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Urinary > Pathology of Urinary Tract Infection > Flashcards

Pathology of Urinary Tract Infection Flashcards

1
Q

What is the common presentation of a UTI?

A

Dysuria
Frequency
Smelly urine

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2
Q

Approximately what proportion of the cardiac output do the kidneys receive?

A

25%

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3
Q

Do the ureters store urine?

A

No, they have a continuous trickle of urine

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4
Q

How is influx of urine from the ureters into the bladder stopped?

A

The ureters enter the bladder at an angle. When the bladder fills and expands this angle is shut off by compression by the bladder wall and urine ceases to enter

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5
Q

Describe the pH, osmolarity and ammonia content of normal urine

A

Low pH
High osmolarity
High ammonia content

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6
Q

What parts, if any, of the urinary tract are sterile?

A

The entire tract bar the terminal urethra, which is contaminated with perineal and rectal flora

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7
Q

How can a sample of urine be taken in a completely sterile manner?

A

Suprapubic aspirate

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8
Q

Describe the challenges of obtaining a non-contaminated sample of urine

A

Because the terminal urethra is contaminated, any urine sample passed by the patient will contain bacteria. Because the healthy bladder is completely sterile, this makes determining whether the bacteria in the sample is from the bladder or from the terminal urethra

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9
Q

What is an MSSU?

A

A mid-stream specimen of urine, designed to avoid the initial flush of bacteria into the same from the first void of urine, but it will always be present

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10
Q

How is it determined whether the flora cultured from a urine sample indicated a UTI or normal terminal urethral flora?

A

They are calculated in log, and a culture of 10^5 usually indicates infection

Below 10^3 usually rules out infection

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11
Q

What are some causes of UTI?

A

Mostly bacteria - gut flora, especially e.coli

Viral infection rare

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12
Q

Describe the rout taken by UTIs

A

Almost always ascending up the tract, the higher the infection the more serious

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13
Q

What is the name for inflammation of the urethra?

A

Urethritis

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14
Q

What is the name for inflammation of the bladder?

A

Cystitis

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15
Q

What is the name for inflammation of the kidney (acute)?

A

Acute pyelonephritis

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16
Q

What is the name for inflammation of the kidney (chronic)?

A

Chronic pyelonephritis

17
Q

What is urethritis?

A

Inflammation of the urethra

18
Q

What is the name for inflammation of the ureter?

A

Ureteritis

19
Q

Give three predisposing factors for UTIs

A

Stasis of urine
Pushing bacteria up urethra from below
Generalised predisposition to infection

20
Q

What may cause stasis of urine?

A

Obstruction

Loss of bladder sensation

21
Q

What may cause UTI as a result of pushing bacteria up the urethra from below?

A

Sexual activity in females

Catheterisation (and other urological procedures)

22
Q

Describe the effects of an obstruction at the level of the urethra

A

There begins a dilation of the upper urethra and bladder, which leads to bilateral hydroureter
this progresses to bilateral hydronephrosis and chronic renal failure

23
Q

What is the effect of an obstruction at the level of the renal pelvis one on side only?

A

Unilateral hydroureter develops and progresses to unilateral hydronephrosis

24
Q

What make up the triad of consequences of obstruction?

A

Infection
Calculi
Obstruction

25
Q

What is the most important cause of obstruction in children?

A

Vesicoureteric reflux

26
Q

What is vesoureteric reflux?

A

Where there is decreased angulation of the point of entry of the ureter into the bladder wall. This means that the compression of the filling bladder does not fully compress the ureter and urine is allowed to reflex up the ureter

27
Q

What is the most common cause of obstruction in male adults?

A

Benign Prostatic Hyperplasia - functional and anatomical obstruction - not a tumour

28
Q

What is the most common cause of obstruction applying only to women?

A

Uterine prolapse

29
Q

How does loss of sensation of the bladder cause stasis of urine?

A

Decreased sensation in the bladder due to spinal cord or brain injury mens that the ability to know when to empty the bladder is impaired and stasis of urine results

30
Q

What factors inherent in women predispose them to UTIs?

A

A short urethra
Lack of prostatic bacteriostatic secretion
Closeness of urethral orifice to rectum
Sexual activity
Pregnancy - pressure on ureters and bladder

31
Q

Give two factors relating to diabetes which predispose to UTI

A

Glucose in the urine

Poor function of WBC

32
Q

What are acute complications of UTIs?

A

Severe sepsis

Septic shock

33
Q

What are chronic complications of UTIs?

A

Chronic damage to the kidneys if repeated infections (chronic polynephritis) which leads to hypertension and chronic renal failure
Calculi, leading to obstruction, hydronephrosis, hypertension and chronic renal failure

Urinary (13 decks)

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