Renal Flashcards
What is cystitis
Inflammation of the bladder
What can cause cystitis
Bacterial infections (most common)
Fungal infections
Chemical irritants
Foreign bodies
Trauma
What consists of lower UTI
Bladder and the urethra
Most commonly affected by bacterial infections
Difference between ascending and descending infections
Depending comes from upper UT, can be caused by bacteria from blood or lymph, starts in kidneys
Ascending often from rectal area
What are some of the protective factors for low UTI infections
Urine descends
PH of urine is low
High concentration of urea
Urine is sterile
What are the bacterial causes of lower UTI
Gram Negative:
EColi (commonest)
Klebsiella
Proteus
Enterobacter
Citrobacter
Gram Positive
Staph Saprophyticus(second most common after ecoli- common in young sexually active women)
Enterococcus
What are the risk factors for a UTI
Sexual intercourse
Shorter urethra in females
Post menopausal - decrease in estrigen causing protective flora of vagina to be lost
Foley catheter
Diabetes (neutrophils normally move out of the blood into infection - diapedesis, and lead to phagocytosis, hyperglycaemia inhibits this making neutrophils less effective to invaders)
Infant boys with foreskin
Impaired bladder emptying
Symptoms of cystitis
Suprapubic pain
Dysuria
Frequent urination
Urgency
Infants : fever, fussy, feed poorly
Elderly: fatigue, incontinece, May develop derilium
Urinalysis results in cystitis
Pyuria- WCC in the urine
- makes urine cloudy
>5 WBC in urine per hyperperfield
>10 WBC per ml on hemocytometer
Dipstix test may reveal presence of leukocyte esterase (enzyme created by leukocytes of WBC)
Nitrites (gram neg bacteria convert nitrates to nitrites)
Urine culture - Gold standard for diagnosis
Positive if >100 000 colony forming units per ml from a urine sample
Less than May also indicate infection
What do results with pyuria (wbc +) but negative urine culture mean
Sterile Pyuria - suggests urethritis, inflammation of just the urethra
Commonly caused by Nisseria gonorrhea and Chlamydia trachomatis (STIs)
Treatment for cystitis
Antibiotics and pain medication
Ampicillin and gentamicin?
Prevention: Drinking lots of fluid to flush out bacteria, relevant for Femakes after sexual activity (peeing a lot)
Good hygiene (wipe F to B)
What virulent factors does ecoli use to adhere to urinary tract epithelium and cause UTI
Fimbrae fom Gram negative indole positive rod
Which UTI causing organism is commonly associated with Foley catheters
Enterococcus
Define AKI
Decline in kidney function during 48hours as demonstrated by increase in serum Cr of more than 50% or the development of oligourea
