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Urinary > Pathology of UTIs > Flashcards

Pathology of UTIs Flashcards

1
Q

What are the 3 most common presenting symptoms of a UTI?

A

Pain (dysuria)
Increased frequency (polyuria)
Smell of urine

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2
Q

How much of the CO do the kidneys receive?§

A

20-25%

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3
Q

Do the ureters store urine?

A

NO

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4
Q

When there is an increase pressure in the bladder what happens to the vesicoureteric openings? Why?

A

Close

To prevent reflux of urine

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5
Q

What is the composition of normal urine?

A

Low pH
High osmolarity
High ammonia

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6
Q

Is normal urine sterile or non-sterile?

A

Sterile (bacterostatic)

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7
Q

All of the urinary tract is sterile apart from which area?

A

Urethra

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8
Q

What type of bacterial flora are present at the urethra?

A

Skin (perineal)

Gut (rectal)

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9
Q

When collecting a urine specimen, what type do you want? Why?

A

Mid-stream specimen of urine (MSSU)

Initial voiding with flush out terminal urethral bacteria

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10
Q

In a MSSU will bacteria be present?

A

Yes, urethral flora will be detected but to lesser extent

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11
Q

What do you use MSSU for?

A

Microbiology culture

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12
Q

In a MSSU culture if there is 10^5 bacteria /ml what would this suggest?

A

Infection (even if asymptomatic)

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13
Q

In a MSSU culture if there is 10^3/4 bacteria /ml what would this suggest?

A

Infection sometimes (if there are symptoms - treat)

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14
Q

In a MSSU culture if there is < 10^3 bacteria /ml what would this suggest?

A

No infection

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15
Q

In what cases can it be difficult to collect MSSU?

A

Young & elderly

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16
Q

What micr-organisms are responsible for caring UTIs?

A

E.coli (gut)

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17
Q

Which direction do bacteria move through urinary tract?

A

Ascend

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18
Q

Inflammation of the urethra is called?

A

Urethritis

19
Q

Inflammation of the bladder is called?

A

Cystitis

20
Q

Inflammation of the ureters?

A

Ureteritis

21
Q

Inflammation of the kidneys is called?

A

Acute pyelonephritis

22
Q

In recurrent/ prolonged infection, what can occur at kidney?

A

Chronic pyelonephritis

23
Q

What are the 3 general predisposing factors to UTI?

A

Stasis of urine
Pushing bacteria back up urethra
General predisposition ot infection

24
Q

What are some of the causes of stasis of urine?

A

Obstruction (acquired or congenital)

Loss of feeling of bladder - spinal cord injury

25
Q

What are some of the causes of pushing bacteria back up urethra?

A

Sexual activity in females

Catheterisation

26
Q

What are some cause which predispose people to infection?

A

Diabetes
Chemotherapy
Immunosuppression

27
Q

If the urethra becomes obstructed, what occurs initially in the urinary tract?

A

Upper urethral & bladder dilation

28
Q

If the urethra becomes obstructed, what can it lead to in the upper urinary tract?

A

Bilateral hydronephrosis

29
Q

If one of the ureters becomes blocked, what will be observed?

A

Unilateral hydroureter leading unilateral hydronephrosis

30
Q

What are the triad of consequences which occur in obstruction?

A

Dilation
Bacteria accumulation
Calculous formation

31
Q

What renal tract abnormality is often seen in children leading to obstruction?

A

Vesicoureteric reflux

32
Q

Why does vesicoureteic reflex occur?

A

Reduced angulation of ureters results in retrograde flux of urine from bladder

33
Q

What can vesicoureteric reflux result in?

A

Hydroureter

34
Q

What is a common cause of urethral obstruction in males?

A

Benign prostatic hypertrophy

35
Q

What is a common cause of urethral obstruction in females?

A

Uterine prolapse

36
Q

What is a common cause of urethral obstruction in both sexes?

A

Calculi & tumours

37
Q

In those with spinal cord injuries, why can stasis of urine occur?

A

No sensation of micturition therefore bladder doesn’t fully empty (high residual volume)

38
Q

What age range are UTIs most common in females?

A

Sexually active (20s)

39
Q

What can predispose a woman to UTIs?

A 
Short urethra
Close relation of urethral orifice to rectum
Sexual activity
Pregnancy
Lack of prostatic secretions
40
Q

What are the properties of prostatic secretions?

A

Bacteriostatic

41
Q

Why is it important to clean urethral orifice before inserting catheter?

A

Can push terminal urethral flora back up urinary tract

42
Q

Why are those with diabetes predisposed to UTIs?

A

Glucose in urine

Poor function of WBC

43
Q

What is an acute complication of a UTI?

A

Sepsis & septic shock

44
Q

What is a chronic complication of UTI?

A

Chronic damage to kidneys (chronic pyelonephritis) > hypertension & chronic renal failure

Urinary (17 decks)

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