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Z MD1 Renal block > microbiology > Flashcards

microbiology Flashcards

0
Q

what is the average number of UTIs for a sexually active women

A

1 every 2 years

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1
Q

what population is most likely to get UTIs

A

women

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2
Q

what is pyelonephritis

A

infection of the kidney and renal pelvis

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3
Q

what is sterile pyuria

A

pus in the urine without bacterial growth

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4
Q

what is it called when you have bacteria in the urine but no clinical symptoms

A

asymptomatic bacteriuria

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5
Q

where abouts in the urinary system should be sterile

A

everything above the lower sphincter of the bladder

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6
Q

what is the most likely cause of UTIs

A

E. coli

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7
Q

what are the main causes of UTI

A

E. coli
Proteus species
Staph saprophyticus
others

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8
Q

how do bacteria get to the urinary tract

A
  • most ascending

- occasionally via the blood

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9
Q

which bacteria causing UTIs get there via the blood

A

Staph aureus –> kidney abscess
Salmonella typhi
TB

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10
Q

which bacteria causing UTIs are associated with Shistasoma

A

Salmonella Typhi

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11
Q

what are our innate defenses against UTIs

A
  • transitional epithelium resists colonisation by most types of bacteria
  • epithelium relatively resistant to bacterial invasion
  • some bacteria dont like growing in urine
  • constant flushing out of the bladder –> regular bladder emptying
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12
Q

what normal host factors predispose us to getting UTIs

A
  • short urethra in girls/women
  • sexual intercourse
  • colonisation of the distal urethra
  • no circumcision (for infant boys only)
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13
Q

what abnormal host factors predispose us to getting UTIs

A
  • incomplete bladder emptying (structural abnormality or functional abnormality)
  • catheterisation
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14
Q

what is vesico-ureteric reflux

A

when the last part of the ureter is not closed off by contraction of the bladder and therefore reflux of urine goes up the ureter with urination

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15
Q

what are PAP pilli associated with

A

pyelonephritis

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16
Q

which adhesins of bacteria make it more likely to get UTIs

A
  • type 1 fimbriae - stick to particular sugar residues on our membranes
  • PAP pilli of E. coli
  • flagella - able to swim up the ureters
17
Q

what microbial bacterial factors make them more likely to cause UTIs

A
  • adhesins
  • polysaccharide capsule
  • intracellular bacterial communities
  • biofilm formation
  • haemolysin
  • siderophores
  • urease
18
Q

which bacteria associated with UTIs have a polysaccharide capusle

A

E. coli and Klebsiella

19
Q

what is the advantage of a bacteria having siderophores

A

sucks iron of transferrin - bacteria will use this for growth

20
Q

how does urease help with bacterial UTI

A

assists growth and promotes formation of struvite stones

21
Q

where do bacteria with type 1 pilli tend to infect in the urinary system

A

bladder

22
Q

what are the types of urine samples

A
  • Midstream urine
  • catheter/nephrostomy sample
  • bag sample (for infants)
  • suprapubic aspirate
23
Q

why dont you want the first part of the urine for testing for UTIs

A

because the first part of the urine will be contaminated with the commensals of the lower urinary tract - so will misdiagnose bacteria in the upper urinary tract if you use this

24
Q

what is the use of a bag sample for detecting UTI

A

can rule out UTIs - if there are no bacteria in it

if there are any bacteria - useless

25
Q

use of suprapubic aspirate

A

if there is any bacteria in the aspirate –> significant (should be sterile where you are taking the sample)

26
Q

how do you collect a sample from a catheter bag

A

never collect it from the bag! - get it from a needle into the tube when fresh urine is being passed

27
Q

what do you look for in the examination of urine under the microscope

A 
WBC
RBC
epithelial cells
casts
crystals
microorganisms
28
Q

what is the normal level of RBC in the urine

A

<10^4

29
Q

what is the normal and abnormal ranges for WBC in the urine

A

normal - less than 10^4

abnormal - more than 10^5

30
Q

what does it mean if you have epithelial cells in the urine

A

suggests poorly gained specimen - using sample from the beginning of the stream

31
Q

what is the cut off for abnormal number of bacteria in a sample collected from a catheter

A

> 10^2

32
Q

what are the normal and abnormal counts for bacteria in the urine

A

normal - <10^3

abnormal - more than 10^5

33
Q

how long do you have to get a urine sample to the lab

A

<1 hour

or keep it at 4 degrees for up to 18 hours

34
Q

which parts of the urine dipstick are useful for detecting UTIs

A

leukocytes and nitrites

35
Q

what are the causes of sterile pyuria

A

non-infectious conditions eg tumour
partial treatment
difficult to grow bacteria - eg. TB

36
Q

what is the Tx for uncomplicated cystitis

A
  • alkalinise urine (check pH first)
  • cephalexin or co-amoxyclav or trimethoprim
  • if <2 years, check for UT abnormality
37
Q

what is the Tx for pyelonephritis

A
  • cephalexin or co-amoxyclav or trimethoprim for 10 days
  • check for UT abnormality
  • if severe sepsis, use ampi/amoxycillin and gentamycin
38
Q

when is the only time that asymptomatic bacteriuria is a problem

A

during pregnancy

39
Q

how do you treat asymptomatic bacteriuria during pregnancy

A

cephalexin/co-amoxyclav or other

40
Q

urease in which bacteria?

What does it do?

A

proteus uses it to make struvite stones (ammonia)

41
Q

what kind of bacteria is proteus

A

gram negative rose

Z MD1 Renal block (8 decks)

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