coamoxiclav +/- gentamicin

18
Q

Uncomplicated UTI in female - tx?

A

Cephalexin or nitrofurantoin

19
Q

UTI in man - Tx?

A

Cephalexin or ciprofloxacin

20
Q

Catheter associated UTI - tx?

A

Gentamicin or amikacin

21
Q

In whom would you consider a 7 day abx course for uncomplicated lower UTI ? list 3

A
  1. Men
  2. previous UTI with resistant organism
  3. > 7 days of Sx
22
Q

Candida UTI - main cause?

A

Indwelling catheter

23
Q

Complications of pyelonephritis - state 4

A

Chronic pyelonephritis
Abscess
Acute papillary necrosis
Septic shock

24
Q

name the only staph bug to commonly cause UTI

A

staph saprophyticus

25
Q

which bug causes stones in UTI

A

proteus mirabilis

26
Q

which bug do you get in hospital with a cather

A

klebsiella aerogenes

27
Q

which type of bacteria cause ascending UTI

A

gram -

28
Q

which bug causes UTI via haematageneous route

A

staph aureus

29
Q

LUTI Sx

A

Dysuria, frequency, urgency, pain suprapubic / on peeing

30
Q

UTI Sx

A

fevers, rigors, flank pain, varied, some LUTI Sx too

31
Q

features on urine dip to suggest UTI

A

leucocytes and nitrites

32
Q

Ix for complicated UTI

A

Renal USS and IV urography

33
Q

Cut off for lab to say bacteria has been grown?

A

Between 10^4 and 10^5 cfu/mL

34
Q

Squamous epithelium in UTI sample. Meaning?

A

Poorly taken sample, as has cells from lower 1/3rd urethra

35
Q

High WCC on microscopy but no bacteria grown. Meaning?

A

TB - not tested for routinely in microscopy so not grown

36
Q

Sampling methods for UTI

A

MSU, catheterisation, suprapubic aspiration

37
Q

Normal length of ABx Tx for UTI

A

3 days

38
Q

List Abx to avoid in UTI in pregnant women

A

Nitrofurentoin and trimethoprim

39
Q

Tx for UTI with catheter?

A

Take out catheter

40
Q

Tx for fungal UTI

A

No Tx if no Sx - fluconazole is not effective

41
Q

complications of pyelonephritis

A

Perinephritic abcess
Chronic pyelonephritis
Sepsis
Acute papillary necrosis

42
Q

Prophylaxis for UTI?

A

No - controversial as can lead to resistance and adverse effects

Pathology (87 decks)

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