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Y2 Renal > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what is a UTI?

A

the presence of pathogens in the urinary tract

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2
Q

what are the two main types of UTI?

A

upper and lower

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3
Q

what is a complicated UTI?

A

one complicated by either systemic symptoms or urinary structural abnormalities/stones

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4
Q

what is bacteriuria?

A

bacteria in the urine

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5
Q

in what situations can bacteriuria often not mean infection?

A

elderly patients

catheter use

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6
Q

what is cystitis?

A

inflammation of the bladder - not always due to infection

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7
Q

what is the microbiological state of normal urine?

A

sterile

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8
Q

what bacteria is found at the lower end of the urethra?

A

commensals from the large bowel

coliforms, enterococci

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9
Q

which sex is more commonly affected by UTI’s and why?

A

women

have a short, wide urethra that is close to the anus

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10
Q

what are the two routes of infection in a UTI?

A

ascending - moves up the urethra

haematogenous

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11
Q

what is the most common causative pathogen of a UTI?

A

e coli

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12
Q

name three gram negative causative organisms of UTI

A

coliforms
proteus
pseudomonas aeruginosa

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13
Q

what are coliforms?

A

gram negative bacilli

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14
Q

name a coliform

A

e coli

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15
Q

what is a common complication of proteus sp UTI?

A

struvite stones

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16
Q

what is produced by proteus sp and what effect does this have in UTIs?

A

produces urease

breaks down urea to ammonia = increased urinary pH

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17
Q

what type of bacteria is pseudomonas aeruginoas?

A

gram negative bacillus

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18
Q

what is pseudomonas UTI associated with?

A

catheters

immunosuppression

19
Q

what antibiotic can be used to manage UTI due to pseudomonas aeruginosa?

A

ciprofloxacin

20
Q

how can ciprofloxacin be administered?

A

oral or IV

21
Q

who should not receive ciprofloxacin?

A

young children

pregnant women

22
Q

what is the mechanism of action of ciprofloxacin?

A

inhibits bacterial DNA gyrase

23
Q

why is use of ciprofloxacin limited?

A

to reduce number of C Diff infections

24
Q

what two gram positive organisms can cause UTI?

A

enterococcus

staphylococcus

25
Q

what is the most common enterococcus in UTI?

A

enterococcus faecalis

26
Q

what is enterococcus UTI often associated with?

A

hospital acquired infection

27
Q

what staph is a cause of UTI?

A

staph saprophyticus

28
Q

what are some common symptoms of UTI?

A

dysuria
frequency
nocturia
haematuria

29
Q

what is dysuria?

A

pain when passing urine

30
Q

what are some symptoms that suggest upper involvement in a UTI?

A

fever
loin pain
rigors

31
Q

what type of urine specimen should be collected?

A

a midstream specimen of urine

32
Q

what type of containers can be used for urine specimens?

A

boricon container

sterile universal container

33
Q

what does a positive leucocyte on urinalysis show?

A

presence of leucocytes in the urine

34
Q

what does positive nitrites on urinalysis show?

A

presence of bacteria in the urine

35
Q

who should not have urinalysis for UTI done?

A

elderly

those with catheters

36
Q

how can lab diagnosis of a UTI be done?

A

microscopy of urine

culture of urine

37
Q

what criteria is applied to women of childbearing ge to determine if they have a UTI?

A

kass’s criteria

38
Q

according to kass’s criteria, what suggests a probable UTI?

A

> 10x5 organisms/ml

39
Q

how long should antibiotics be given for to women with uncomplicated lower UTI’s?

A

three days course

40
Q

when would antibiotics be given for asymptomatic bacteriuria?

A

if pregnant

41
Q

what is the empirical treatment for a female with a lower UTI?

A

nitrofurantoin or trimethoprim orally for 3 days

42
Q

what is the empirical treatment for an uncatheterised male with a UTI?

A

get cultures

nitrofurantoin or trimethoprim for 7 days

43
Q

what is the empirical treatment for an uncomplicated UTI or pyelonephritis

A

co-amoxiclav or co-trimoxazole for 7 days

44
Q

what is the empirical treatment for a complicated UTI or pyelonephritis?

A

amoxicillin + gentamicin IV for three days

co-trim + gent if penicillin allergic

Y2 Renal (29 decks)

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