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Year 2- Urinary > Pathology of UTI > Flashcards

Pathology of UTI Flashcards

1
Q

What is the presentation of a UTI?

A
  1. Dysuria
  2. Frequency
  3. Smelly urine
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2
Q

Which groups of people may have a UTI and be unaware?

A

Very young- unwell, failure to thrive
Very old- incontinent anyways and may not notice

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3
Q

Do the ureters store urine?

A

No- they have continuous trickle of urine but do not store

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4
Q

How is reflux of urine from the ureter prevented?

A

Increasing pressure from the bladder as it fills closes off the ureter

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5
Q

What are some of the properties of normal urinary tracts which help to limit infection?

A

Prostatic bacteriostatic secretion
Low pH
High osmolarity
High ammonia content of urine
Anti-bacterial antibodies

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6
Q

What is the only part of the urinary tract which is not sterile?

A

Terminal urethra and perianal skin

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7
Q

Usual urine samples are always contaminated by terminal urethra flora.
How could a sterile urine sample be taken if required?

A

Suprapubic aspiration of urine

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8
Q

What is urinary voiding?

A

Process of removing urine from the body

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9
Q

If you send a urine specimen for culture, the initial void is heavily contaminated by urine.
What can be done to prevent this?

A

Patient voids and then stops mid-stream, discarding the initial urine output which is heavily contaminated, and then collects the next volume of urine

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10
Q

MSSU?

A

Mid-stream specimen of urine

->this is what is tested as has far less bacteria

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11
Q

In a MSSU, will there be urethral flora in it?

A

Yes but will be far less than initial urine output

This urethral flora is diminished in the lab as normal

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12
Q

In which phase of growth do bacteria muliply?

A

Log phase

->I think this could be something covered in higher bio tbh

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13
Q

What quantity of bacteria usually suggests infection in MSSU culture?

A

10 to power of 5

->99/100 with these level will have an infection

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14
Q

If someone has an MSSU culture of 10 to the power of 3 or 4, could they have a UTI?

A

Yes, probable infection but most often when they have symptoms
Be aware they could be asymptomatic and have these results and still have one tho

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15
Q

MSSU culture of what usually means no infection?

A

<10 to power of 3

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16
Q

Who can it be difficult to get a MSSU sample from?

A

Young children and elderly

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17
Q

What is on of the problems with interpretation of urine cultures?

A

Some bacterial species are not normally present in terminal urethra/rectal flora and may be pathogenic at low colony numbers

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18
Q

What organisms usually cause UTIs?

A

Bacteria, like gut flora.
Especially E.coli

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19
Q

Is the route of infection in UTI’s usually ascending or descending?

A

Ascending

20
Q

If there is infection of the kidneys, where has the infection usually spread from?

A

Bladder

21
Q

If the infection is in the upper urinary tract, is this more or less serious?

A

More

22
Q

Infection of urethra?

A

Urethritis

23
Q

Infection of bladder wall?

A

Cystitis

24
Q

Infection of ureter?

A

Ureteritis

25
Q

Bacterial infection of kidney?

A

Acute pyelonephritis

26
Q

What are some of the predisposing factors for a UTI?

A

-Stasis of urine (inactivity)
-Pushing bacteria up urethra from below
-Generalised predisposition to infection

27
Q

What can cause stasis of urine?

A

Obstruction
Loss of feeling e.g. unable to tell when bladder is full

28
Q

What can result in pushing bacteria up from the urethra?

A

Sexual activity in females
Catheterisation or other urinary procedures

29
Q

What could give someone a predisposition to developing infection?

A

Diabetes

30
Q

Why does stasis of urine lead to UTI?

A

Bacteria is not flushed out

31
Q

What happens if there is obstruction to the urinary system at the level of the urethra?

A

Upper urethral dilatation -> bladder dilatation -> ureteric dilatation (bilateral hydroureter)

32
Q

What can happen as a result of bilateral hydroureter?

A

Kidneys enlarge and can cause chronic renal failure

33
Q

What would happen if there was obstruction of the urinary tract at the level of the renal pelvis on one side only?

A

Unilateral hydroureter

This can then develop into unilateral hydronephrosis

34
Q

Hydronephrosis?

A

Hydronephrosis is a condition where one or both kidneys become stretched and swollen due to build-up of urine inside them

35
Q

What are the consequences of obstruction of the urinary system?

A

Proximal dilatation

Slowed urine flow -> cannot flush out bacteria -> infection

Slowed urine flow -> sediments from calculous formation -> further obstruction -> further infection

36
Q

What is the triad of obstruction and UTI?

A

Cycle of:

Infection -> Calculi -> Obstruction -> Infection etc.

37
Q

What is the most important example of obstruction of the urinary system in children?

A

Vesicoureteric reflux
When urine moves backwards from the bladder to the kidneys

->often those w vesicouretic reflux are born w it

38
Q

What happens in vesicoureteric reflux?

A

Decreased angle of the ureter inserting into the bladder hence backflow of urine as cannot get into bladder as efficiently

39
Q

What is the most common cause of urinary obstruction in adult males?

A

Benign prostatic hyperplasia

Tumours and calculi are causes too

40
Q

What is the most common cause of urinary obstruction in adult females?

A

Uterine prolapse

Tumours and calculi are causes too

41
Q

What is loss of feeling of full bladder due to?

A

Brain or spinal cord injury

42
Q

What are some predisposition to UTI’s in females?

A

Short urethra
Lack of prostatic bacteriostatic secretion (as only happens in males)
Closeness of urethral orifice to rectum
Sexual activity (helps if void after intercourse)
Pregnancy as pressure on ureters and bladder

43
Q

What is an acute complication of a UTI?

A

Severe sepsis and septic shock

44
Q

What are some of the chronic complications of a UTI?

A

Chronic damage to kidneys if repeated infections
Chronic renal failure
Hypertension

45
Q
A

Year 2- Urinary (22 decks)

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