Simple and complicated UTIs Flashcards
1
Q
What is a UTI
A
lower urinary tract infection - cystitis/urethritis
2
Q
Ascending UTI
A
Pyelonephritis
3
Q
Most common bacterium causing UTI
A
E.coli
4
Q
How do e.coli adhere to cells?
A
Fimbrae
5
Q
How does proteus spp adhere to cell
A
urease - promotes urolithiasis (stone formation) - allows organism to stay in tract
6
Q
Risk factors for UTIs
A
- Young women (sexual activity, short urethra)
- Older gentlemen (enlarged prostate)
- Diabetes
- Benign prostatic hypertrophy
- Dehydration (reduced flushing)
Sexual activity (transfer of microorganism)
Impaired immune response - Causes delirium in elderly
- Can lead to sepsis
7
Q
Symptoms of UTIs
A
- Frequent urination
- Painful/difficult urination
- Suprapubic discomfort
- Cloudy urine
- Undifferentiated sepsis
8
Q
pathology of UTIs
A
- Gram -ve = ascending and systemic
- Endotoxin - inflammatory response
- Vasodilation reduces BP and results in inadequate end organ perfusion = septic shock
- Renal abscess/collection may occur
- Early morning sample - microorganisms in contact with urine overnight
- Leukocytes and nitrites in urine are important - staph can’t convert nitrates to nitrites
9
Q
Investigations for UTI
A
- Urine dipstick
- Agar
- Midstream urine for MC
- Separates e.coli from other bacteria dependent on whether can metabolise lactose - MacConkey agar
- Blood test
- Renal tract imaging
10
Q
Leukocytes in urine
A
Immune reaction
11
Q
Nitrites in urine
A
Bacterial presence
12
Q
Protein in urine
A
Renal disease
13
Q
Glucose in urine
A
Elevated serum glucose
14
Q
Ketones in urine
A
Fat metabolism
15
Q
Function of type 1 fibrae
A
Allow e.coli to stick together