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Path Y > Microbiology 10 - Urinary Tract Infections > Flashcards

Microbiology 10 - Urinary Tract Infections Flashcards

1
Q

Which organism is the most common cause of UTI?

A

E coli (95%)

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2
Q

What are the symptoms of UTI in babies?

A

Vomiting and failure to thrive

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3
Q

What are the symptoms of pyelonephritis?

A

Fever, rigors, flank pain and urinary symptoms

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4
Q

What are squamous epithlial cells in a MSU indicative of?

A

Contamination

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5
Q

For how long should antibiotics be taken in uncomplicated UTI?

A

3 days

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6
Q

What is the most common route of infection for candida UTIs?

A

Urinary catheters
note oral fluconazole is not useful
do not treat asymptomatic fungal infection

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7
Q

What is the empirical antibiotic treatment for pyelonephritis?

A

Co-amoxiclav +/- gentamycin

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8
Q

what’s the 2nd most common cause of UTI in younger women`?

A

staph saprophyticus (coagulase -ve staph)

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9
Q

what organism causes UTI in presence of prosthesis?

A

staph epidermis

e.g in a long term catheter

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10
Q

are the urethra and bladder sterile?

A

urethra - not

bladder is sterile

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11
Q

define complicated vs uncomplicated UTI? in whom is it complicated

A

complicated =infection w functional or structural abnormalities
complicated = men, pregnancy women, children (not young girls), patient in healthcare setting
uncomplicated = infection in a structurally and neurologically normal urinary tract

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12
Q

what does e coli have to prevent it being flushed out of urine

A

adherence factors

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13
Q

what type of cells at end of urethra

A

squamous epithelial

if found in MSU sample hasn’t been taken properly

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14
Q

fever is absent in what type of UTI?

A

lower

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15
Q

what are lower UTI symptoms

A 
FUND - Storage/Irritative
Frequency
Urgency
Nocturia
Dysuria
HIPS 
Voiding/Obstructive
Hesitancy
Incomplete emptying
Poor stream
Straining
Others: terminal dribbling, overflow incontinence
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16
Q

what’s the treatment of pyelonephritis

A

prior to culture results - amoxicillin

if results - coamox w/wout gentamicin

17
Q

what investigations for a UTI/pyeloneph

A 
Urine dipstick
		- MSU for urine microscopy, culture and 
           sensitivities
		- Bloods – FBC, UE, CRP (inflammatory
           markers and renal function)
18
Q

what investigations for a complicated UTI/pyeloneph

A

Renal USS

Intravenous urography

19
Q

negative nitrites & leucocyte esterase =

A

unlikely infection

20
Q

if either nitrite or lecuocyte esterase are positive and patient is symptomatic?

A

start antibiotics and send culture

21
Q

2 treatment options of uncomplicated UTI in female

A

nitrofurantoin 50mg QDS 7days
OR
cephalexin 500mg BD 3 days

22
Q

treatment of UTI if pregnant or breastfeeding

A 
1st = Nitrofurantoin (avoid at term) 100mg modified-release twice a day for 7 days if egfr is above 45
2nd = cephalexin 500mg BD for 7 days
23
Q

treatment of UTI in a male

A

cephalexin 500mg BD 7days

24
Q

treatment of catheter associated UTI

A

Nitrofurantoin (if eGFR ≥45ml/minute) 100mg modified-release twice a day for 7 days.

Trimethoprim (if low risk of resistance) 200mg twice a day for 7 days.
Amoxicillin (only if culture results available and susceptible) 500mg three times a day for 7 days.

25
Q

are more organisms needed to infect medulla or cortex

A

few = medulla

many (10,000 x) = cortex

26
Q

give 4 complications of pyelonephritis

A

Perinephric abscess
Chronic pyelonephritis (scarring, chronic renal impairment)
Septic shock
Acute papillary necrosis

27
Q

upper UTI symptoms

A

similar to lower
also fever
flank pain

28
Q

what culture results are diagnostic of a UTI

A

over 10^5 CFUs/mL

29
Q

give 3 Antibacterial Host Defences in the Urinary Tract

A

Urine (osmolality, pH, organic acids)

Urine flow and micturition

Urinary tract mucosa (bactericidal activity, cytokines)

30
Q

what condition increases the risk of ascending UTI in women

A

vesicoureteric reflux

31
Q

what is sterile pyuria? give 5 causes

A 
raised WCC but no growth on culture 
prior ABx treatment - most common 
Catheter
TB 
STI - chlmaydia 
calculi
32
Q

pink agar is what bacteria

A

e coli

33
Q

light blue agar is what group of bacteria

A

gram negative

34
Q

what agar is used to identify causes of UTI

A

chromogenic agar (changes colour)

35
Q

give 2 extra renal causes of obstruction that may lead to UTI

A

BPH

calculi

36
Q

give 2 intra renal causes of obstruction that may lead to UTI

A

PKD

nephrocalcinosis

37
Q

give 2 neurogenic causes of obstruction that may lead to UTI

A

diabetic neuropathy

tabes dorsalis

38
Q

define recurrent UTI

A

Recurrent UTI in adults is defined as repeated UTI with a frequency of 2 or more UTIs in the last 6 months or 3 or more UTIs in the last 12 months.

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