PBL 2

Question 1

What are the 3 types of UTIs?

Answer 1

cystitis, urethritis and pyelonephritis

Question 2

what are the symptoms of a lower UTI?

Answer 2

dysuria, polyuria and feeling the need to urinate despite having an empty bladder, increased frequency and urgency, blood in urine, cloudy urine, brown urine, strong odoured urine, pelvic pain in women and rectal pain in men

Question 3

what additional symptoms do upper UTIs have?

Answer 3

flank pain (loin to groin)
fever
nausea and avomiting

Question 4

what symptoms do you get in infants with UTIs?

Answer 4

fever, crying during urination, cloudy, foul smelling or bloody urine, irritability, vomiting, refusing to eat

Question 5

what symptoms do you get in an older child with a UTI?

Answer 5

pain when peeing, need to pee a lot, or have lower belly pain.

Question 6

what symptoms would you get in a young child with a UTI?

Answer 6

fever, vomiting, lethargy, irritability, poor feeding, not gaining weight properly, jaundice

Question 7

what symptoms might you get in an elderly person with a UTI?

Answer 7

there might be a lack of symptoms but typically get incontinence, change in mental status, confusion and fatigue

Question 8

what usually causes UTIs?

Answer 8

E.coli entering the bladder via the urethra or through haematogenous spread

Question 9

how can you prevent UTIs?

Answer 9

urinate immediately after intercourse
avoid synthetic underwear e.g. nylon
wipe from front to back
personal hygeine
exclusively breast feed for first 6 months
avoid scented soaps and bubble baths

Question 10

what is the first line treatment for UTIs?

Answer 10

antibiotics

Question 11

what antibiotics are given in UTIs?

Answer 11

Trimethoprim/sulfamethoxazole, nitrofurantoin, and fosfomycin

Question 12

why might Phenazopyridine be prescribed in UTIs?

Answer 12

to help with burning and urgency often felt with bladder infections

Question 13

what can seem an alarming side effect of phenzopyridine?

Answer 13

it will most likely darken the color of your urine to an orange or red color. This is a normal effect and is not harmful.

Question 14

how quickly should UTIs clear up in children on antibiotics?

Answer 14

24-48 hours

Question 15

what’s the treatment for pyelonephritis?

Answer 15

Outpatient oral antibiotic therapy with a fluoroquinolone

Question 16

what’s the difference between the female and Male urethra?

Answer 16

urethra is 5 times longer in males than females
urethra is divided into 3 segments in males but is only a short tube in females
urethra is.a common duct for urinary and reproductive system in males but there are 2 separate systems in the female

Question 17

why are females more likely to get UTIs than men?

Answer 17

the urethra is shorter and closer to the rectum so bacteria has a shorter distance to travel

Question 18

what is cystitis?

Answer 18

UTI of bladder

Question 19

what is pyelonephritis?

Answer 19

UTI of kidneys

Question 20

what are the ureters?

Answer 20

hollow muscular tubes 25-30cm long beginning as funnel-shaped tubes at the renal pelvis and run retropeitoneally over the posterior abdominal wall in front of the external iliac artery down to the pelvic brim

Question 21

what is the ureter surrounded by?

Answer 21

the urothelium - a type of transitional epithelium that is capable of responding to stretched in the ureter

Question 22

what is the structure of the bladder walls ?

Answer 22

its yellow with rugae which allows expansion with increased internal pressure

Question 23

what are the 2 sphincters controlling the outflow of urine?

Answer 23

the internal and external urethral sphincters

Question 24

what are the 3 parts of the male urethra? and what is the histology?

Answer 24

prostatic urethra - transitional epithelium
membranous urethra - pseudostrtified columnar epithelium
spongy urethra - pseudostratified columnar epithelium proximally and stratified squamous epithelium distally

Question 25

what are the 3 coats of the female urethra?

Answer 25

muscular, erectile and mucous

Question 26

outline the histology of the female uretha?

Answer 26

transitional cells as it enters the bladder, pseudostratified columnar epithelium further down, then stratified columnar epithelium and finally stratified squamous cells near the external urethral orifice

Question 27

what is the prostate gland covered by?

Answer 27

the prostatic capsule

Question 28

what are the 3 types of cells in the prostate?

Answer 28

gland cells producing fluid portion of semen
muscle cells controlling urine flow and ejaculation
fibrous cells provide supportive structure of the gland

Question 29

what are the 3 ones of the postate?

Answer 29

peripheral - closest to rectum
transition - between central and peripheral zones
central - furthest from rectum

Question 30

what’s the blood supply of the prostate?

Answer 30

infeiror vesical artery and drains via the prostatic plexus to the vesical plexus and internal iliac vein

Question 31

what is the prostate innervated by?

Answer 31

the prostatic plexus